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A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#
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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.

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Publication Date
Mon Sep 01 2025
Journal Name
Iranian Journal Of Nursing And Midwifery Research
Girls’ Experiences Regarding Obesity: A Qualitative Study in Iraq
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Obesity among girls can cause physical, psychological, or social problems. Different cultures have different lifestyle and dietary habits which affect people’s experience about obesity. This study aimed to assess girls’ experience toward obesity.

Materials and Methods:

In 2023, a qualitative conventional content analysis method was used in this study to meet the study’s objective in Baghdad and Babylon, Iraq. A probability purposive sampling method was used to gather the sample from three high schools in t

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Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Female education in Iraq 1921-1958 - A historical Study-
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In spite of the foundation of Iraqi state in 1921 and the formation of the new features of
the modern state, however, the inherited costumes and traditions sustained in the conservative
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the staff in all fields and requirement conducting to female learning. After WW II and the
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Publication Date
Tue Apr 11 2023
Journal Name
College Of Islamic Sciences
Collision in the dispute between the two imams Shafi’i and Abu Hanifa by Sheikh Mansour bin Muhammad bin Abd al-Jabbar al-Marwazi al-Samani Abi al-Muzaffar (d. 498 AH) from the issue (If one of the Muslim spouses apostatized and one of the infidel spouses
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Thu Dec 01 2022
Journal Name
Wiadomości Lekarskie
EVALUATION OF TWO CRYOPROTECTANTS USED IN A NEW HUMAN SPERM CRYOPRESERVATION TECHNIQUE
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The aim: To examine the efficiency of different concentrations of Dimethyl sulfoxide (DMSO) and glycerol as a cytoprotectants in protection of human sperms during cryopres¬ervation in this technique. Materials and methods: Thirty oligozoospermic semen samples were used in this study. Samples diagnosed according to WHO 2010 criteria. Sheep’s ovarian follicles obtained from local slaughterhouse and prepared by slicing the ovaries and evacuating the follicular fluid and oocyte. Each semen sample divided into six equal parts, and diluted 1:1 with cryosolution contains 5%, 10%, 15% DMSO or glycerol and injected within the emptied follicles. After freezing and thawing, the semen mixture aspired outside the follicles and sperm concentr

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Publication Date
Tue Dec 01 2020
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The Bayesian Estimation in Competing Risks Analysis for Discrete Survival Data under Dynamic Methodology with Application to Dialysis Patients in Basra/ Iraq
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Survival analysis is one of the types of data analysis that describes the time period until the occurrence of an event of interest such as death or other events of importance in determining what will happen to the phenomenon studied. There may be more than one endpoint for the event, in which case it is called Competing risks. The purpose of this research is to apply the dynamic approach in the analysis of discrete survival time in order to estimate the effect of covariates over time, as well as modeling the nonlinear relationship between the covariates and the discrete hazard function through the use of the multinomial logistic model and the multivariate Cox model. For the purpose of conducting the estimation process for both the discrete

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Sun Jun 12 2011
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Measurement of Background Radioactivity in Sewage Sludge for Baghdad City Treatment Stations
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Sewage sludge samples were collected from Al-rasafa and Al-karkh refinement stations which represent the main stations of Baghdad city. Samples were collected from all treatment stages: before, after, and during refinement processes. The High Purity Germanium Coaxial Detector system with energy resolution 1.8 keV for energy line 1333 keV of Co – 60 radioactive sources was used to measure radioactivity from both natural and artificial sources. GENIE – 2000 analysis the results statistically and qualitatively. The results showed that all sewage sludge samples exhibited natural radioactive level and sometimes less than the international regular standards, but Al–Karkh station showed increment in radioactive levels than Al– Rasa

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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening for Attention Deficit Hyperactivity Disorder at Elementary Schools in Baghdad City
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Objective(s): To determine the prevalence of ADHD among elementary school pupils; identify the association between pupil's level of ADHD and age, etc., and investigate the differences in pupils ADHD based on gender, and grade.

Methodology: A descriptive study was conducted on elementary school pupils. The study started from the period of 16th of September 2019 to the 1st of October 2020. A cluster sample of 800 pupils was selected. The questionnaire was constructed and developed and include two parts: the first part includes the pupil's general information and the second part includes scale of ADHD prevalence.

Results: The results of the present study indicated that 38(4.

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Publication Date
Wed Dec 30 2020
Journal Name
Journal Of Planner And Development
"2030 City Tour". New paradigm for intervention in the XXI century cities
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Publication Date
Tue Dec 15 2020
Journal Name
Aip Conference Proceedings
Land cover change for Baghdad City in the period 1986 to 2019
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Earth cover of the city of Baghdad was studied exclusively within its administrative border during the period 1986-2019 using satellite scenes every five years, as Landsat TM5 and OLI8 satellite images were used. The land has been classified into ten subclasses according to the characteristics of the land cover and was classified using the Maximum Likelihood classifier. A study of the changing urban reality of the city of Baghdad during that period and the change of vegetation due to environmental factors, human influences and some human phenomena that affected the accuracy of the classification for some areas east of the city of Baghdad is presented. The year 2019 has been highlighted because of its privacy in changing the land cover of th

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Publication Date
Wed Dec 12 2018
Journal Name
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Evaluation of Quality of Life for Secondary School Students in Kirkuk City
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Objective(s):To evaluate the quality of life among secondary and to find out the relationship between students'quality of life and their socio-demographic characteristics of age, gender, residence, marital status, father's and mother's education, and family financial status in Kirkuk City. Methodology: A cross-sectional study is conducted on (100) studentwho are boys and girls aged(13 to 24) years old. These subjects are studying at secondary schools in Kirkuk City.The study is carried out at secondary schools in Kirkuk City from 7th July 7th 2014 to May 7th 2015. A questionnaire is constructed for the purpose

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