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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
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Frames of Al-Alam TV channel’s handling of the Iraqi and Lebanese protests Analytical study of the main news bulletin for the period from October 1, 2019, to December 31, 2019
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        In October 2019, Iraq and Lebanon witnessed widespread protests, which aroused the interest of the media, as they began with demands for the provision of services, then escalated with the overthrow of the political system. The researchers chose a satellite channel that represents a direction for a country accused of entering the line of protests. This paper aims to analyze the main bulletin of Al-Alam channel to find out how it deals with the protests in the news. It is classified descriptively, using the survey method and the method of content analysis. The study community was represented by the main news bulletin of Al-Alam channel. The researchers adopted a deliberate sample for the period from 1/10/2019 to

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Sun Jun 11 2017
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Statistical Modeling for Traffic Noise: The Case of Kirkuk City
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The auditory system can suffer from exposure to loud noise and human health can be affected. Traffic noise is a primary contributor to noise pollution. To measure the noise levels, 3 variables were examined at 25 locations. It was found that the main factors that determine the increase in noise level are traffic volume, vehicle speed, and road functional class. The data have been taken during three different periods per day so that they represent and cover the traffic noise of the city during heavy traffic flow conditions. Analysis of traffic noise prediction was conducted using a simple linear regression model to accurately predict the equivalent continuous sound level. The difference between the predicted and the measured noise shows that

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Fri May 17 2013
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Applied Minimized Matrix Size Algorithm on the Transformed Images by DCT and DWT used for Image Compression
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Thu Nov 18 2021
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Dentists' Practices and Attitudes Toward Using Personal Protection Equipment and Associated Drawbacks and Cost Implications During the COVID-19 Pandemic
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Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic.

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Publication Date
Sun Jun 20 2021
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Studying the Changes in Solar Radiation and Their Influence on Temperature Trend in Iraq for a Whole Century
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Most studies indicated that the values ​​of atmospheric variables have changed from their general rates due to pollution or global warming etc. Hence, the research indicates the changes of direct solar radiation values ​​over a whole century i.e. from 1900 to 2000 depending on registered data for four cities, namely (Mosul - Baghdad - Rutba - Basra. Moreover, attemptsto correlate the direct solar radiation with the temperature values have been ​​recorded over that period. The results showed that there is a decreasing pattern of radiation quantities over time throughout the study period, where the value of direct radiation over the city of Baghdad 5550 w/m2 was recorded in the year 1900, but this ratio decreased cle

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Sun Mar 19 2023
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An Assessment of People with Intellectual Disabilities Practicing of Physical Activities and Its Challenges under Corona Pandemic (Covid-19) from Their Families' Point of View
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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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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
The semantics of terms in terms of inclusiveness when Imam Ibn Hajar al-Askalani (d. 852 e) in his book Fath al-Bari: Door of worship - Practical models
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Praise be to Allaah.
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Publication Date
Tue Apr 18 2023
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Al–bahith Al–a'alami
Counter Psychological Warfare in the partisan press during the operations of Mosul liberation: An analytical study in the “Tareek Al Shaab” Newspaper
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The research aims to monitor the methods of Counter psychological warfare in the Iraqi press during the operations to liberate Mosul from the control of the terrorist organization ISIS.The research used the survey method, and “Tareek Al Shaab” Newspaper as a research sample, chosen according to the systematic random sample.
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