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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 Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
Teaching skills for Public and Private Schools’ Teachers: comparative study : Teaching skills for Public and Private Schools’ Teachers: comparative study
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The great expansion of teaching skills requires finding ways and methods to help teachers acquire experiences of all kinds. The researcher found in the subject of the teaching skills for teachers in public and private schools a fertile field for conducting a study that enables the measurement of these skills. Thus, the study aims to identify the skills of teaching lessons for teachers, the difference in teaching lesson skills for teachers according to the years of service, the differences in teaching lesson skills for teachers according to the specialized teachers and non-specialized teachers, the differences in teaching lesson skills for teachers according to the public and private school. The

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Sun Feb 03 2019
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Journal Of Accounting And Financial Studies ( Jafs )
The Role of Developmental loans in Developing Wheat and Barley Crops In Iraq for the Period ( 2006 – 2012)
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Sun Jun 01 2014
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The role of monetary policy in achieving economic stability and growth in Iraq for the period (2004-2011)
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The objective of this research to analyze the effectiveness of monetary policy in achieving economic stability and growth for the period 2004-2011 ،This period of time saw a fundamental shift in monetary policy after the issuing new law the Central Bank of the full independence of the monetary authority ،This is Prompt the monetary authority to bring about a change in the philosophy and objectives and the tools used to achieve the desired  goals ،Which give them the ability to control the size of the money supply and to achieve price stability Indeed، Monetary policy has been able to achieve the golden triangle of economic stability ،Consisted of staff، exchange rate stability and low and stable general level of prices

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Publication Date
Fri Jan 01 2021
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The impact of the strategic foresight capabilities in green creativity An exploratory study for the State Company for Food Products
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Sun Jul 09 2023
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Fabricating a new Rheometer for Concrete
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A new concrete rheometer is introduced including its innovation, actual design, working rules,
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(0.442) is used as a non-Newtonian fluid. Th

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A Procedure for Analysing Reinforced Embankments
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Tue Mar 15 2022
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Literary works include, for the most part, text thresholds, which are the first entry into reading them and understanding their connotations, and (literary works) vary according to text thresholds, some of which are limited to the title and on the cover page only, and others, in addition to these two thresholds, are based on the dedication threshold too, and others ...

This study takes the story of "Mamo Zain" of the poet Ahmed Al-Khani and his translator Sheikh Muhammad Ramadan Al-Bouti as the field of study, as it is a unique literary work, which included a number of textual thresholds which supported each other and cooperated with the content of the work.

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Tue Jun 15 2010
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Journal Of Baghdad College Of Dentistry
Prosthodontist’s ability to detect parallelism of two lines used in occlusal plane determination
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Background: Prosthodontists estimated the parallelism of the occlusal plane to different anatomical landmarks, which was somewhat arbitrary and depended mainly on their vision. The aim of this research was to assess the degree of accuracy of prosthodontists in determining the parallelism of two lines. This research was aimed to assess which technique would be more accurate for the prosthodontist to distinguish parallelism; the comparison of the occlusal plane with the interpupillary line or with the inferior border of the earlobes. Materials and methods: Twenty eight prosthodontic specialists were included in this research. Illustrations of two lines with different tilts were presented to the participants to distinguish whether parallel or

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