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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
Sat Dec 21 2019
Journal Name
International Journal Of Pharmaceutical Quality Assurance
Evaluation of the Immunomodulatory Effects of Thymus vulgaris Ethanolic Leaf Extract Combination with Partially Purified Lipopolysaccharide from Proteus mirabilis in Mice
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The current study was carried out to study a high injection dose of the ethanolic extract thymus vulgaris leaf (500 ug /Kg) against the immune response combination with partially purified extracted Lipopolysaccharide ( LPS) from Proteus mirablis.Study groups were included four groups; Group I :treated with normal saline. Group II : treated with LPS antigen, Group III: injected subcutaneously ((500 ug /Kg) from ethanolic extract thymus vulgaris, group IV : injected subcutaneously (500 ug /Kg) from ethanolic extract thymus vulgaris leaf and LPS antigen, the immunological assays were measured through the phagocytic activity as (non specific immunity) after day 8 by using the phagocytic activity index.After day I4 the lymphocyte proliferations

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Situation of Refugees and Displaced Women in Arab Countries during Conflicts According to the Perspective of the Arab Women's Organization
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Abstract

The scope of the humanitarian tragedies in the Arab region has widened after the conflicts that erupted over the past years, exacerbation to include educational, cultural, and social dimensions, economic and moral aspects of the displaced families, especially after the emergence of terrorist organizations and sectarian conflicts which overthrew human and led to various political and demographic changes, forcing citizens to leave their homes, fleeing with their families from the danger of murder, terrorism, and violation to other safer areas inside or outside their countries. Women and children were the vast majority of the displaced who were subjected to great pressures, The host communities bore the pro

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Publication Date
Thu Jun 02 2016
Journal Name
مجلة العلوم التربوية والنفسية
The effect of the K.W.L.Plus strategy in developing the mental skills and reflective thinking of first-year middle school female students
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Publication Date
Sat Sep 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Difficulties of scientific research in the financial and administrative fieldaccording to the quality standardsfrom the point of view of the teachers
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The research aims to identify the most important difficulties facing the scientific research in the technical university in the financial, organizational and administrative according to the quality standards according to the paragraphs studied in the questionnaire questionnaire prepared for this purpose, including the research community on the Central Technical University, which includes several technical colleges and technical institutes were selected A sample of the researchers in the Institute of Technical Management where the number of training was 78 teachers took a random sample of researchers amounted to 40% of the questionnaire, and after the collection and classification of data were used statistical means, including the mean ar

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Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The strategic vision and its impact on the growth strategy of insurance companies: Applied research in the Iraqi General Insurance Company
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The subject of the strategic vision is of great importance to all companies because they live in an environment of rapid change in various areas of life. Supports the performance of its operations in a better way, towards appropriate strategic growth and achieving success. The research aims to determine the level of interest of the researched company in the research variables (strategic vision and growth strategy), and the importance of the research came in being an attempt to provide the theoretical and scientific foundations for the research variables (strategic vision and growth strategy). As for the research method, it was relied on the descriptive analytical method, relying on the questionnaire as a means of obtaining data from the

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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Impact of Different Doses of Nicorandil-Induced Ulceration (Oral , Gastrointestinal Tract, and Anal) in Rats: Roles of Leptin and Prostaglandin E2
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Many reports confirm ulcers as an adverse effect of drugs such as nicorandil and aspirin. The exact responsible mechanisms of ulceration have until now not proved. Mucosal ulcers associated with the onset of ulcer are manifested by an increase in proinflammatory cytokine, excessive prostaglandin, and up-regulation of Endothilin-1 level, which directly impacts the release of leptin. These, released locally within mucosal tissues, have played a role in controlling the extent of local inflammatory responses and processes of mucosal repair.
This study was designed to find out the correlation of plasma leptin and prostaglandin levels as a possible mechanism of oral ulcer formation as an adverse effect of nicorandil. The effect of nicorandi

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Publication Date
Fri Jun 23 2023
Journal Name
Journal Of Communicable Diseases
Downregulation of the Gene Expression of Efflux Pump Gene (acrA) and its Regulator (ramA) in Klebsiella pneumoniae by Quaternary Ammonium Compounds
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Introduction: Biocides are commonly used for disinfection in a variety of contexts. They are generally used to avoid infection by controlling biofilm on medical equipment. However, the literature lacks information on the effect of biocide on efflux pump gene expression. Objective: To determine the influence of biocide on biofilm development and efflux pump acrA and ramA gene expression. Methodology: The microtiter plate method was used to identify biofilm development in 80 isolates of K. pneumoniae. The minimal inhibitory concentrations (MIC) of three biocides (quaternary ammonium compound (QAC), chlorohexidine digluconate, and chloroxylenol) were estimated. The effect of QAC on the intensity and viability of biofilms was investigated as we

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Publication Date
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Using the Generative Learning Model on the Achievement of First-Grade Intermediate Students of Chemical Concepts in Science
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Abstract

The current research aims to identify the effect of using a model of generative learning in the achievement of first-middle students of chemical concepts in science. The researcher adopted the null hypothesis, which is there is no statistically significant difference at the level (0.05) between the mean scores of the experimental group who study using the generative learning model and the average scores of the control group who study using the traditional method in the chemical concepts achievement test. The research consisted of (200) students of the first intermediate at Al-Farqadin Intermediate School for Boys affiliated with the Directorate of General Education in Baghdad Governorate / Al-Karkh 3 wit

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of The Mechanical Behavior Of Materials
Performance of concrete thrust block at several burial conditions under the influence of thrust forces generated in the water distribution networks
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Abstract<p>This study was prepared to investigate the performance and behavior of concrete thrust blocks supporting pipe fittings. In the water distribution networks, it is always necessary to change the path of the pipes at different degrees or to create new branches. In these regions, an unbalanced force called the thrust force is generated. In order to counter this force, these regions are supported with concrete blocks. In this article, the system components (soil, pipe with its bend and thrust blocks) have been numerically modeled and simulated by the ABAQUS CAE/2019 software program in order to study the behavior and stability of the thrust block with different burial conditions (several b</p> ... Show More
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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Planning the Production of the Electrical Distribution Converter (400KV/11) Using Time Series Methods and Goal Programming in the Fuzzy Environment
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This Paper aims to plan the production of the electrical distribution converter (400 KV/11) for one month at Diyala Public Company and with more than one goal for the decision-maker in a fuzzy environment. The fuzzy demand was forecasting using the fuzzy time series model. The fuzzy lead time for raw materials involved in the production of the electrical distribution converter (400 KV/11) was addressed using the fuzzy inference matrix through the application of the matrix in Matlab, and since the decision-maker has more than one goal, so a mathematical model of goal programming was create, which aims to achieve two goals, the first is to reduce the total production costs of the electrical distribution converter (400 KV/11) and th

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