title: Evaluation of the cost of cervical cancer at the National Institute of Oncology, Rabat.
abstract: BACKGROUND
  The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds.
  
  
  METHODS
  550 patients were treated for their cervical cancer in the Rabat's NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO.
  
  
  RESULTS
  The global cost was about US$ 1,429,673 with an average estimated at US$ 2,599 ± US$ 839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001).
  
  
  CONCLUSIONS
  The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan.
authors.affiliation: Team of Pharmacoepidemiology and Pharmacoeconomics, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco; Department of pharmacy, International Hospital Cheikh Zaid, Rabat, Morocco; Faculty of Medicine, Abulcasis University, Rabat, Morocco.
authors.forename: Amine
authors.initials: A
authors.lastname: Cheikh
authors.affiliation: Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Sanaa
authors.initials: S
authors.lastname: El Majjaoui
authors.affiliation: Department of oncology, Regional Cancer Centre, Marrakech, Morocco.
authors.forename: Nabil
authors.initials: N
authors.lastname: Ismaili
authors.affiliation: Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Zakia
authors.initials: Z
authors.lastname: Cheikh
authors.affiliation: Department of Radiotherapy, International Hospital Cheikh Zaid, Rabat, Morocco.
authors.forename: Jamal
authors.initials: J
authors.lastname: Bouajaj
authors.affiliation: National Institute of Public Health, Rabat, Morocco; Department of Epidemiology, Faculty of Medicine and Pharmacy, Hassan II University, Fes, Morocco.
authors.forename: Chakib
authors.initials: C
authors.lastname: Nejjari
authors.affiliation: Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco; Head of Hospital, International Hospital Cheikh Zaid, Rabat, Morocco.
authors.forename: Amine
authors.initials: A
authors.lastname: El Hassani
authors.affiliation: Team of Pharmacoepidemiology and Pharmacoeconomics, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Cherrah
authors.affiliation: Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco.
authors.forename: Noureddine
authors.initials: N
authors.lastname: Benjaafar
mesh_terms: D000328:Adult; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008875:Middle Aged; D009018:Morocco; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000473:pathology / Q000628:therapy*
keywords: Cervical cancer; cost evaluation; direct cost