Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
The main risks arising from the WTO Agreement are the inequality and lack of competitiveness of most pharmaceutical goods, as well as the fact that Iraq is a net importer of medicines that are at the core of consumer needs, The subject matter of the Convention on the Protection of Intellectual Property Rights and its implications for the pharmaceutical industry, in particular, coinciding with the situation of financial and administrative corruption, all of which has resulted in drug fraud in the Iraqi market and its impact on public health. The control of medical technology, the persistence of the technological gap and its effects on high price levels, and the fact that domestic drug producers are obliged to obtain production licens
... Show MoreReflect the sustainable development of the interaction of three key elements are the economic component and the social component and the environmental component while focusing economic component to achieve economic growth and focuses social element to achieve social justice in the distribution of income and achieve prosperity, the environmental component related fields and including emphasizes the protection of the environment and to ensure the continuation and sustainability of resources physical, biological and form in which it believes the interaction required for development process real and effective and sustainable, and is considered the province of Kurdistan Iraq of important areas where the movement of developmental mount
... Show MoreVolcaniclastic rocks of Al Muqdadiya Formation (Pliocene) in Injana area, southern Hemrin anticline, NE of Iraq, were studied ( petrographically, physically, mineralogically and geochemically , as well as the engineering properties) to assess the suitability of volcaniclastic rocks to use them in industry as refractories. The results show that the physical and engineering properties change with the temperature change. The bulk density and the specific gravity increase by increasing temperature while the apparent porosity, water sorption and the linear shrinkage decrease. On the other hand the compressive strength increase by increasing temperature. The volcaniclastics have very low thermal conductivi
... Show MoreThe general budget is usually linked to the role of the state in public life and economic activity, whether this role is neutral or interventionist and thus reflects the general objectives that the state seeks to achieve.
for importance of the public budget in clarifying the image of the political state philosophy and its objectives it seeks to achieve on the one hand and clarifying the degree and rank it occupies in the ladder of development among the other countries. This study is intended to highlight the concepts of the general budget and how its concept has evolved since the Middle Ages. Of the importance of the general budget in Iraq was not based on scientific and objective and then the study
... Show MoreThere is no doubt that Agricultural Policy is the main responsible for the degrading in Agricultural sector in Iraq during the period 2003-2013, and that was very clear from magnitude of indicators because of little sharing of each of agricultural product in GDP because it was (9.38%) in average during the study period and the annual changing of it was negative (-5.82%), and there is increasing in deficit of trade balance in Agriculture during the study period about (4185.73) million US$, and the percentage of agricultural exports from total exports was (0.14%) in average only. The foreign trade policy in Agricultural products also cannot determine map of Revealed Comparative Advantage (RCA) of Agricultural products and crops. The study sh
... Show MoreIndicators of government debt is of extreme importanse in economic activity through knowledge of the economic impact of government debt, if the phenomenon is accepted or prepared to dangerous stage by stage, and there fore it can Through these indicators to measure the degree of indebtedness in relation to the economic activity of the Government on the one hand, the governments ability to repay the other hand.
Due to this it inferred that the degree of indebtedness in Iraq specificratio has exceed 60% during the period 1990 – 2002 ntejh lack of political and economic stability of the government, which led to the governments inability to repay the ma
... Show More(Sepak takraw) is a game that mixes football and volleyball, it is played on a court similar to a badminton court, in which players have the right to play the ball with any part of the body except the arm and hand. The object of the game is to return the ball to the opponent's court and score a point. Since it is a newly emerging game, all aspects related to it must be studied and covered in order to reach the highest levels, and it is known that each game or sporting activity has its own physical and motor capabilities, which is important to determine the level of technical performance, as the game's abilities contribute to mastering the skills. The importance of research in determining standard levels of physical and motor abilities for y
... Show MoreThe external shocks are one of the phenomena that the Iraqi economy is exposed to over a period of time. It is referred to as changes and events that come from outside the economic system and extends to many economic variables. However, foreign direct investment may be severely affected due to the extreme sensitivity to changes and local and international developments. This type of trauma and its characteristics to help manage and cope with external shocks, and in order to avoid the standard problems experienced by some models of simple linear regression, multi-linear regression models were used with variables Scientific and other dummy variables .
The study foun
... Show MoreForm recurrence of financial crises phenomenon disturbing and attention , and returns the reasons so that its negative effects were sharp and dangerous , because of the nature and cause of Ncaha , threatened political and economic stability of the countries in which they occur these crises , in addition to Machmlh these crises spread of contagion across multiple channels to include other countries many developed and developing , and the reason for this to the openness of the economic and financial witnessed by the countries affected by crises and other countries concerned, the financial crisis is a case of financial turmoil appears in one of the sections of the financial system one and extends to
... Show More