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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 Jun 30 2021
Journal Name
College Of Islamic Sciences
What Imam Ibn al-Subki disagreed with Imam al-Amadi in Tashnif al-Masma’, the chapter on analogy as a model
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Takbiratul Ehram "The First Takbeer to Start Prayer" means: the words that the worshiper says to start his prayers, and refrain from anything invalidates it. the findings revealed that the four school jurists agreed that the prayer is not valid without Takbiratul Ehram "The First Takbeer to Start Prayer", and they disagreed on its description, so the majority of jurists said that it is a pillar, and some of them called it an obligatory, but Hanafi made it a condition. Likewise, the four jurists agreed that the one who articulates Takbiratul Ehram "The First Takbeer to Start Prayer" with the word: “Allahu Akbar,”; his Takbeer is correct, and they disagreed about the one who adds a word, or replaced it with another, where the m

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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
COVID-19 and Alimentary Tract: Current Evidence and Recent Recommendations
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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
Psychological Stress As A Result of the Spread of the COVID-19 Pandemic
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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Measurable Mistakes in Architecture the Effect of Designer's Experience on the Propagation of Mistakes in Architectural Design - Residential Buildings in Al Sulaymaniyah City as a Case Study
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The importance of physical and nonphysical architectural design values made architectural designers need good experience to be experts of architectural values reasonably without neglecting any value in the design process.  The importance of such values made that ignoring any values and mistakes occurs in the design process. Simultaneously, architectural designers' different nature and the difference in their experiences are causing different understandings of the design values, thus causing architectural mistakes. The research problem appears from the randomly propagating of mistakes in contemporary architecture, which is about to become a phenomenon in Al Sulaymaniyah city. The research aims to find the main reason

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Publication Date
Mon Aug 18 2025
Journal Name
Journal Of Almaarif University College
Land Cover Change in Al-Jadriya Twist For the Period (1976-2024)
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The study addressed the change in the nature of the land cover of the Al-Jadriya Twist area for the period from 1976-2024 with an area of (140 km2)and for a period of (48 years) based on satellite images and their analysis using geographic information systems. The main classifications of the area were reached (water cover, residential areas, vegetation cover, in addition to empty, unused areas). The extracted data indicate a decrease in the water cover and the change rate reached (-14.29) and the residential areas increased with a change rate of (28.26), while the vegetation cover rate was recorded from (45 km2) to (66 km2) and the empty areas had a change rate of (-78.57).

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Publication Date
Mon May 21 2007
Journal Name
Journal Of Planner And Development
The Efficiency of the Distribution for Educational Services in Al-Athamiyah area
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The educational service one of activities which have great effect in the city life and it's community which considered as an affective instrument for the social and civilized construction and its role in the development of culture and determining the general features of the society. Therefore planning for educational service is considered as a necessary for economical, social and cultural conditions in the Arab community lives in general and the Iraqi community in special. The educational service buildings and distribution forms an insurmountable obstacle in the urban areas. So the balance distribution in Baghdad presents an indication to ensure the equality of educational opportunities besides the correlation of these institutes with th

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The idea of divinity for al-Kindi and its roots in Greece
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Perceptions of deity have practical effects in a person’s life, especially in his attitudes toward natural things since nature was created, in which man has treated it as something sacred. The Greek philosophers before Plato and Aristotle did not find in them the idea of divinity clear. Rather, they all searched for the first substance or the first cause of existence, and then gave it all the attributes of God from eternity and eternity, and considered it a first reason without which the universe would not have existed. knowledg

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of stressful life events for patients with substance abuse in Baghdad city
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Objective: The present study aims to assess the stressful life events for patients with substance abuse in Baghdad city.
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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Quality of Life for Patients with Permanent Pacemaker in Baghdad City
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Objectives: To determine the (QoL) for patients with permanent pacemaker and to find-out the relationship between
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information form, 3.socioeconomic data form, and 4.Permanent pacemaker patient’s quality of life questionnaire data
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Publication Date
Sun Mar 26 2023
Journal Name
Wasit Journal Of Pure Sciences
Covid-19 Prediction using Machine Learning Methods: An Article Review
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The COVID-19 pandemic has necessitated new methods for controlling the spread of the virus, and machine learning (ML) holds promise in this regard. Our study aims to explore the latest ML algorithms utilized for COVID-19 prediction, with a focus on their potential to optimize decision-making and resource allocation during peak periods of the pandemic. Our review stands out from others as it concentrates primarily on ML methods for disease prediction.To conduct this scoping review, we performed a Google Scholar literature search using "COVID-19," "prediction," and "machine learning" as keywords, with a custom range from 2020 to 2022. Of the 99 articles that were screened for eligibility, we selected 20 for the final review.Our system

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