Purpose of review We summarize the research published between 2011 and 2015 in healthcare utilization and costs for persons with intellectual disabilities/intellectual developmental disorders with a particular focus on context studies for evidence-informed policy. Recent findings Persons with intellectual disability show higher unmet needs and lower use of promotion and prevention services and generic health services. Use of generic psychiatric services varies across countries. Persons with intellectual disability and comorbid mental disorders have the highest rates of specialized service use, costs, and unmet needs. International and national cost-of-illness studies show the high impact of intellectual disability in the total direct health costs of mental disorders at least in Europe. On the contrary, the burden-of-illness studies show conflicting results in intellectual disability. Summary Contextual studies of healthcare and costs have improved the knowledge base for evidence-informed planning in intellectual disability in a number of countries. However, only two of these studies have used local atlases of healthcare for improving decision making. The paucity of information on prevalence, comorbidity, and demographic indicators hampers the advance of evidence-informed policy in intellectual disability.