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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 Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
A Standard Study of the Role of the Tourism Sector in Achieving Economic Growth in Tunisia for the Period (1995-2017
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Thu Jan 04 2018
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Iraqi Journal Of Market Research And Consumer Protection
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Thu Feb 24 2022
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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
(Dynamic& Static) Forecast of surplus or Deficit of Public budget in Iraq for (2017،2018)
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Publication Date
Wed May 31 2017
Journal Name
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Evaluating the Performance of High Modulus Asphalt Concrete Mixture for Base Course in Iraq
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In the 1980s, the French Administration Roads LCPC developed high modulus mixtures (EME) by using hard binder. This type of mixture presented good resistance to moisture damage and improved mechanical properties for asphalt mixtures including high modulus, good fatigue behaviour and excellent resistance to rutting. In Iraq, this type of mixture has not been used yet. The main objective of this research is to evaluate the performance of high modulus mixtures and comparing them with the conventional mixture, to achieve this objective, asphalt concrete mixes were prepared and then tested to evaluate their engineering properties which include moisture damage, resilient modulus, permanent deformation and fatigue characteristics. These pro

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Expansion the engineering consultancy offices in the universities of Iraq, about (14) offices, leading to increas the competition between them, especially after the great trends of Iraqi government agencies to use the academic experiences and their efficiencies in general, due to non-existence of the engineering qualification in the government institutions to do the engineering designs ,supervision of projects and other engineering works which are practicing by the engineering consultancy offices in order to get the best performance of the work.Within this serious competition, needing a specific approach to enable government agencies to choose the optimal and alternative consultancy office to meet specific project and not rely on cronyis

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Publication Date
Thu Dec 26 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
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This paper aims to explain the effect of the taxes policy including direct & indirect taxes on supporting the domestic Investment in Iraq. This could help the official planners for drawing the future policies that help provoking (istumlating) the domestic investment in Iraq the quantitative analysis approach was adopted using regression model. The results showed the significance of the effects of both direct & indirect taxes policies on domestic as a simple correlation coefficient ( r ) of ( 0.6 ) , ( 0.64 ) respectively.  

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Publication Date
Thu Aug 01 2019
Journal Name
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Public Bank Debt and Foreign reserve constraint in Iraq for the Period (2017-2004)
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Public debt has posed a major challenge to both developing and developed countries, which has focused attention on the optimal limits (threshold of debt) and its determinants.

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Publication Date
Sat Sep 01 2012
Journal Name
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Role of Tourism Industry in the Developing of Economie to Iraq for (1990- 2009)
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