Polypharmacy in old age is a clinical, societal and economic concern. Evidence suggests that polypharmacy in elderly populations can lead to higher rates of patients needing outpatient care as well as higher rates of hospitalizations due to adverse drug events (ADEs). While this has potential economic implications for healthcare systems, the relationship between polypharmacy, healthcare utilization and costs still holds questions. This talk will provide a brief overview of the available evidence of the effects of polypharmacy on healthcare expenditures and the cost effectiveness of interventions to reduce the potential harms of polypharmacy. It will conclude by offering insights into policy instruments that may prove effective in alleviating the negative consequences of polypharmacy.