Tobacco-attributable lung cancer: Cost analysis

Abstract

Smoking-attributable lung cancer is a burden in terms of health care costs. This makes it essential to estimate the economic cost of the management of cases of lung cancer attributable to

tobacco at the level of the pneumology department of the CHU My Youssef in Rabat for the year 2018.

A retrospective descriptive study covering a period of one year (2018) was carried out in 2019 on 65 patients hospitalized in the pneumology department of the CHU My Youssef in Rabat.

The calculation of the direct medical cost is obtained according to the pricing of the stay, acts and examinations specific to the hospital structure subject to our study. Medicines not available at the CHU and purchased externally are calculated at the market price of private pharmacies. For the non-medical cost, in our case, the transport of patients was estimated using the prices of the means of transport existing in their most used places of residence.

Regarding the indirect cost related to the loss of income following the illness, it is obtained on the basis of the average annual income of the individual and the period of his disability. The loss of income following the premature death of the patient is estimated on the basis of the years of life lost compared to the life expectancy in Morocco, and the income lost during these years discounted according to a rate of 3%.

Since the specificity of the study is smoking, an attributable fraction is used when calculating the direct and indirect cost, derived from the study by Tachfouti in 2014 on the estimation of mortality attributed to tobacco in Morocco.

After collecting fundamental data for our study and using previous calculation methods, we were able to estimate the following costs:

The economic cost rises to 1 639 168,47MAD (154 930,85EUR) on the order of 25 217,98 ±5989,47MAD (2383,55±566,11EUR) per patient, the indirect cost represents 71,82% with the amount of 1 177 300,96MAD (111 276EUR) an average of 18 112,32±81 387,11MAD (1724,98±7 692,54EUR) upon 28,18% of the direct cost with amount of 461 867,51MAD (43 654,77EUR) and an average of 7105,65±2773,38MAD (676,72±262,13EUR).

The stay in hospital with the sum of 291 000 represents the most important post of expenses of direct cost with 63,40% of the direct medical cost being an average of 4 480 ± 2 644.57MAD (423.44 ± 249.95EUR) per patient monitored by complementary examinations with a sum of 78 634MAD (7 432,32EUR) and an average of 1 209,75 ± 703,13 MAD / patient (114,34 ± 66,45EUR) then x- ray examinations which goes up to 74 306 MAD (7 023,25EUR) with an average of  1 143,17 ± 610,70 MAD /patient (108,05 ± 57,72EUR).

With a view to controlling expenditure and in a context where public budgets are increasingly tight, a primary prevention relies essentially on policies fighting tobacco serving as the excellent strategy to overcome this disease.

JEL Classification: D23, D24, I10

Paper type: Empirical research