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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
Thu Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
Intellectual and Religious Characteristics Andalusion Societ Image Beni Al-Ahmar Era Poetry as a model
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The intellectual and religious characteristics were an influential presence in the same Andalusian poet, especially among the poets of Beni El-Ahmar because they are part of the heritage of poets, and that is to push them towards the glory of this heritage and to take care of it and benefit from its inclusion, inspiration and similarity.

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Tue Jun 01 2021
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Iop Conference Series: Earth And Environmental Science
Treatment of Al-Muthanna Petroleum Refinery Wastewater by Electrocoagulation Using a Tubular batch Electrochemical Reactor
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Abstract<p>An electrocoagulation process has been used to eliminate the chemical oxygen demand (COD) from wastewaters discharged from the Al-Muthanna petroleum refinery plant. In this process, a circular aluminum bar was used as a sacrificial anode, and hallow cylinder made from stainless steel was used as a cathode in a tubular batch electrochemical Reactor. Impacts of the operating factors like current density (5-25mAcm<sup>-2</sup>), NaCl addition at concentrations (0-2g/l), and pH at values (3-11) on the COD removal efficiency were studied.</p><p>Results revealed that the increase in current density increases the COD removal efficiency, whereas an increase</p> ... Show More
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Wed Mar 30 2016
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Message to Sheikh Jamal Bukhari conclusion of Sheikh Suleiman al - Jamal   (1204 AH) Study and investigation
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Scientists have mastered the codification of the hadeeth and authorship in it, and walked in a variety of courses, including what is known when the late books seal books, which is inclined by Sheikh Sheikh students in the last Council is reading a book of the books of the year or so, and mention a party from the translation of the book owner After that methodology of what he sees important, then speak to the last hadeeth in the book Sindh and Manta, and sometimes market attribution to the author of the book as did Suleiman al-Jamal (God's mercy) deceased in 1204 AH, in this seal on the true Imam Bukhari Which we will investigate and publish. (God willing).

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Publication Date
Tue Jun 20 2023
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Assessing the Activity of Renin and GST in the Serum of Ladies Suffering from Polycystic Ovary Syndrome and COVID-19 to Predict the Danger of Cardiac Disease
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The coronavirus-pandemic has a major impact on women's-mental and physical-health. Polycystic-ovary-syndrome (PCOS) has a high-predisposition to many cardiometabolic-risk factors that increase susceptibility to severe complications of COVID-19 and also exhibit an increased likelihood of subfertility. The study includes the extent of the effect of COVID-19-virus on renin-levels, glutathione-s-transferase-activity and other biochemical parameters in PCOS-women. The study included 120 samples of ladies that involved: 80 PCOS-patients, and 40 healthy-ladies. Both main groups were divided into subgroups based on COVID-19 infected or not. Blood-samples were collected from PCOS-patients in Kamal-Al-Samara Hospital, at the period between Decembe

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Sat Jun 04 2022
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Motives for public exposure to specialized sports satellite channels and the gratifications achieved from it: A survey study on the public of the city of Baghdad
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Motives for public exposure to specialized sports satellite channels and the gratifications achieved about it - Research presented by (Dr. Dr. Laila Ali Jumaa), Imam Al-Kadhim College (peace be upon him) - Department of Information-2021.

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Sun Dec 27 2020
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Digital Citizenship and its Relationship to the Level of Health Awareness of Corona Virus (Covid-19) among a Sample of Palestinian University Students: محمود عبد المجيد عساف
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The study aims to identify the degree of appreciation for the level of digital citizenship of a sample of Palestinian university students in the governorates of Gaza, and its relationship to the level of health awareness about the emerging coronavirus (covid-19). To achieve the objectives of the study, the researcher followed a descriptive approach by applying two questionnaires; the first, which consists of 30 items, was used  to measure the level of digital citizenship.  The second, which consists of 19 items, was used to measure the level of health awareness. Both questionnaires  were applied on a sample of 367 students who were electronically selected using the manner simple randomness. Results have shown that the degr

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Wed Jan 01 2020
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Evaluation of selection criteria for patients indicated for fixed orthodontic appliance treatment
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Tue Jan 01 2019
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Detection of Antibiotics in Drinking Water Treatment Plants in Baghdad City, Iraq
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Persistence of antibiotics in the aquatic environment has raised concerns regarding their potential influence on potable water quality and human health. This study analyzes the presence of antibiotics in potable water from two treatment plants in Baghdad City. The collected samples were separated using a solid-phase extraction method with hydrophilic-lipophilic balance (HLB) cartridge before being analyzed. The detected antibiotics in the raw and finished drinking water were analyzed and assessed using high-performance liquid chromatography (HPLC), with fluorometric detector and UV detector. The results confirmed that different antibiotics including fluoroquinolones andB-lactams were detected in the raw an

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Assessing Environmental Sustainability and Design Integration in the Context of District 838, Al-Dawra, Baghdad, Iraq - An Analysis of Urban Multifunctional Land Uses
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