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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 12 2019
Journal Name
Al-kindy College Medical Journal
Knowledge, attitude and practice regarding osteoarthritis management among physicians of primary health care centers; Al-rusafa/ Baghdad/2017
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Background:-Osteoarthritis (OA) is the most common form of arthritis and the leading source of physical disability in elderly people. The Prevalence of OA is increasing and will continue to do so as the population gets older. The OA is predominantly managed in primary care centers by primary health care physicians and much can be done to alleviate symptoms from osteoarthritis by combinations of therapeutic options including pharmacological and non-pharmacological treatments.

Objectives of study :- To assess the knowledge, attitude and practice of Iraqi PHCC physicians in Baghdad, AL-Rusafa, regarding the management of osteoarthritis patient, and it's association with sociodemogra

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Tue Feb 01 2022
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Materials Chemistry And Physics
Structural, surface electronic bonding, optical, and mechanical features of sputtering deposited CrNiN coatings with Si and Al additives
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Tue Aug 01 2023
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Iop Conference Series: Earth And Environmental Science
Modis Satellite Data Evaluation for Detecting the Dust Storm Using Remote Sensing Techniques Over Iraq
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Thu Jul 01 2004
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
KEYS FOR IDENTIFICATION OF GENERA AND SPECIES OF THRIPS (THYSANOPTERA: THRIPIDAE) FROM MIDLE OF IRAQ
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Keys for 22 species representing 10 genera of Thripidae were provided collection of
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Publication Date
Sun Jun 30 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Non-Pharmacological Pain Management Methods on Reduction the Duration of Labor Stages in Primigravida Women at AL-Elwyia Maternity Teaching Hospital
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Sun Jun 02 2019
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Baghdad Science Journal
Assessing of Some Toxic Heavy Metals Levels and Using Geo Accumulation Index in Sediment of Shatt Al-Arab and the Iraqi Marine Region
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Mercury, arsenic, cadmium and lead, were measured in sediment samples of river and marine environmental of Basra governorate in southern of Iraq. Sixteen sites of sediment were selected and distributed along Shatt Al-Arab River and the Iraqi marine environment. The samples were distributed among one station on Euphrates River before its confluence with Tigris River and Shatt Al-Arab formation, seven stations along Shatt Al-Arab River and eight stations were selected from the Iraqi marine region. All samples were collected from surface sediment in low tide time. ICP technique was used for the determination of mercury and arsenic for all samples, while cadmium and lead were measured for the same samples by using Atomic Absorption Spectrosc

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Wed Dec 30 2020
Journal Name
Journal Of Planner And Development
The proportionality of decision taken to sign the AL-Ayadi residential investment project within the Hittin neighborhood in Baghdad by Urban filling style
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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Non-Pharmacological Pain Management Methods on Reduction the Duration of Labor Stages in Primigravida Women at AL-Elwyia Maternity Teaching Hospital
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Objectives: To evaluate the effect of non-pharmacological pain relief methods on duration of labor stage.
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Result: The highest percentages of study and control groups were in age group (< 20) years old, primary schools graduates, housewife, from "urban area", within low category of socioeconomic scal

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of the core Competence for audit companies & offices On the Earning Quality of banks in Iraq Stock Exchange
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The research aims at measuring the extent of the relationship and influence of the indicators of the Core competencies of the audit firms and offices in the Earning Quality of the private banks listed in the Iraq Stock Exchange under audit. The research community represents 38 banks. The sample of the research has been approved only 10 banks continue to issue their financial statements for the period (2007 – 2017), in addition to the audit offices assigned to audit these banks, which amounted to 14 companies and auditing offices. John's (1999) model revised by Kothari et al., (2005) was adopted to measure the Earning Quality by finding discretionary accruals and non-discretionary accruals, to measure the Core competencies indicators ,

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