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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 30 2017
Journal Name
College Of Islamic Sciences
Book of Musaka (by Imam Abu al-Qasim Abdul-Karim Muhammad ibn Abd al-Karim al-Rafii)
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Al-Aziz's book was chosen as a subject for research as it is one of the important books in the Islamic world in general and the Shafi'i school in particular and its author Imam Abdul Karim bin Mohammed bin Abdul Karim Al-Rafi's, who in the doctrine of the jurisprudence has made prominent lines and left behind invaluable scientific treasures in the service of religion. Its importance is summarized as follows:
1. Being an explanation of the book (brief) of the argument of Islam Imam Ghazali (God's mercy), one of the five books adopted in Shafi'i jurisprudence.
2. His work is Imam Abu al-Qasim al-Rafii known for the brilliance of the investigation and the power of weighting in the doctrine.
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Publication Date
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Women’s Knowledge about Health Promotion after Cesarean Delivery at Maternity and Pediatric Hospital in Al-Samawa City
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Objective(s): To assess women’s knowledge about health promotion after a cesarean delivery and to determine the association between women’s knowledge and their demographic data of age, level of education, and monthly income.
Methodology: A descriptive design is carried out to assess women’s knowledge about health promotion after cesarean delivery at Maternity and Pediatric Hospital in Al-Samawa City. This study starts from 26th of September 2020 up to 16th March 2021. Sample of (100) woman who are at reproductive age, pregnant (prime or multipara) who have planned to have birth by elective cesarean section or had previous elective caesarian section without medical indication or women who had cesarean section with medical indicat

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Using Social Media upon the Mental Health of Adolescent Students of preparatory Schools in Al-Diwanyah City
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Objective: To know the impact of social networks on the mental health of adolescents in the city of Diwaniyah.
Methodology: A descriptive cross-sectional study was conducted on adolescents in preparatory schools in ALDiwaniyah
City Center, for the period from Jun 26, 2015 through to October 20, 2015. The schools were
selected from using Probability sampling (240 random samples) six schools were selected from 32 schools (20 %
from total number) the schools were chosen by writing the names of all schools on a pieces of paper and put in
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Different Degrees of Uterine Prolapse on Sexual Function of Women at Teaching Hospitals in Al-Hilla City
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Background: Women sexuality is basic right and it plays a major role in women's Health aspects. Up is one of the factors that lead to sexual dysfunction while the incidence of it is rising as UP severity being more. Objectives: To assess the impact of different degrees of uterine prolapse on sexual function of women at teaching hospitals in AL-Hilla City. Methodology: A descriptive analytical study was conducted from 1ST Feb to 10th Jun /2014 to assess the impact of different degrees of uterine prolapse on sexual function for women who attend to consultant clinic at teaching hospitals in AL-Hilla City

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Publication Date
Fri Jan 01 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Women’s Knowledge about Health Promotion after Cesarean Delivery at Maternity and Pediatric Hospital in Al-Samawa City
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Objective(s): To assess women’s knowledge about health promotion after a cesarean delivery and to determine the association between women’s knowledge and their demographic data of age, level of education, and monthly income. Methodology: A descriptive design is carried out to assess women’s knowledge about health promotion after cesarean delivery at Maternity and Pediatric Hospital in Al-Samawa City. This study starts from 26th of September 2020 up to 16th March 2021. Sample of (100) woman who are at reproductive age, pregnant (prime or multipara) who have planned to have birth by elective cesarean section or had previous elective caesarian section without medical indication or women who had cesarean section with medical indication or

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Publication Date
Fri Dec 15 2023
Journal Name
Muthanna Journal For Agricultural Sciences
Evaluating of Different Types of Agricultural Nozzles Locally Used in Iraq
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The experiment aimed to Manufacture a device for checking the nozzles and testing its efficiency and to study the effect of research factors on the studied traits. The device was manufactured locally through using materials available in the Iraqi market. The system is Both Hydraulic and electronic (ISO 5682-1)1 relay on sensors technology and the test platform was built and designed on a movable trolly at the department of Agricultural Machines and Equipment / College of Agricultural Science / University of Baghdad. The design includes the use of mechanical water pump and electrical AC water pump. The design includes a nozzle holder that can accommodate three nozzles per test. The design also consists of spreading wings and stationa

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Sat Jan 01 2022
Journal Name
Open Engineering
Field tests of grouted ground anchors in the sandy soil of Najaf, Iraq
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Wed Mar 30 2022
Journal Name
College Of Islamic Sciences
What the linguists commented on, "I do not know" in the dictionary of Lisan al-Arab, a semantic study
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Absitract

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Publication Date
Fri Dec 30 2022
Journal Name
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The Death Scene in the "Ayniyah" Poems of Abi Thuayib Al-Huthali and Suda bint Shamardal: A Contrastive Study
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Mon Sep 25 2023
Journal Name
International Journal Of Energy Production And Management
Reducing Energy Consumption in Iraqi Campuses with Passive Building Strategies: A Case Study at Al-Khwarizmi College of Engineering
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University campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the

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