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bijps-1538
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 Jun 15 2015
Journal Name
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.

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Wed Dec 29 2021
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Effect of rehabilitation exercises in improving the motor range of people with partial rupture of the anterior cruciate ligament of the knee joint by ages (30-35) men
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Sun Oct 07 2012
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Journal Of Educational And Psychological Researches
The Effect of KWL Strategy on the Achievement of the Students of the fourth class literary in the subject of History and the Development of Cognitive Thinking skills
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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Prevalence and localization of the posterior superior alveolar artery in relation to the floor of the maxillary sinus and alveolar crest among sample of Iraqis using computed tomography
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An in vitro evaluation of fit of the crowns fabricated by zirconium oxide-based ceramic CAD/CAM systems, before and after porcelain firing cycles and after glaze cycles
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Background: The objective of this in vitro study was to evaluate the vertical marginal fit of crowns fabricated with ZrO2 CAD/CAM, before and after porcelain firing cycles and after glaze cycles. Materials and Methods: An acrylic resin model of a left maxillary first molar was prepared and duplicated to have Nickel-Chromium master die. Ten die stone dies were sent to the CAD/CAM (Amann Girrbach) for crowns fabrication. Marginal gaps along vertical planes were measured at four indentations at the (mid mesial, mid distal, mid buccal, mid palatal) before (Time 0) and after porcelain firing cycles (Time 1) and after glaze cycles (Time 2) using a light microscope at a magnification of ×100. One way ANOVA LSD tests were performed to determine wh

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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Active Role of Admin strative Skills in Reinforcing Strategic Entrepreneur Ship Through Organizational Flexibility: دراسة استطلاعية لأراء عينة من الإدارات العليا والوسطى في المصارف العراقية الخاصة / بغداد
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Publication Date
Fri Feb 18 2022
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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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Modern French novel has gained a distinctive status in the history of French literature during the first half of the twentieth century. This is due to many factors including the new literary descriptive objective style adopted by novelists like Alain Robbe – Grillet that  has long been regarded as the outstanding writer of the nouveau roman, as well as its major spokesman, a representative writer and a leading theoretician of the new novel that has broken the classical rules of the one hero and evolved, through questioning the relationship of man and the world and  reevaluating the limits of contemporary fiction , into  creating a new form of narrative.

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Publication Date
Sun Jan 01 2023
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The Effectiveness of Teaching impact of the Reflex Learning Strategy on the Fifth Class Female Student Achievement of the Geography Content Material
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