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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 Sep 15 2022
Journal Name
Alustath Journal For Human And Social Sciences
The Degree of Commitment of Social Workers Who Work in the ‎Ministry of Social Development to the Professional Principles of ‎the Social Work Profession under the Corona Pandemic
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The study aimed to identify the degree of commitment of social workers working in the Ministry of Social Development to the professional principles of the social work profession in light of the Corona pandemic, and the sample consisted of (135) specialists. The study reached several results: the most important one is  the degree of commitment of social workers working in the Ministry of Social Development to the professional principles of social service was great. The other result is the absence of statistically significant differences according to the variables of sex and place of residence. Moreover, the results also showed the absence of statistically significant differences in the principles of ( Acceptance o

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Mon Jun 15 2015
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Translation Studies
Difficulties Encountered By EFL Iraqi Undergraduate Students in Handling Subordinate Clauses الصعوبات التي يواجهها طلبة المرحلة الجامعية العراقيون من دارسي اللغة الإنكليزية كلغة أجنبية في استخدام الجمل التابعة
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this paper consists of three sections, Section one deals with the most important difficulties and characteristics of English subordinate clauses whereas section two tackles the difficulties faced by the Iraqi EFL students at the third year in the Department of English, College of languages, University of Baghdad in recognizing and producing the subordinate clauses submitting them to a test consisting of two questions (recognition and production). Finally, some pedagogical recommendation of the findings can be found in section four.

Publication Date
Fri Feb 18 2022
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Journal Of Blood Medicine
Circulating miR-126-3p and miR-423-5p Expression in de novo Adult Acute Myeloid Leukemia: Correlations with Response to Induction Therapy and the 2-Year Overall Survival
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Abstract Background: Acute myeloid leukemia (AML) results from sequential genetic alterations in a normal hematopoietic stem cell or its progenitors giving rise to an autonomous clone that dominates the bone marrow leading to marrow failure. MicroRNAs are short non-coding nucleic acid sequences that regulate post-transcriptional gene expression by base-pairing with their target mRNAs. MiRNAs can be secreted into extracellular fluids and carried to target cells by vesicles or bound to proteins. Intracellular and circulating miRNAs are believed to be useful markers in the diagnosis, prognosis, and treatment of various cancers. Practically, circulating miRNAs are more stable at room temperatures and extreme conditions. Purpose: This study aim

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Circulating miR-126-3p and miR-423-5p Expression in de novo Adult Acute Myeloid Leukemia: Correlations with Response to Induction Therapy and the 2-Year Overall Survival
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Mon Mar 07 2022
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Publication Date
Sat Jan 05 2019
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Evaluating the level of readiness to teach science in the light of the information, media, and technology skills among undergraduate students at the Faculty of Education, King Khalid University
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Publication Date
Wed Nov 14 2018
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Wed Jun 19 2019
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Elements of Promotion Mix and Their Effect in Insurance Service Marketing by Using Factor Analysis Approach: An Exploratory Research foe views of works Sample at the National Insurance Company
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