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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
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
A Cognitive Linguistic Study of the Satirical Language in Al-Hajjar's Caricatures
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The present study is a qualitative study that aims to investigate the way the Iraqi caricaturist,Dheaa Al-Hajjar uses caricatures to produce a satirical meaning humorously.Producing satire while at the same maintaining humor requires a creative thinking on the part of the caricaturist. Thus, the study examines the production of humorous satire in terms of creativity. The analysis is done from the cognitive linguistic point of view using Arthur Koestler's theory of bisociation as presented in his book The Act of Creation in 1964. The main principle on which the theory is based is that humor is created via linking (or bisociating in Koestler's terms) two habitually incompatible trains of thought in order to come up with a novel me

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Wed Jan 01 2014
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Journal Of The College Of Languages (jcl)
The stylistics of expressive structure in Al-Sayyab's attempt- A textual study
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Mon Jan 01 2018
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Estimation of concentration of radioactive elements for the Liquid Waste pool in radiochemistry laboratories in Al Tuwaitha site Baghdad-Iraq
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Tue Oct 11 2022
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College Of Islamic Sciences
(639هـ) The speech act in the grammatical discourse, a study in the book "Guiding Al-Luma'" by Ibn Al-Khabbaz (639 AH)
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Publication Date
Tue Jan 03 2023
Journal Name
College Of Islamic Sciences
Formulas The command and its style in Surat Al-Ma’idah is a rhetorical fundamentalist study.: The command and its style in Surat Al-Ma’idah is a rhetorical fundamentalist study
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Publication Date
Wed Jan 24 2024
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Pharmacia
Novel anticoagulants in the management of atrial fibrillation: A comprehensive comparative analysis
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Background: Atrial fibrillation (AF) stands as the most prevalent cardiac arrhythmia, with associated risks of stroke and systemic thromboembolism. While vitamin K antagonists, specifically warfarin, have historically been the mainstay for stroke prevention in AF, they come with inherent limitations.

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Method: A meticulous examination of pivotal clinical trials, meta-analyses, and recent research publications was conducted.

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Thu Jun 09 2022
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Khadija Al-Hadithi was known for her love of the Arabic language. She was a distinguished and serious phenomenon in Arabic science and culture. She was born in Basra Governorate, one of the ancient and important cities in the history of Arabic grammar and one of the centers of the intellectual and scientific movement. The Basra Grammar School emerged there and made numerous achievements in the field of Arabic linguistics that remain an important source for students of the specialty.

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Sun Dec 02 2018
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The Famous Muslims' Graveyards in the Persian Country in the Islamic Ages: A Historical Study in the Maraqid Al-Maaraf Book for Harz Aldeen
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There are many studies that discussed the famous museum's graveyards in the Islamic worlds, to study the lives of these figures, there are many difficulties for their studies because the first we need the regularity and history information, and many sciences support, such as in language, geography information.

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Chemo-sensory loss and FUT2 gene in COVID-19 infected Iraqi dentists
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Aim: To find any association between specific ABO blood groups and FUT2 secretory status and COVID-19 in a sample of Iraqi dentists. Materials and Methods: For each participant, a questionnaire including demography, COVID-19 status, blood grouping, and RH factor, with chemo-sensitive symptoms was recorded. The saliva samples were collected and DNA was extracted from leukocytes. Sequencing of molecular detection of the FUT2 gene by real-time PCR and the data was done, whilst drawing the phylogenetic tree. Results: Out of 133, most of the dentists were female 61%, most were just under 35 years of age. The most participants in this study were predominantly with blood group O (40%), followed by B, A, and AB, with (90%) of them were RH+.

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