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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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Wed May 10 2023
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Journal Of Planner And Development
the Planning and Management of Services in Rural Areas, AL-Gharraf sub-district in Dhi Qar Governorate, a case study.
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Mon Nov 10 2014
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The Functions of Onomatopoeia in Modern English and Arabic Poetry: A Study in Selected Poems by Lawrence and al-Sayyab
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Onomatopoeia has always been a functional poetic device which enjoys a high sound significance in the poetry of many languages. In modern English and Arabic poetry alike, it proves to be vital and useful at different levels: musical, thematic and at the level of meaning. Still, the cultural difference looms large over the ways it is employed by the poets of each. The present paper investigates the employment of onomatopoeia in the poetry of D. H. Lawrence (1885-1930) and Badr Shakir al-Sayyab (1926-1964) who are chosen due to the importance they enjoy in modern English and Arabic poetry and the richness of their poems in onomatopoeias. The conclusions reached at are in a sense related to cultural differences which govern the use of onomato

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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:
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Publication Date
Thu Feb 16 2023
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Phytochemical Screening of Petroleum Ether Fractions by GC/MS and Isolation of Lupeol from Two Different Parts of Iraqi Leucaena leuco-cephala. (Conference Paper )#
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This work is considered the first study for the components of the Iraqi Leucaena leucocephala plant, where the different phytochemical compounds that present in the aerial parts were identified by using the gas chromatography/mass spectrometry technique (GC/MS). The type of the components and their concentration will differ according to the part of the plant used and the method of extraction (hot and cold). This study made a comparison in lupeol concentration that was identified and isolated from petroleum ether fractions of Leucaena leucocephala by using Gas Chromatography/Mass Spectrometry (GC/MS), High-performance thin-layer chromatography (HPTLC), and Preparative High-Performance Li

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Wed Mar 10 2021
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Gel clot assay used for detection of candida spp onfection in urinary tract
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Tue Mar 30 2021
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Aquatic Oligochaeta (Annalida:Clitellata) as Bio Indication for Sediment Quality Assessment in Tigris River Within Baghdad City /Iraq
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Mathematical Models Used for Brachytherapy Treatment Planning Dose Calculation Algorithms
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Fri Dec 30 2022
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Publication Date
Tue Feb 05 2019
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Al-Rawandi and His Book “Rahat Il-Sudoor and Ayat Il-Suroor” A historical Study in Content and Style
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The Rwandan author of comfort chests and verse pleasure of the most important historians of the Seljuks in the sixth century AH / twelfth century and belongs to the mostly ethnic scientists family has won favor with the Sultans of the Seljuks until he became the most famous Markhém is his main source of research sources with respect to the political and social history the Seljuks and the relationship of the Seljuk sultans of the Abbasid caliphs in Baghdad.
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