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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
Sat Jun 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Alpha-Alumina Extraction from Al-Ga'ara Bauxite
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The bauxite produced from Al-Ga 'ara area in Al-Enbar containing 50.4 wt. percentages Al2O3 was used for a- alumina production.                                                                                                

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Fri Jan 01 2016
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Journal Of The College Of Languages (jcl)
Al-Taa comparative studies among Semitic languages
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We have studied in this research litter (Taa) a morphological , sonic indicative and comparative study among four Semitic languages. They are Arabic , Hebrew, Syriac and Akkadian languages . We have divided the research into a number of pivots beginning with an entrance about the letter (Taa) in Semitic languages and the symbols which are used by these languages referring to . Then we have studied (Taa) from sonic side with letters phenomenon (b, g, k, p, t) the six in both Hebrew and Syriac languages . The letter (Taa) is formed one of them and the sonic change that is happening in articulation (Taa) according to sonic rules related to these letters in case of emphasis or in case of neglected (not emphasis). Then we have studied the pro

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Prof. Mohammad Al-Drubi's Manuscripts Editing Methodology
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Efforts of evaluating manuscripts have developed into sciences that take interest into the development of authorship movement. Expanding the rules and fundamentals of this scientific process along with the growing use of modern methods and techniques contributed further to its development.
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Publication Date
Sun Dec 31 2017
Journal Name
College Of Islamic Sciences
Abu Al-Shammaq, the tramp of spelling
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Research summary

Praise be to God, Lord of the worlds, and prayers and peace be upon the one who was the most eloquent of people in language and the most eloquent of them in eloquence, our Master Muhammad (peace and blessings of God be upon him).

To proceed... There is no doubt that many studies have preceded me in talking about chalk, each according to his own destination and view, and what I do not deny is that I benefited a lot from it, and it provided me with a lot of valuable information, and I liked to be one of those study pens, trying as much as possible To add something new and different in the study, far from similarity and repetition. Especially in the Abbasid study.

The babble in the Abbasid society was d

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Religious Authority Poetry Adnan AL-Sayegh,s
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Publication Date
Tue Dec 01 2015
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The Role of Green Productivity to Success the industrial organizations Applied Study in Midland Refineries Company – Al Daura Refinery
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      The Green Productivity topic is considered as one of  the more conceptual novelty in the field of Production and Operations Management, and one of the least topics addressed in the literature competent, Green Productivity (GP) is a strategy for enhancing a business's Productivity and environmental performance at the same time, for overall socio - economic development, It is  the application of appropriate techniques , technologies , and management systems to produce environmentally compatible goods and services. the research aimed to find the contribution of this concept for success the industrial Organizations.

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Thu Jan 01 2026
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Using zooplankton as bioindicators, this study evaluates the ecological condition of the Euphrates River in Iraq's Babylon Province. Site 1 (North Hillah, next to the old Babylon ruins), Site 2 (Hillah city center), Site 3 (South Hillah, close to Al-Mahaweel), and Site 4 (near Al-Kifl town) were the four monitoring locations chosen along the river. The highest and lowest averages of the measured physical and chemical factors indicate temperature (25.1°-29.4°), pH (7.2-7.9), electrical conductivity (EC) (940 µS/cm-1241µS/cm), total dissolved solids TDS (591 mg/L-789mg/L), dissolved oxygen (DO) (5.6 mg/ l-7.1 mg/L), biological oxygen demand (BOD5) (2.4mg/L-4.2 mg/L), nitrate (1.3 mg/L–3.2 mg/L), nitrite (0.04 mg/L–0.13 mg/L),

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Study a bout the Epidemiology of Vulvo Vaginal Candidiasis (Candida spp.) in Baghdad City
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This Study was conducted to investigate vaginitis in women who live in Baghdad City. Results Revealed that Candida spp. were the causal agent of 38.5% of symptomatic cases the yeasts Candidaalbicans, C.glabrata, C.tropicalis, C.parapsilosis and C.krusei were isolated with the percentage of 38.1, 9.1, 3.9, 2.6, 1.3 respectively also there were 18% of women in control group carrying Candida spp. The direct smear method were not efficient because the percentage of infection was 17.5% comparing with the culture method the sensitivity of direct smear method was 45.5% The percentage of WBC to Epithelial cells was less than one in 76.6% of women.

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