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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
Thu Nov 21 2019
Journal Name
Journal Of Engineering
Comparative Permeability Estimation Method and Identification of Rock Types using Cluster Analysis from Well Logs and Core Analysis Data in Tertiary Carbonate Reservoir-Khabaz Oil Field
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Characterization of the heterogonous reservoir is complex representation and evaluation of petrophysical properties and application of the relationships between porosity-permeability within the framework of hydraulic flow units is used to estimate permeability in un-cored wells. Techniques of flow unit or hydraulic flow unit (HFU) divided the reservoir into zones laterally and vertically which can be managed and control fluid flow within flow unit and considerably is entirely different with other flow units through reservoir. Each flow unit can be distinguished by applying the relationships of flow zone indicator (FZI) method. Supporting the relationship between porosity and permeability by using flow zone indictor is ca

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Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using the Balanced Performance Approach to Increase the Effectiveness of Strategic Planning in order to Maximize the Job Satisfaction Rates at the Faculties of Bisha University
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Wed Sep 15 2021
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Al-academy
The effect of differentiated education strategy on the achievement of the students of the Institute of Fine Arts in the subject of aesthetics: وفاء شكر حسن
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Current research targeted: Recognizing the impact of the differentiated education strategy on the achievement of the students of the Institute of Fine Arts / Diyala, for the academic year (2018-2019).
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Publication Date
Fri Mar 15 2019
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Assessing the Brief Book of the Modern and Contemporary History of Asia from the Perspective of the Students in the Department of History - University of Baghdad
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The current research aims to assess the Brief Book of the Modern and Contemporary History of Asia from the perspective of the students in the Department of History, University of Baghdad. The study is carried out in Iraq and the research group has included students of the Department of History in the College of Education--Ibn Rushd and the College of Education for Women- University of Baghdad. The chosen sample of the assigned research consisted of (72) students from third stage in the Department of History, which equals (0.38%) of the total group members amounted (188) female and male students representing (40) students from the College of Education--Ibn Rushd, and 32 students from

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Publication Date
Fri Dec 01 2023
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Investigating the Impact of Phenolic and Terpene Fractions extracted from Prunus arabica on p53 Protein Expression in AMJ13 and SK-GT-4 Human Cancer Cell Lines
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Publication Date
Sat Dec 01 2018
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Journal Of Accounting And Financial Studies ( Jafs )
Rationalization the costs of agricultural Activities under the use of genetic engineering: An applied research in ministry of agriculture - The directorate of inspection & certification of seeds
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Publication Date
Thu Dec 01 2016
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The role of the legal rules to the reduction of public office Crimes(Search in the Office of the Inspector General of the Ministry of Environment)
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Publication Date
Wed May 01 2019
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The Iraqi Journal For Information And Documentation Studies
The role and importance of scientific research in creating new knowledge and its impact on developing the cognitive capabilities of information and librarians and their Employees
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The research aims at identifying the importance of scientific research for researchers and in creating new knowledge، development and utilization of mental and cognitive energies and developed them with the ability to research، extrapolation، meditation and then conclusion. The information was collected by interviewing the Secretary-General of the Central Library and by distributing questionnaire forms to the (33) teaching staff of the College of Higher Education. The responses of the society were analyzed the result and the recommendations were the most important 1. Information specialist and all employees of the administrators and technicians in the centers of information sources (libraries) and in the field are considered scientific r

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Thu Dec 30 2004
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Comparison of the results of some tests of passing and dribbling of the basketball of tow different years between teams of chosen young players in Baghdad
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This study is concerned with the comparison of the results of some tests of passing and dribbling of the basketball of tow different years between teams of chosen young players in Baghdad. Calculative methods were used namely (Arithmetic mean, Value digression and T.test for incompatible specimens). After careful calculative treatments, it has been that there were abstract or no abstract differences in the find results of chestpass, highdribble and cross-over dribble. The clubs were: (Al-Khark, Air defence, Police and Al-Adamiyah) each one separate from the other for the year (2000-2001). After all that many findings were reached such as the lack of objective valuation (periodical tests) between one sport season and the other. In the light

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Immunohistochemical Expression of MMP2, VEGF and D2-40 as Biological Markers of Local Invasion Potential, Angiogenesis and Lymphangiogenesis in Oral Squamous Cell Carcinoma and Verrucous Carcinoma
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