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bijps-1538
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
Mon Jul 10 2023
Journal Name
Journal Of Engineering
Application of Water Quality Index and Water Suitability for Drinking of the Euphrates River within Al-Anbar Province, Iraq
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In this study water quality was indicated in terms of Water Quality Index that was determined through summarizing multiple parameters of water test results. This index offers a useful representation of the overall quality of water for public or any intended
use as well as indicating pollution, which are useful in water quality management and decision making. The application of Water Quality Index (WQI) with ten physicochemical water quality parameters was performed to evaluate the quality of Euphrates River water for drinking usage. This was done by subjecting the water samples collected from seven stations within Al-Anbar province during the period 2004-2010 to comprehensive physicochemical analysis. The ten physicochemical paramete

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Sun Dec 01 2013
Journal Name
Journal Of Engineering
Application of Water Quality Index and Water Suitability for Drinking of the Euphrates River within Al-Anbar Province, Iraq.
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Fri Jun 30 2023
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Sat Feb 01 2014
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Assessment Efficiency Evaluation of Al-Diwaniya Sewage Treatment Plant in Iraq
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This study aims to evaluate the performance of the sewage treatment plant in Al- Diwaniya, one of cities in the southern part in Iraq. This evaluation could be used to facilitate effluent quality assessment or optimal process control of the plant. The influent reaching the plant is considered a medium to strong in strength with BOD5/COD ratio in the range 0.23 and 0.69 which can be considered an easily degradable sewage by the biological processes performed by the activated sludge unit. The quality of the effluent was found to be higher than the Iraqi standards for disposal to water bodies. The BOD5/COD ratios of the treated sewage varied over a wide range as low of 0.13 to 1.48 indicating operational problems in the plant. Regressio

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Thu Apr 01 2021
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Iop Conference Series: Earth And Environmental Science
Phytoplankton community within Al-Auda marsh in maysan province southern Iraq
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Impact of COVID-19 on Dental Students' Psychological Health
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Tue Aug 02 2022
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