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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 Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Dental anomalies in permanent teeth and the associated etiological factors among fifteen years-old students in Basrah city\Iraq
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ABSTRACT Background: Dental anomalies of teeth are major issue that contributes to dental problems encountered in general practice. The aim of this study is to measure the prevalence of dental anomalies and the associated etiological factors among 15 years old students in Basrah city –Iraq. Materials and methods: The total sample composed of 1000 students (435 males and 565 females) from urban area selected randomly from different high schools in the city. Diagnosis of dental anomalies were recorded by present or absent, diagnosis and recording of enamel defects were done according to the criteria of WHO (1997). Results: The prevalence of hypodontia was 4.6%, Females have higher prevalence than males (5.8% females and 3.0% males), ta

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Thu Dec 31 2020
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Effectiveness of the Health Action Process Approach on Promoting the Health Behaviors of Male High School Students in Al-Rusafa District
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Mon Sep 03 2018
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A new vision for the classic in contemporary fashion designResearch
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Sat Jun 01 2013
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Distances Scale Determination for a Planetary Nebula in Galagtic Bulge
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Publication Date
Sun Jan 02 2022
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Dimension feminine in The Respectful Prostitute’s Jean- Paul Sartre and The Blind Prostitute’s Badr Shaker al-Sayyabe: La dimension féminine dans La P….respectueuse de Jean-Paul Sartre et La Prostituée Aveugle de Badr Shaker al-Sayyabe
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      Jean-Paul Sartre and Badr Shakir al-Sayyabe are among the most prominent writers that critiqued the destructive role of capitalism and the patriarchal power system in the period of the Post-World War II crisis. Divided into three chapters, the present study examines two of the most eminent literary works in the history of the Western and Eastern societies in the fifties of the last decade: Jean Paul Sartre’s play : The Respectful Prostitute and Badr Shaker al-Sayyabe’s poem: The Blind Prostitute.

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In this article, a new deterministic primality test for Mersenne primes is presented. It also includes a comparative study between well-known primality tests in order to identify the best test. Moreover, new modifications are suggested in order to eliminate pseudoprimes. The study covers random primes such as Mersenne primes and Proth primes. Finally, these tests are arranged from the best to the worst according to strength, speed, and effectiveness based on the results obtained through programs prepared and operated by Mathematica, and the results are presented through tables and graphs.

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