Changes in bioethics are often supported not only by progressive ideologies but can also be traced to business interests.
An example is surrogacy, which is a very profitable and complex business. Medical interventions and the supervision of expectant mothers entail enormous costs and generate substantial revenue. In the case of euthanasia, there could likewise be a hidden ‘death-tech’ sector offering investors a gold mine. There is interest in euthanasia, and where there is strong demand, there is room for supply.
Intuitively, this may look like an excellent opportunity. However, this is only a superficial view. The business of euthanasia is very complex, for several reasons. The first is, of course, PR and communications. For large pharmaceutical companies, which often face reputational damage and lawsuits, producing a ‘death pill’ is not exactly a strategic choice.
The illusion of a pharmaceutical gold mine
Several figures illustrate this reality. Canada is now the global symbol of assisted dying (MAID) and the jurisdiction with the most robust data. Despite thousands of people each year opting for the procedure, the illusion of a billion-dollar pharmaceutical business quickly vanishes when one looks at government accounts.
According to Canada’s Parliamentary Budget Officer (PBO), in 2021 the direct drug costs for MAID across the country amounted to just C$8.6 million. The overall budgetary impact of the programme represents a change of only 0.08% for provincial health budgets. From a macroeconomic perspective, this is a statistical marginality on which no growth business can be built.
Although the number of cases is rising steeply and more than 16,400 Canadians will undergo MAID in 2024 (equivalent to 5.1% of all deaths), this does not translate into higher profits for pharmaceutical companies. Doctors use a mix of older, inexpensive and off-patent substances, with manufacturing costs in the tens or hundreds of dollars per dose.
The story of Bausch Health confirms this. The company was the sole supplier of secobarbital capsules (Seconal), often used for assisted dying, but ceased production in January 2022. This move suggests that this is an uninteresting market that large pharmaceutical companies are leaving, not a new sector for investment.
Last but not least, this is a final service in which no recurring expenditure by the client can be expected. In the US, the out-of-pocket cost for a death pill ranges from roughly $2,000 to $12,000. The maximum cost for assisted dying in the American healthcare system thus corresponds to routine medical expenditure. For the market, repeat treatments remain far more attractive.
The silver economy and the property anomaly
So is the euthanasia business without potential? Not entirely. The gold, or more precisely the silver, lies in what is referred to as the silver economy. The term covers economic activities, products and services aimed at the needs of an ageing population, usually people over 55 or 60. In this case, however, it does not include traditional sectors such as care services or the spa industry.
Canadian data sharply challenge one of the most widespread assumptions about euthanasia, namely that it is primarily a desperate solution for people affected by poverty or lack of care. The numbers show the opposite.
When Canadian statisticians divided society into five equally sized groups according to income, from the poorest to the richest, a clear pattern emerged. In natural mortality, the poorest group accounts for the largest share (27.1%). Poverty is directly associated with poorer health, which in the North American context is further intensified by financial constraints.
People with lower incomes often cannot afford preventive healthcare or a generally healthier lifestyle. That is increasingly becoming a luxury, whether through access to quality food, supplements or simply the time and resources needed for prevention and self-care.
At the other end of the spectrum, the opposite occurs. The richest fifth of Canadians account for 15.1% of natural deaths. In assisted dying, however, their share rises to 17.5%. The conclusion is clear: interest in assisted dying is more pronounced among the wealthiest segment of the population.
Planning the end and moving large sums of money
How does this translate into business terms? Those who opt for euthanasia are over-represented among higher-income groups. At the same time, they hold assets, real estate and investment portfolios. This is not an escape from misery, but a rational and planned decision by the upper middle class.
This is where private bankers and notaries come into play. For them, such ‘planning for the end’ becomes an entry point into managing significant wealth transfers.
Euthanasia thus becomes relevant for lawyers and trustees managing estates and trusts. According to a 2025 study by IG Wealth Management, although a historic wealth transfer is under way, as many as 54% of Canadians still have no estate plan.
Canada’s RBC Bank reports similar findings: only 26% of wealth donors have a coherent strategy and only 35% of heirs feel prepared to take over inherited assets. Those considering euthanasia, however, often have the time to prepare carefully, including their financial affairs. In that sense, they represent highly prepared clients.
If investors and analysts are searching for so-called ‘death stocks’, they should look beyond pharmaceutical companies, which remain on the sidelines producing inexpensive substances. The real end-of-life business no longer takes place primarily in hospital beds. It unfolds in the offices of private banks, family trusts and notaries, where vast sums are being transferred with precision.