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Direct Costs of Cervical Cancer Management in Morocco

  • Berraho, Mohamed (Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine) ;
  • Najdi, Adil (Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine) ;
  • Mathoulin-Pelissier, Simone (Inserm CIC-EC7, axe cancer. Institut de Sante publique Epidemiologie et Developpement (ISPED)) ;
  • Salamon, Roger (Inserm CIC-EC7, axe cancer. Institut de Sante publique Epidemiologie et Developpement (ISPED)) ;
  • Nejjari, Chakib (Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine)
  • Published : 2012.07.31

Abstract

Background: For cervical cancer the epidemiological profile is poorly known in Morocco and no data is available concerning the direct medical costs. The purpose of this work is to estimate the direct cost of medical management of invasive cervical cancer during the first year after diagnosis in Morocco. Methods: The estimation of direct costs of medical management of invasive cervical cancer during the first year after diagnosis in Morocco is based on the estimation of individual cost in each stage which covers diagnosis, treatment and follow-up during first year. The cost was estimated per patient and whole cycle-set using the costs for each drug and procedure as indicated by the Moroccan National Agency for Health Insurance. Extrapolation of the results to the whole country was used to calculate the total annual cost of cervical cancer treatments in Morocco. Results: Overall approximately 1,978 new cases of cervical cancer occur each year in Morocco. The majority (82.96%) of these cases were diagnosed at a late stage (stageII or more). The cost of one case of cervical cancer depends on stage of diagnosis, the lowest cost is $382 for stageCis followed by the cost of stageIA1 for young women (< 40 years) which is $2,952. The highest cost is for stageIV, which is $7,827. The total cost of cervical cancer care for one year after diagnosis is estimated at $13,589,360. The share allocated to treatment is the most important part of the global care budget with an annual sum of $13,027,609 whereas other cost components are represented as follows: $435,694 for annual follow-up activity and $126,057 for diagnosis and preclinical staging. Conclusion: This study provides health decision-makers with a first estimate of costs and the opportunity to achieve the optimal use of available data to estimate the needs of health facilities in Morocco.

Keywords

References

  1. AROME (2011). Guidelines, minimal requirements and standard of cancer care around the Mediterranean Area: Report from the Collaborative AROME (Association of Radiotherapy and Oncology of the Mediterranean Area). Crit Rev Oncol Hematol, 78, 1-16. https://doi.org/10.1016/j.critrevonc.2010.03.007
  2. Arveux P, Benard S, Bouee S, et al (2007). Cout de la prise en charge du cancer invasif du col de l'uterus en France. Bull Cancer, 94, 219-24.
  3. El M'rini T, Arveux P, Gay C, et al (1997). Estimation du cout du traitement du cancer du col. Rev Epidemiol Sante Publique, 45, 508-15.
  4. Fahs MC, Mandelblatt J, Schechter C, Muller C (1992). Cost effectiveness of cervical cancer screening for the elderly. Ann Intern Med, 117, 520-7. https://doi.org/10.7326/0003-4819-117-6-520
  5. Ferlay J, Shin H, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  6. Goldie SJ, Kim JJ, Myers E (2006). Chapter 19: Cost-effectiveness of cervical cancer screening. Vaccine, 24, 164-70. https://doi.org/10.1016/j.vaccine.2006.05.114
  7. Gueddari M (2001). Diagnostic precoce des cancers du sein et du col uterin. Ministere de la Sante, direction de l'epidemiologie et de lutte contre les maladies, Rabat 2001.
  8. Holmes J, Hemmett L, Garfield S (2005). The cost-effectiveness of human papillomavirus screening for cervical cancer. A review of recent modelling studies. Eur J Health Econ, 6, 30-7.
  9. International Agency for Research on Cancer (IARC) (2008). World cancer report.
  10. Lalla Salma Association against Cancer, (2009). National Cancer Plan, Volume 3: Etude des stades de diagnostique et des resultats de traitement des cancers au Maroc.
  11. Lehtinen M, Paavonen J, Wheeler CM, et al (2012). Overall efficacy of HPV-16/18 AS04-adjuvanted vaccine against grade 3 or greater cervical intraepithelial neoplasia: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol, 13, 89-99. https://doi.org/10.1016/S1470-2045(11)70286-8
  12. Mandelblatt JS, Lawrence WF, Gaffikin L, et al (2002). Costs and benefits of different strategies to screen for cervical cancer in less-developed countries. J Natl Cancer Inst, 94, 1469-83. https://doi.org/10.1093/jnci/94.19.1469
  13. Ministry of health - Morocco (2011). Sante en chiffre 2011.
  14. National Cancer Institute - France (2007). Etude et Expertises : Analyse economique des couts du cancer en France : Impact sur la qualite de vie, prevention, depistage, soins, recherche.
  15. Panorama de la sante 2007 : Les indicateurs de l'OCDE. Qualite des soins. Cancer. Paris, Editions de l'OCDE, 2007, 195 p.
  16. Parkin DM, Bray F, Ferlay J, Pisani P (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  17. Rocconi RP, Estes JM, Leath 3rd CA, et al (2005). Management strategies for stage IB2 cervical cancer: a costeffectiveness analysis. Gynecol Oncol, 97, 387-94. https://doi.org/10.1016/j.ygyno.2005.01.028
  18. Sanders GD, Taira AV (2003). Cost-effectiveness of a potential vaccine for human papillomavirus. Emerg Infect Dis, 9, 37-48. https://doi.org/10.3201/eid0901.020168
  19. Schaffer P, Bilger P, Allemand H (1994). L'efficacite et le cout du depistage du cancer du col de l'uterus. Rev Med Assurance Maladie, 2, 108-20.
  20. Villa LL, Costa RL, Petta CA, et al (2005). Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol, 6, 256-7. https://doi.org/10.1016/S1470-2045(05)70141-8
  21. Wolstenholme JL, Whynes DK (1998). Stage-specific treatment costs for cervical cancer in the United Kingdom. Eur J Cancer, 34, 1889-93. https://doi.org/10.1016/S0959-8049(98)00232-9
  22. Zappa M, Cecchini S, Ciatto S, et al (1998). Measurement of the cost of screening for cervical cancer in the district of Florence, Italy. Tumori, 84, 631-5.

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