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A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#

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 Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city –Iraq(Conference Paper )#

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. O

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Publication Date
Tue Apr 13 2021
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Latin American Journal Of Pharmacy
The Experience with Hospitalized COVID-19 Patients in Al-Basra, Iraq: Predictors of the disease severity

SUMMARY. The objectives of the present study were to assess the possible predictors of COVID-19 severity and duration of hospitalization and to identify the possible correlation between patient parameters, disease severity and duration of hospitalization. The study included retrospective medical record extraction of previous coron avirus COVID-19 patients in Basra hospitals, Iraq from March 1st and May 31st, 2020. The information of the participants was investigated anonymously. All the patients’ characteristics, treatments, vital signs and laboratory tests (hematological, renal and liver function tests) were collected. The analysis was conducted using the SPSS (version 22, USA). Spearman correlation was used to measure the relations

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Thu Nov 08 2018
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Iraqi National Journal Of Nursing Specialties
Nutritional status of adult hemodialysis patients in Al-Najaf Al-Ashraf Governorate

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Methodology: A descriptive quantitative cross sectional study was effectuated in hemodialysis centers from
February 2011 to September 2011. A purposive "non-probability" sample of (70) male and female hemodialysis
patients in al-Najaf al-Ashraf Governorate from those who have spent more than six months on maintenance
hemodialysis schedule. Data collected through using of a well-designed questionnaire consist of five parts, part
one consists of sociodemographic contain (9) items, and part two consists of medical data contain (8) items, and
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Publication Date
Sat Oct 13 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE BIODIVERSITY OF BAHR AL-NAJAF DEPRESSION, AL-NAJAF AL-ASHRAF PROVINCE

    The tentative list of the biodiversity (plants and vertebrates) of Bahr Al-Najaf depression is found to comprise 104 vertebrate species including 2 fishes, 14 reptiles, 73 resident and migratory birds and 15 mammals. The flora consists of 31 species, mainly of plants well adapted to desert conditions that dominate the area, besides few examples of water plants. The salinity was found, through chemical analysis of the lake water, to be of high value which reduces the diversity of aquatic animal and plant diversity.

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Publication Date
Tue Jun 16 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Epidemiology of the domestic and repatriation (Covid-19) Infection in Al Najaf province , Iraq

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Background: Al-Najaf province , Iraq , has experienced an outbreak of coronavirus disease 2019 (Covid-19). Epidemiological and clinical characteristics of (Covid-19) infection have been reported but a detailed clinical course and risk factors for mortality including medical comorbidities and severity of illness at time of presentation , have not been well described.

Methods: From February 24 to April 7, 2020, a case series study done on 123 PCR-confirmed cases of (Covid-19) admitted to Al-Hakeem Hospital And Quarantine Center (AHQC), in Al-Najaf Province, Iraq. Demographics, clinical and laboratory data  gathered from a local database at (AHQC). SPSS(statist

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Publication Date
Sun Sep 27 2020
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Effectiveness of an Instructional Program Concerning Non-Pharmacological Guideline on Controlling Essential Hypertension among Patients at AL-Sader Hospital in AL-Najaf AL-Ashraf City

Objective: The aims of present study to detect the effectiveness of instruction program of non-pharmacological guideline on blood pressure and laboratory test.

 

Methodology: A pre-experimental study was conducted in Al-Sader Teaching Hospital   from 8th of September 2019 to 25th of May 2020, in order to find out the effectiveness of instruction program concerning non-pharmacological guideline on controlling essential hypertension among patients. A non- probability (purposive sample) of 50 patients with essential hypertension is selected. Those patients are already diagnosed with Essential Hypertension

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Publication Date
Wed Feb 20 2019
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Iraqi Journal Of Physics
Measurement of radon concentrations for some houses in Al-Najaf city /Iraq

    Measurement of radon concentration level was carried out in 40 houses in Al – Najaf city during summer season of 2012. Long term measurement of indoor of old building radon concentrations have been taken, using a previously calibrated passive diffusion dosimeters containing CR – 39 solid state nuclear track detectors which are very sensitive for alpha particles. The measurement of the indoor radon concentration obtained in summer in these regions ranged from 11.654±4.216 Bq.m-3 to 53.610±8.777 Bq.m-3. The results were within universally permitted levels.     

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Publication Date
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Knowledge, Attitudes, Practices, and Online Distance Learning Experience of Malaysian University Students towards COVID-19: A Cross Sectional Study(Conference Paper )#

Some new norms need to be adapted due to COVID-19 pandemic period where people need to wear masks, wash their hands frequently, maintain social distancing, and avoid going out unless necessary. Therefore, educational institutions were closed to minimize the spread of COVID-19. As a result of this, online education was adapted to substitute face-to-face learning. Therefore, this study aimed to assess the Malaysian university students’ adaptation to the new norms, knowledge and practices toward COVID-19, besides, their attitudes toward online learning. A convenient sampling technique was used to recruit 500 Malaysian university students from January to February 2021 through social media. For data collection, all students

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Publication Date
Sat Apr 29 2023
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Assessment of Serum Neopterin Levels in patients hospitalized with severe COVID-19

Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Objective: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID‐19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID

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