This paper analyses the health expenditure profile by age and gender of survivors and deceased in four Italian regions. Per capita spending on the deceased constantly diminishes after middle age. The ratio between per capita expenditures on deceased and survivors by age shows a downward trend after about 40 years. Although we chose four regions situated in the North, Centre and South of Italy, we may conclude that there are no significant differences among them with respect to health costs near death, in spite of the wide regional gap and the different Regional Health Service models. Health spending projections for Italy – as well as for other countries – are less pessimistic when account is taken of costs near death. The main result of this study is that both the specific profile of per capita health expenditure for the deceased and the characteristic trend of the deceased/survived ratio, found for Tuscany and for other countries, can be roughly confirmed for Italy.