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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
Sat Sep 23 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of pharmacist interventions on pulmonary function parameters of Iraqi asthmatic patients: A comparative study: Effect of pharmacist interventions on pulmonary functions tests
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Background: Despite the fact that asthma is a long-term disease that may be treated, many people are unable to control their symptoms due to a lack of knowledge about their condition. The study's purpose was to find out if a pharmacist intervention improved asthma management because of this.

Objective: this study designed to assess the effect of pharmaceutical care on pulmonary functions test.

Method: The study was completed in three months. The patients who were enrolled were divided into two groups: Group 1 consists of 23 asthma patients who were randomly assigned to receive conventional therapy for chronic bronchial asthma based on disease stage and se

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Publication Date
Mon Dec 30 2019
Journal Name
College Of Islamic Sciences
Question and answer about the hadith (People are partners in three) To Mr. Muhammad bin Ismail, Prince Al-San’ani, may God have mercy on him (1182 AH)
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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic innovation components of the application Business process re-engineering: A survey Study of the consultant of a sample of managers and their assistants and consultants in the General Company for Post & Telecommunications
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        Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear

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Publication Date
Thu Apr 25 2019
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE ANTIBACTERIAL ACTIVITY AND INHIBITION EFFECT OF REACTIVE RED (31) DYE FOR THE CORROSION OF CARBON STEEL IN CORROSIVE MEDIA: STUDY THE ANTIBACTERIAL ACTIVITY AND INHIBITION EFFECT OF REACTIVE RED (31) DYE FOR THE CORROSION OF CARBON STEEL IN CORROSIVE MEDIA
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The inhibitive action of Reactive Red (RR31) dye against corrosion of carbon steel in 1M acetic acid solution has been studied using gravimetric method at temperature ranged (288-318)K. The antibacterial activity for the different concentrations of RR31 dye against different bacterial species was studied. The experimental data indicates that this dye acts as a potential inhibitor for carbon-steel in acetic acid medium and the protection efficiency increase with increasing (RR31) dye. The adsorption of (RR31) dye on the carbon steel surface was found to follow Langmuir adsorption isotherm. Thermodynamic data for the adsorption process such as Gibbs free energy change ∆Gads, enthalpy change ∆Hads, and entropy change ∆Sads were estima

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Publication Date
Sat Aug 10 2024
Journal Name
American Journal Of Economics And Business Innovation
Factors Associated with Employees’ Intention to Leave in ICT Sector in Iraq: A Factor Analysis
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The current paper aims to identify potential factors associated with employees’ intentions to leave information and communication technology companies in Iraq. There is evident variability in the literature regarding these factors; hence, a factor analysis approach was employed to identify these factors within the surveyed environment. Due to the difficulty in precisely delineating the size of the research population, a purposive sampling method was employed to reach an appropriate number of respondents within the aforementioned companies. A total of 288 employees responded to the survey conducted via Google Forms. The test results revealed the presence of five primary factors associated with employees’ intentions to leave, name

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Arts Faculty Of Baghdad University
The Discourse of Christian Minority in Saad Hana's Novel "Abducted in Iraq": A Critical Perspective.
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Sun Sep 01 2013
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Journal Of Economics And Administrative Sciences
The Role Of The economic And External Factors In Selecting Aggregate Planning Alternatives For Workforce Case Study In Yarmouk Teaching Hospital
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The research aimed to achieve many objectives represented in two variables, which are the impacted factors and the aggregate planning alternatives of workforce in Educational Al- yarmouk Hospital , This research started from a problem focused on finding solutions to the demand’s  fluctuation  or the energy limitation while the study importance is emerged from diagnosis the suitable strategy and adopt the suitable alternatives due to their importance in meeting the demand for the health service submitted by the hospital .This study  based on choosing assumptions of connection relationship and the impact among the mentioned variables in the(surgery and internal diseases) departments. The research is dependent on ch

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Media in Developing the Tax Awareness of the Iraqi Citizen: Applied Study in the General Commission for Taxes
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 Interested in many scholars and reseachers  the subject of the media and means varied his roleinfluential in the definition of the public of issues and political, cultural, social and because of its spread wide and ability to address the people of all levels effect them  in the formation consciousness of those issues and types of this awareness is an awareness of the tax, contribute to media formation consciousness tax through the definition of people what tax and importance of the role of its revenues to supplement the state budget by posting tax laws and regulations of applied and all what respect process account tax, to be in charge of the tax familiar enough about this, which avoid being cheated taxmisleading when rev

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Publication Date
Sun Sep 01 2024
Journal Name
Results In Engineering
Implementation of a control and monitoring system for a cathodic protection cell to mitigate localized corrosion in fixed and mobile steel structures
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Publication Date
Sun Sep 01 2024
Journal Name
Results In Engineering
Implementation of a control and monitoring system for a cathodic protection cell to mitigate localized corrosion in fixed and mobile steel structures
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The current study introduces a novel technique to handle electrochemical localized corrosion in certain limited regions rather than applying comprehensive cathodic protection (CP) treatment. An impressed current cathodic protection cell (ICCPC) was fabricated and firmly installed on the middle of a steel structure surface to deter localized corrosion in fixed or mobile steel structures. The designed ICCPC comprises three essential parts: an anode, a cathode, and an artificial electrolyte. The latter was developed to mimic the function of the natural electrolyte in CP. A proportional-integrated-derivative (PID) controller was designed to stabilize this potential below the ICCPC at a cathodic potential of −850 mV, which is crucial for prote

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