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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
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Fatigue Characterization for Composite Materials used in Artificial Socket Prostheses with the Adding of Nanoparticles
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Abstract<p>The prostheses sockets use normally composite materials which means that their applications may be related with the human body. Therefore, it was very necessary to improve the mechanical properties of these materials. The prosthetic sockets are subjected to varying stresses in gait cycle scenario which may cause a fatigue damage. Therefore, it is necessary or this work to modify the fatigue behavior of the materials used for manufacturing the prostheses sockets. In this work, different Nano particle materials are used to modify the mechanical properties of the composite materials, and increase the fatigue strength. By using an experimental technique, the effect of using different volu</p> ... Show More
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Sun Sep 05 2010
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Effect of Hydroxyapatite Coatings on Corrosion Behavior for Biotype 316L SS Used in Orthopaedic Applications
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Electrochemical corrosion of hydroxyapatite (HAP) coated performance depends on various parameters like applied potential, time, thickness and sintering temperature. Thus, the optimum parameters required for the development of stable HAP coatings was found by using electrophoretic deposition (EPD) technique. This study discusses the results obtained from open circuit potential-time measurements (OCP-time), potentiodynamic polarisation and immersion tests for all alloy samples done under varying experimental conditions, so that the optimum coating parameters can be established. The ageing studies of the coated samples were carried out by immersing them in Ringer’s solution for a period of 30 days indicates the importance of stable HAP c

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Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Ibn Tulun's personal and scientific biography Shams Id-Din Mohammad Ibn Ali AL-Dimashqi Al-Salihi (953 A .H / 1546 A.D)
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and learning , sheds light on his tutors and his authorities , scientific stations and travels , his
scholarly status , and Ibn Tulun's alumni or his students .

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Publication Date
Fri Aug 31 2012
Journal Name
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Wed Feb 11 2009
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Thyroid Autoimmune Antibodies For Enzyme Peroxidase, Thyroglobulin and Se, Zn Levels in Elderly Patients with Hypothyroidism in Iraq
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Wed Jun 30 2021
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Mon Apr 01 2019
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Applied Water Science
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Sun Jul 07 2013
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