Chronic obstructive pulmonary disease and tobacco: A cost analysis

Abstract

Tobacco-relateddiseasesmainly affect the respiratory system, the first system in contact with the air that is inhaled, making tobacco a leading cause of death and illness, closely linked to the chronic obstructive pulmonary disease of which it is responsible in 90% of cases. It isalsoresponsible for the impoverishment of the population, given the heavyeconomicburdenit imposes. The purpose of the studyisto estimate the economic cost of chronic obstructive pulmonary disease attributable to smoking in 2018, whether it is related to the medical management of the disease, or the loss of productivity following the disease itself or a premature death.

An approach based on the specific cost to COPD caused by smoking for 62 patients hospitalized in the Department of Pneumology at Moulay Youssef Hospital in Rabat. The direct medical costs are obtained according to the stay, acts and examinations specific to the university hospital center. Drugs not available at this hospital and purchased externally are calculated at the market price of private pharmacies. For non-medical costs, in our case the transport of patients was estimated by using the prices of the means of transport existing in their most used places of residence. Regarding indirect costs related to loss of income following illness, it’s calculated on the basis of the average annual income of the individual and the period of his disability.Another indirect cost, that of the loss of productivity following the premature death of the patient, this one is calculated at the base of the years of life lost compared to the life expectancy in Morocco and the lost income during these years, discounted at a rate of 3%.

Since the specificity of the study is smoking, an attributable fraction was used in the direct and indirect costs calculations, which was derived from Tachfouti’s 2014 study of the estimated mortality attributed to tobacco in Morocco, based on the 2006 Marta study on the prevalence of smoking and the relative risk associated with the quantities of tobacco smoked.

After collecting essential data for our study and using the previous calculation methods, we were able to estimate the following costs. The overall economic cost of COPD attributable to smoking in 2018 is 1 784 503,74 MAD (168 667,65 Euro).The direct cost of COPD attributable to smoking is: 389 973,33 MAD ( 36 859,48 Euro), and the indirect cost of COPD attributable to smoking is: 1 394 530,41  MAD  ( 131808,17 Euro). Indirect cost accounts 78 % of the economic cost of COPD linked to tobacco.

In the case of conflict between health and economy, this type of study helps guide public decision-makers in the formulation of health system strategies and  policies, in a context of prevention and control of  non-transmissible diseases. Our study addresses a preventable chronic disease by acting on the major risk factor that is tobacco, all with the aim of controlling expenditure in the face of limited financial resources, and avoiding economic losses for society, the system of health and the country’s economy. 

JEL Classification : G21

Paper type : Empirical research