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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
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
The artistic image of flowers in the poetry of Abi Waki` al-Tanisi
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Man was closely associated with nature in its various forms, as it represented the incubator for him in all areas of his life, so writers often made it a material for their literature and a fertile ground for their productions, so it appeared in its various forms and man’s need for it, its good and its bad in literature throughout history, and the Arabs are like Other nations, since the pre-Islamic era, nature was an important outlet and a refuge for poets in the production and creativity of literature and to this day, and when we talk about a poet from the Fatimid state, we find that nature - especially spring and its flowers - in that period took its take from literature and represented a phenomenon for many Among the

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Wed Mar 30 2016
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College Of Islamic Sciences
Graphical significance To (if) and (if) the two cops in Surat al-Maidah
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Sun Apr 01 2018
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Journal Of Educational And Psychological Researches
The reality of administrative creativity of secondary schools' managers in Al-zarqaa province
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The study focuses on identifying the reality of administrative creativity of secondary schools' managers in Al-zarqaa province. The descriptive approach was adopted to conduct this study. To achieve the study objective, the author designed a questionnaire composed of (24) items included (4) domains applied on (80) male and female school managers were selected randomly. The results showed that the administrative creativity level of secondary school's managers over all domains were too high which ranked as school management domain followed by public community domain then teacher domain and finally, school environment domain. Additionally, each of male, private sector, and experience over 10 years revealed significant differences.

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering
Roughness Effect on Velocity Distribution in Selected Reach of Shatt al-Arab River
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Wed Oct 28 2020
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Modeling the Contamination of Soil Adjacent to Mohammed AL-Qassim Highway in Baghdad
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The aim of this paper is to estimate the concentrations of some heavy metals in Mohammed AL-Qassim Highway in Baghdad city for different distances by using the polynomial interpolation method for functions passing from the data, which is proposed by using the MATLAB software. The sample soil in this paper was taken from the surface layer (0-25 cm depth) at the two sides of the road with four distances (1.5, 10, 25 and 60 m) in each  side of the road. Using this method, we can find the concentrations of heavy metals in the soil at any depth and time without using the laboratory, so this method reduces the time, effort and costs of conducting laboratory analyzes.

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Wed Jan 10 2018
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Tue Jan 02 2018
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Publication Date
Tue Apr 09 2019
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Journal Of The College Of Education For Women
The Role of Civil Society Institutions for the Care of Young People in Iraq ( Possibilities and constraints): A Field Study from the Point of view of University Students
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Fri Apr 12 2019
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Imported inflation ... concept, transmission channels, effects, and processors Iraq Case study for the period (1990-2015)
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