Objective: To estimate direct medical cost of the lung cancer management in Morocco, and determine its determinants.

Materials and Methods: A cost of illness study was conducted among patients treated in Moahammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using bottum up approsh. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by national health insurance agency. The horizon time adopted was 12 months

Results: The average age of 271 included patients was 62.5 ± 9.5 years, 93.4% were men and 92.1% were former smokers, 60.9% were in stage T4 while 36.2% in stage T3. Adenocarcinoma was present in 43.5% of cases. Patients underwent 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95% CI: 4037.4 - 4873.2). Chemotherapy presented 19.9%, while radiological explorations and drugs presented 18.7% and 17.6% successively. Diagnostic tests and radiotherapy each presented 7.6%, while biological tests presented 7.5% and hospitalizations presented 7.1% of the total cost.

The cost was statistically higher in young patients (5039.0 ± .4058,6 Vs 4124.6 ± 3093.9 USD/ p = 0.017), in patients with adenocarcinoma (5293.0 ± 3853.0 Vs 4708.0 ± 3401.1 / p < 0.0001) and in patients with stage T3 tumors (5072.0 ± 3557.3 Vs 3976.0 ± 2143.6 / p< 0.03),

Conclusion: Our results provide evidence to advocate for the ratification of the Framework Convention on Tobacco Control and for the full adherence of the Kingdom of Morocco to the MPOWER measures.