Economic Burden of Ischemic Heart Disease in Morocco: Evidence From a Teaching Hospital, a Cost-of-Illness Study

OBJECTIVES: To estimate the direct and indirect costs of ischemic heart disease (IHD) in Morocco and identify its main determinants. METHODS: A retrospective prevalence-based cost-of-illness study was carried out in patients with IHD admitted to a university hospital in 2019. Collected data included sociodemographic data, clinical profiles, and healthcare utilization. Direct medical costs were estimated using national insurance rates. Indirect costs, due to productivity loss, were calculated using the human capital approach and limited to working-age individuals based on Morocco's retirement age. A bottom-up approach from a societal perspective was used over a 12-month period. The mean total cost was compared according to sociodemographic and clinical characteristics. RESULTS: The study included 180 patients; 58.3% were male, mean age was 62.1 years, and 46.1% were current or former smokers. Mean direct medical cost per patient was $3519.9 (95% CI $3141.8-$3898.0), with revascularization and medications as the main cost components. The mean indirect cost was $336.4 (95% CI $313.7-$359.0), with a mean productivity loss of 41.8 days. The mean total cost was $3856.3 (95% CI $3349.1-$4129.2), significantly higher for males (P = .015) and smokers (P < .001). The national economic burden of IHD was approximately $1.23 billion annually. CONCLUSIONS: IHD imposes a substantial economic burden in Morocco, particularly among high-risk populations. Beyond tobacco control, integrated prevention strategies, including early detection and risk factor management, are urgently needed. In addition, healthcare resource planning and equitable access to medications are essential to reduce the burden of IHD.