BACKGROUND: Cost of illness (COI) studies provide crucial data to policymakers for prioritizing resource allocation, particularly in Iraq that lacks such studies. The objective of this COI study was to measure the direct medical costs for acute coronary syndrome (ACS) during hospitalization from the payer perspective. METHODS: This multi-source hospital-based study collected data from patient medical records, healthcare providers, and hospital administration from December 2023 through January 2024. This study was conducted in a leading public cardiac hospital in Iraq, which serves a diverse patient population from across the country. The direct medical costs of ACS treatment were calculated from the payer's point of view (the Ministry of Health (MOH)) for patients admitted to the public department and from the patient's point of view for those admitted to the private department. RESULTS: The study included 70 patients
50 in the public department and 20 in the private department. The average cost of ACS treatment during hospitalization for a single patient in the public department was Iraqi Dinar (IQD) 1,101,390 (25). The coronary angiography/angioplasty (CAA) procedure was the largest contributor to spending, accounting for 72.12 % of total expenditures. The patients who were admitted to the private department paid IQD 864,375 (69) per patient, on average. CONCLUSION: This study developed a pragmatic approach to calculate cost-of-illness for health systems following the Beveridge Health Model and do not have specific fees for each service. The Iraqi MOH covers all the expenses in the public department within the public hospitals. Although the patients pay fees for ACS treatment in the private department, the MOH may provide subsidized prices to reduce the actual costs.This study opens the door to study the cost of illness for other diseases in the future and informs the payers about the required budget allocation. The study methods are potentially transferable to any country utilizing the Beveridge Model for healthcare delivery.