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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
Wed Feb 20 2019
Journal Name
Political Sciences Journal
Independent government agencies in Iraq / Integrity Commission a model
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The state did not witness the emergence of independent bodies because of the nature of the ruling regimes that were characterized by political tyranny represented by the king at the time, as is the case with Greece and the Greeks and Persia and the Romans and others. As for the Islamic state, which emerged later, it saw the emergence of what looks like independent bodies that we see today, There was the so-called Diwan Al-Hesba and the Ombudsman's Office as an independent body from the Islamic State, which operated independently to support the oppressed and the equitable distribution of financial resources, even though it was headed by well-known governors of justice and honesty. A state in the modern era, many countries, especially in E

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Publication Date
Mon Jul 01 2013
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
ZOOPHTHORA PHYTONOMI (ZYGOMYCETES: ENTOMOPHTHORACEAE) A NEW RECORD IN IRAQ
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Sun Jul 01 2001
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
HAEMATOZO`A OF THE AVIAN FAMILY PHASIANIDAE IN IRAQ
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Publication Date
Thu Aug 02 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Performance Study for Mixed Transforms Generated by Tensor Product in Image Compression and Processing
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In all applications and specially in real time applications, image processing and compression plays in modern life a very important part in both storage and transmission over internet for example, but finding orthogonal matrices as a filter or transform in different sizes is very complex and importance to using in different applications like image processing and communications systems, at present, new method to find orthogonal matrices as transform filter then used for Mixed Transforms Generated by using a technique so-called Tensor Product based for Data Processing, these techniques are developed and utilized. Our aims at this paper are to evaluate and analyze this new mixed technique in Image Compression using the Discrete Wavelet Transfo

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Tue Jan 03 2023
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College Of Islamic Sciences
Narrative Structures in the Novel “Qiamat Baghdad” for the Novelist Alia Talib – Semiotic Study
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The human mind knew the philosophy and logic in the ancient times, and the history afterwards, while the semiotics concept appeared in the modern time, and became a new knowledge field like the other knowledge fields. It deals, in its different concepts and references, with the processes that lead to and reveals the meaning through what is hidden in addition to what is disclosed. It is the result of human activity in its pragmatic and cognitive dimensions together. The semiotic token concept became a knowledge key to access all the study, research, and  investigation fields, due to its ability of description, explanation, and dismantling. The paper is divided into two sections preceded by a the

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
In Vitro Cytotoxic Study for Purified Resveratrol Extracted from Grape Skin Fruit Vitis vinifera
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This study  was  conducted  with the  aim to  extract and  purify  a  polyphenolic  compound  â€œ Resveratrol” from the skin of black grapes Vitis vinifera cultivated in Iraq. The purified resveratrol is obtained after ethanolic extraction with 80% v/v solution for fresh grape skin, followed by acid hydrolysis   with   10%   HCl   solution then   the  aglycon   moiety   was  taken  with   organic   solvent

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Publication Date
Tue Jun 30 2020
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The research shows the importance of orientation towards the formulation of the green strategy and its effect in determining the behavior of the green municipal institution in Babel governorate. The research highlighted the formulation of the green strategy as an important variable, especially today, the trend towards protecting the environment and minimizing the damage resulting from the delivery of services, and through it also the type of green behavior or performance adopted by the municipal institution and the emergence of the need for a strategy that is not harmful to the environment. The research took the sample intentionally comprehensive size of 222 personnel of municipal institutions and some formations concerned with t

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Publication Date
Mon Sep 03 2018
Journal Name
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The Technical Treatment for Pottery Body by (Kintsugi) Technique in Japanese Pottery – Analytic Study
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The aesthetic and technical expertise help  in producing the artistic work and achieving results in aesthetic formulations that reflect the aesthetic and  expressive dimensions and the reflective dimensions of the pottery, surpassing its traditions, asserting  its active presence in life, cherishing it  even when it  breaks  or get damaged   by employing techniques that are originated  from  the Japanese environment.

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Publication Date
Sun Mar 01 2015
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Baghdad Science Journal
A study of adsorption isotherms for the removal of herbicide Atlantis WG from aqueous solutions by using Bentonite clay
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The subject of this research involves studying adsorption to removal herbicide Atlantis WG from aqueous solutions by bentonite clay. The equilibrium concentration have been determined spectra photometry by using UV-Vis spectrophotometer. The experimental equilibrium sorption data were analyzed by two widely, Langmuir and Freundlish isotherm models. The Langmuir model gave a better fit than Freundlich model The adsorption amount of (Atlantis WG) increased when the temperature and pH decreased. The thermodynamic parameters like ?G, ?H, and ?S have been calculated from the effect of temperature on adsorption process, is exothermic. The kinetic of adsorption process was studied depending on Lagergren ,Morris ? Weber and Rauschenberg equati

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Publication Date
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Palm dates as a source for isolation of Aspergillus niger to produce citric acid by submerged fermentation; kinetics study
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Abstract<p>The study discussed here deals with the isolation of Aspergillus niger from palm dates, the formal and the most famous fruit in Iraq, to test and qualify this fungus isolate for its ability to produce citric acid. Submerged fermentation technique was used in the fermentation process. A.niger isolated from “Zahdi” Palme dates was used in the study of the fermentation kinetics to get the production efficiency of citric acid. Kinetics of CA production via fermentation by A. niger S11 was evaluated within 432 h fermentation time and under submerged conditions of 11% (w/v) sucrose, 5% (v/v) inoculum size, pH 4, 30 °C and 150 rpm. The maximum citric acid produced was (37.116 g/l). Kine</p> ... Show More
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