Economic burden of lung cancer in Morocco: A cost of illness study

I El Harch; S Guendaoui; M Charkaoui; S Benmaamar; M Omari; M El Youbi; L Belakhhel; L Abouselham; H Hachri; I El Menchay; S El Fakir; M Berraho; N Benchekroun; N Tachfouti

doi:10.1016/j.jcpo.2023.100428

Economic burden of lung cancer in Morocco: A cost of illness study

J Cancer Policy. 2023 Sep:37:100428. doi: 10.1016/j.jcpo.2023.100428. Epub 2023 Jun 22.

Authors

I El Harch¹, S Guendaoui², M Charkaoui², S Benmaamar³, M Omari³, M El Youbi⁴, L Belakhhel⁴, L Abouselham⁴, H Hachri⁵, I El Menchay⁵, S El Fakir³, M Berraho³, N Benchekroun², N Tachfouti³

Affiliations

¹ Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco. Electronic address: ibtissam.elharch@usmba.ac.ma.
² Moahammed VI Center for Cancer Care, Casablanca, Morocco.
³ Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fes, Morocco.
⁴ Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco.
⁵ World Health Oranization Country of Morocco, Morocco.

PMID: 37353003
DOI: 10.1016/j.jcpo.2023.100428

Abstract

Introduction: Lung cancer is the most common cancer in men and the second most common cancer in women. It is associated with substantial economic impact in terms of direct and indirect costs. The main objective of this study is to estimate the direct medical cost of lung cancer management in Morocco MATERIALS AND METHODS: A cost-of-illness study was conducted among patients treated at the Mohammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using a bottom-up approach. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by the national health insurance agency. The horizon time adopted was 12 months.

Results: The study included 271 patients, with an average age of 62.5 ± 9.5 years. Of these, 93.4 % were men and 92.1 % were former smokers. In terms of cancer staging, 68.3 % of patients were in stage IV while 28.8 % were in stage III. Adenocarcinoma was present in 43.5 % of cases. Patients underwent an average of 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests, and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95 % CI: 4037.4-4873.2). Chemotherapy accounted for 19.9 % of the total cost, while radiological investigations and drugs accounted for 18.7 % and 17.6 %, respectively. Diagnostic tests and radiotherapy each accounted for 7.6 % of the total cost, while biological tests accounted for 7.5 % and hospitalizations accounted for 7.1 %. The cost was statistically higher in young patients (p = 0.017), in patients with adenocarcinoma (p < 0.0001), in patients with stage II tumor (< 0.00001), in patients who have undergone surgery (p = 0.002), chemotherapy (p < 0.0001), radiotherapy (p < 0.001) and in those without metastases (p < 0.0001).

Conclusion: These results provide evidence to support the ratification of the Framework Convention on Tobacco Control and the full adherence of the Kingdom of Morocco to the MPOWER measures.

Keywords: Cost of lung cancer; Direct medical cost; Lung cancer; Morocco.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adenocarcinoma*
Aged
Cost of Illness
Female
Financial Stress
Humans
Lung Neoplasms* / epidemiology
Male
Middle Aged
Morocco / epidemiology
Retrospective Studies