Hypertension cost in primary health care facilities in Morocco: a cost-of-illness study

Hypertension in low- and middle-income countries such as Morocco has an economic importance due to its high prevalence and cost. The aim of this study is to estimate direct health costs (DHC) for hypertension patients followed in primary health care facilities in Morocco. A cost of illness prevalence-based study was carried out on hypertension patients followed in public primary health care facilities in Fez. Data were collected using a questionnaire, including sociodemographic and clinical data and healthcare resources utilization: medical tests, medications, and medical visits. DHC was estimated using a bottom-up approach method from a societal perspective and a one-year time horizon. Official prices published by the national agency for health insurance were adopted as unit costs. Cost was compared to annual household income for calculating the catastrophic cost.  Cost is defined as catastrophic if it exceeds 10% of annual household income. We included 146 patients. The mean age was 60.7±11.1 years; 70.5% were men. More than half (54.2%) of participants had uncontrolled hypertension. The direct medical cost was estimated at 368.8±120.8 United States dollars per patient. Costs of medical tests and drugs represented, respectively, 58.6% and 30.5% of total direct cost. The incidence of catastrophic cost was 76.8%. Hypertensive patients incur substantial direct costs. High rates of catastrophic costs illustrate the urgency of improving financial risk protection for these patients and strengthening primary care to ensure the affordability of hypertension care.