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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 Jan 01 2018
Journal Name
Journal Of The College Of Languages (jcl)
Analisis de la metáfora en la poema " Noche oscura del alma" de San Juan de la Cruz Analysis metaphor in the poem "Dark Night of the Soul" John of the Cross
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RESUMEN

 Una joven cuenta cómo, en plena noche, aprovechando la tranquilidad de esa hora, sale a escondidas de su casa y va a reunirse con su enamorado. Envuelta en la oscuridad, se deja dirigir por la luz de su propio amor hasta el lugar de la cita, donde la pasión de los amantes culmina. A continuación, relajados por la brisa nocturna, los amantes se adormecen, primero, el amado velado por la amada, por último, ella misma.

Amor entre dos enamorados. Unión mística de alma y Dios , aunque , de hecho , podría servirnos de clara exposición temática el subtitulo con que el poema suele publicarse en la tradición , tanto manuscrita como impresa : Canciones del alma que se goza d

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Publication Date
Sun Dec 12 2010
Journal Name
Journal Of Planner And Development
Utilizing the resources of the local environment in the establishment of the constituent units of the urban fabric within the framework of preservation of the urban heritage (Hassan Fathi's model experiment)
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No country in the world has an ancient heritage of its own. It represents the product of the civilizations left behind by previous eras. It represents the development of urban life and its capital of the interest of its people in the field of construction and reconstruction. The urban heritage and its associated arts may seem to be a material heritage at first glance, but it is not free from the spiritual side. Therefore, the nations in different parts of the earth cherish it and care for it with all due diligence, because it mixes with its history, memories and emotions.
This research discusses the use of local environment materials in the production of urban fabric constituents. I

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The Mathematical construct and its relationship with effective mathematical operations in both sides of the brain among students of the Department of Mathematics at the Colleges of Education and Basic Education
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The current research aims to identify: 1. The level of mathematical construct among the Department of Mathematics students in the colleges of education and basic education. 2. The level of effective mathematical operations in both sides of the brain at the Department of Mathematics students in the colleges of education and basic education. 3. The strength and direction of the correlation between the mathematical construct and effective mathematical operations on both sides of the brain at the Department of Mathematics students in the colleges of Education and Basic Education. To investigate the research objectives, the researcher formulated zero-main hypothesis for each aim and from the same hypothesis, three sub-zero hypotheses are deri

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Dialectic of the Living Body (the actor) and the Dead Body (the Sinography Item) in the Construction of the Staged Image of the Play: جاسم كاظم عبد - عماد هادي عباس
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The current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
(comparative analysis of phraseological units in the lexical-semantic field "on the material of Arabic and Russian languages"): (сопоставительный анализ фразеологических единиц лексико-семантического поля " на материале арабского и русского языков")
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Establishing the systemic character of vocabulary, its relationship with other language systems, their interdependence creates the possibility of a comprehensive scientific study and description of the lexical system of each language, as well as contrastive comparative studies of several languages, including their phraseological composition.

It is known that not all words-components of phraseological units are equivalent in their role in the formation of the semantic content of phraseological units. In this regard, it is necessary to introduce the concept of a lexical dominant. To this we include words, which are kind of centers around which the entire semantic complex of phraseological units, the entire set of its words-componen

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Publication Date
Sun Jan 01 2017
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Topical 40% &amp;lt;i&amp;gt;Loranthus europaeus&amp;lt;/i&amp;gt; Ointment as an Alternative Medicine in the Treatment of Acute Cutaneous Leishmaniasis versus Topical 25% Podophyllin Solution
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Physical Education Program on the Domains of the University Students, Attitudes toward Physical Fitness
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Objectives: To determine the effectiveness of physical education program on the domains of the university
students attitudes of physical activity and health, physical activity and mental health, physical activity and nutrition
toward physical fitness.
Methodology: A quasi-experimental design is carried out throughout the present study with the application of
test-retest approach through the period from February 3rd 2013 to June 30th 2013. The study is conducted on
purposive sample of(40) Undergraduate Students at the College of Science University of Baghdad . The sample is
Consisted of (20) males and (20) females. Questionnaire of two main parts, Personal and demographic
information and students' attitudes about phys

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Publication Date
Thu Mar 02 2023
Journal Name
Iar Journal Of Business Management
Reducing The Costs Of Transporting Multiple Products (Linear Transport Problems) Using Excel QM
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The transportation model is a well-recognized and applied algorithm in the distribution of products of logistics operations in enterprises. Multiple forms of solution are algorithmic and technological, which are applied to determine the optimal allocation of one type of product. In this research, the general formulation of the transport model by means of linear programming, where the optimal solution is integrated for different types of related products, and through a digital, dynamic, easy illustration Develops understanding of the Computer in Excel QM program. When choosing, the implementation of the form in the organization is provided.

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Publication Date
Tue Oct 23 2018
Journal Name
Journal Of Economics And Administrative Sciences
The integration between target cost to value engineering green achieve competitive advantage
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Recently, there has been a major trend towards environmental issues and concern for the green product because traditional products cause serious environmental impacts such as reduced resources, global warming, energy consumption, emissions and other environmental damage. Under these developments, economic units are looking for cost-effective technologies that reduce the cost of a green product that has four main dimensions: reducing energy, reducing resource consumption, preventing pollution, and using renewable energy while not compromising quality and satisfying customers in order to enhance competitive advantage.

This research will address one of the most important cost-effective green technologies, Gr

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Target cost tool to achieve competitive advantage
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Target costing is one of the modern techniques in strategic Management accounting, Is has shown active adoption to changes in current business environments, In addition, is has seen a growth in strategic approach, The goal of using target costing is to build and strengthen competition abilities of economic units through introducing appropriate ways to decrease cost values while maintaining and improving quality of product, So this study is aim to show how can  economic units use target costing to achieve competitive advantages .

 

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