An Animal Health Economics Evaluation of Pet Health Insurance, Economic Euthanasia, and Dysthanasia

Advances in companion animal medicine have substantially improved diagnostic and therapeutic capabilities but have also increased the financial burden of veterinary care. Rising treatment costs may contribute to economic euthanasia, whereas greater access to advanced interventions may also raise concerns regarding dysthanasia. Although pet health insurance has been proposed as a mechanism to improve access to veterinary care, its potential role in balancing these outcomes has received limited attention, particularly in Türkiye. This study evaluated the relationships among pet health insurance, economic euthanasia, and dysthanasia from an animal health economics perspective and examined their potential implications for companion animal welfare and veterinary healthcare in Türkiye. A scenario-based conceptual assessment was conducted using publicly available national data from the Companion Animal Registration System operated by the Republic of Türkiye Ministry of Agriculture and Forestry (PETVET), the Insurance Association of Türkiye (TSB), the Insurance and Private Pension Regulation and Supervision Agency (SEDDK), and the European Pet Food Industry Federation (FEDIAF), together with evidence synthesized from the international scientific literature. Four hypothetical insurance coverage scenarios (5%, 10%, 20%, and 40%) were developed to examine the potential effects of increasing insurance coverage. The synthesized evidence suggests that financial barriers remain an important determinant of access to veterinary care and may contribute to economically motivated treatment refusal. Increasing insurance coverage may improve access to recommended treatment and reduce the likelihood of economic euthanasia. However, broader use of advanced diagnostic and therapeutic interventions also emphasizes the need for quality-of-life assessment and welfare-oriented clinical decision-making to minimize the potential risk of dysthanasia. Pet health insurance should be viewed not only as a financial protection mechanism but also as a component of animal health economics and animal welfare strategies. The proposed conceptual framework highlights important knowledge gaps and provides a basis for future nationwide studies evaluating economic euthanasia, dysthanasia, and veterinary decision-making in Türkiye.