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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 30 2019
Journal Name
College Of Islamic Sciences
Attitudes and prayers Ahl al-Bayt peace be upon them to poets In the Umayyad and Abbasid periods Objective study
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Poetry occupied the Arabs in a unique position, especially in the era; ignorant, Umayyad and Abbasid, in addition to its literary and aesthetic dimensions, it is at the forefront of tools and media at the time. The poet appointed society and poetry Diwan Arabs records their exploits and virtues and their valor in the wars... The Prophet Muhammad () realized the importance of poetry, so he took advantage of him in the libel for his Islamic call. In the Umayyad and Abbasid states, poetry had a clear role in social, literary and political life, as the ruling authority used its influence on many poets to be media to support its political theory, by praising the Caliph and his aides, and exposing those who dissented and opposing them. The

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Establish Growth Curve in Light of Body Mass Index for Infertile Women in Baghdad City
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Methodology: Non-probability (purposive sample) of (100) infertile women, who visit Kamal Al-Samaraee
Hospital/ fertility and IVF center . The data are collected through the use of constructed questionnaire, which
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Publication Date
Wed Mar 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Dispensing of Antimicrobial Agents Without a Prescription in Iraq: A Call for Upholding the Legislations to Change Long-Standing Practices
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Fri Mar 01 2019
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Study the random walking of the ISX60 market index For the Iraq Stock Exchange
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Sun Mar 01 2020
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Determination of Some Volatile Organic Compounds in the water produced at Al-Ahdab oilfield in the Governorate of Wasit, Iraq using Headspace SPE-GC-FID
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