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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 Mar 01 2017
Journal Name
Auditing & Interior Magazine Of Educational &scientific Studies
Seeds morphological study of different species of Medicago L., Leguminosae (Fabaceae) family in Iraq.
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This research delts with study seven species of seeds and wild varieties wild belonging to the genus Medicago L., these species are: M. constricta Dur., M. coronata (L.) Bartal., M. intertexta (L.) Mill., M. intertexta.var. ciliaris (L.) Hyen., M. laciniata (L.) Mill., M. lupulina L., M. minima (L.) Bartal. and M. sativa L., the research involved characteristics of shapes, dimensions, colors and the nature of the surface ornamentation of seeds and also the hilum site. the seeds forms ranged between crescent, reniform and ovate, in addition there was a clear difference in seeds dimensions in height and width, while, the color has been vary between light brown to brown and dark brown. The nature of the surface ornamentation was smooth, retic

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Thu Sep 28 2023
Journal Name
International Journal Of Membrane Science And Technology
Morphological and Anatomical Study of Some Species of Ziziphus L. (Rhamnaceae) Growing in Iraq
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The genus Ziziphus is one of the Family Rhamnaceae and consists of more than 170 species distributed in tropical and subtropical regions. All the species in the genus are of economical and medical importance. This study was conducted to identify the morphologically and anatomically features of the genus in Iraq.  The field survey was conducted across the study area where 4 species (Ziziphus jujube, Z. mauritiana, Z. nummularia and Z. spina-christi) were collected and used in the study.  The result showed that there is variation in morphological and anatomical features among the species in the stem cross-section and longitudinal section of leaves also the differences appeared in the epidermis of leaves.

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Sat Dec 01 2018
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Iraq after war and strategy of reconstruction : Analytical study in reality and future horizon
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Sun Jun 04 2017
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Analysis and Study of the Effect of Atmospheric Turbulence on Laser weapon in Iraq
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Thu Dec 15 2022
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Anatomical study of the vegetative parts of the species Arum colocasia L. in Iraq
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Thu Dec 26 2019
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Study the incidence of Candida infection in Diabetic patients submitted to the Balad Town Hospital in Salah –Eldeen, Province
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Wed Oct 11 2023
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Teaching Problems Faced by Female Teachers of Students with Intellectual Disability in Special Education Programs and the Proposed Solutions for that from their point of view - a qualitative study
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This study aims to identify the teaching problems that teachers of students with intellectual disabilities face, in addition to exploring the solutions suggested by them in order to overcome such problems or challenges. The researchers used a qualitative approach in order to understand the teachers' perceptions about these problems in a more in-depth way. The interview tools (in-depth and semi-structured interviews) were used to collect data from (3) female teachers from special education programs in the Asir region. The results revealed a number of themes including problems related to students, teachers and the teaching methods they use, curricula, school environment, and school administration. Moreover, the results indicated that famil

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Thu Mar 21 2024
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THE EFFECT OF USING A DISABLING FORCE TRAINING TOOL ON WALKING PERFORMANCE: AN ANALYTICAL STUDY OF TIME AND STEP LENGTH IN THE 20 KM WALKING RACE EVENT FOR APPLICANTS
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