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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
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Insights of Experienced Pharmacists Regarding the Iraqi health Insurance Program: A Qualitative Study(Conference Paper )#
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The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.

This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Analysis of Four Maternity Deaths in Iraq by COVID-19
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This study aims to identify maternal death cases caused by Coronavirus infection 2019 pneumonia, including disease progression, fetal consequences, and the fatality cause.

Patients and methodology: A retrospective case collection of Iraqi pregnant women in their second and third trimesters diagnosed with COVID-19 pneumonia and died due to it.

The four cases were all of a young age, had a brief complaint period, and had no comorbidities. Fever, dyspnea, and fatigue were the most common symptoms. Hypoxia was present in all cases and was the cause of mortality in three cases, with thromboembolism being a potential cause in the fourth. Prelabour membrane breakup, fetal growth restriction, and fetal death are al

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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
Determine an Equation to Calculate the Annual Maintenance Cost for Public Hospitals (Al Sader City Hospital as a Case Study)
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Maintenance of  hospital buildings and its management are regarded as an important subject which needs attention because hospital buildings are service institutions which are very important to a society, requiring the search for the best procedure to develop maintenance in hospitals. The research is aimed to determine an equation to estimate the annual maintenance cost for public hospital. To achieve this aim, Al-Sader City Hospital maintenance system in Al-Najaf province has been studied with its main elements through survey of data, records and reports relating to maintenance during the years of the study 2008-2014 and to identify the strengths, weaknesses, opportunities and threat points in the current system through Swat analysi

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Publication Date
Sat Oct 29 2022
Journal Name
Current Trends In Geotechnical Engineering And Construction
Calculating the Real Need for Fire Brigade Stations in Al-Samawah City
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The location of fire brigade stations and equipment has a significant impact on the efficacy and efficiency of fire brigade department services. The challenge addressed by this study was that the fire brigade department required a consistent and repeatable technique to assess the response capabilities and safeguarding levels offered as the city of Samawah/Iraq grew and changed. Evaluating the locations of the current fire brigade stations in the city of Samawah is the aspect addressed by the research to determine the accuracy and validity of the locations of these stations by the competent authorities and their suitability to the area of the city’s neighborhoods and its residents. The Iraqi Ministry of Housing, Construction, Municipalitie

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Publication Date
Thu Sep 01 2016
Journal Name
Journal Of Engineering
Improvement of Traffic Movement for Roads Network in Al-Kadhimiya City Center
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Numerous regions in the city of Baghdad experience the congestion and traffic problems. Due to the religious and economic significance, Al-Kadhimiya city (inside the metropolitan range of Baghdad) was chosen as study area. The data gathering stage was separated into two branches: the questionnaire method which is utilized to estimate the traffic volumes for the chosen roads and field data collection method which included video recording and manual counting for the volumes entering the selected signal intersections. The stage of analysis and evaluation for the seventeen urban roads, one highway, and three intersections was performed by HCS-2000 software.The presented work plots a system for assessing the level of service

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Publication Date
Thu Jun 01 2023
Journal Name
Ifip Advances In Information And Communication Technology
Rapid Thrombogenesis Prediction in Covid-19 Patients Using Machine Learning
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Machine Learning (ML) algorithms are increasingly being utilized in the medical field to manage and diagnose diseases, leading to improved patient treatment and disease management. Several recent studies have found that Covid-19 patients have a higher incidence of blood clots, and understanding the pathological pathways that lead to blood clot formation (thrombogenesis) is critical. Current methods of reporting thrombogenesis-related fluid dynamic metrics for patient-specific anatomies are based on computational fluid dynamics (CFD) analysis, which can take weeks to months for a single patient. In this paper, we propose a ML-based method for rapid thrombogenesis prediction in the carotid artery of Covid-19 patients. Our proposed system aims

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Publication Date
Sun Jun 27 2021
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Detection of Depression among Nurses Providing Care for Patients with COVID-19 at Baqubah Teaching Hospital
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Objectives: The present study aims at detecting the depression among nurses who provide care for infected patients with corona virus phenomenon and to find out relationships between the depression and their demographic characteristics of age, gender, marital status, type of family, education, and years of experience of nurses in heath institutions, infection by corona virus, and their participation in training courses.
Methodology: A descriptive study is established for a period from October 10th, 2020 to April 15th, 2021. The study is conducted on a purposive (non-probability) sample of (100) nurse who are providing care for patients with COVID-19 and they are selected from the isolation wards. The instrument of the study is develope

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
A New Model Design for Combating COVID -19 Pandemic Based on SVM and CNN Approaches
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       In the current worldwide health crisis produced by coronavirus disease (COVID-19), researchers and medical specialists began looking for new ways to tackle the epidemic. According to recent studies, Machine Learning (ML) has been effectively deployed in the health sector. Medical imaging sources (radiography and computed tomography) have aided in the development of artificial intelligence(AI) strategies to tackle the coronavirus outbreak. As a result, a classical machine learning approach for coronavirus detection from      Computerized Tomography (CT) images was developed. In this study, the convolutional neural network (CNN) model for feature extraction and support vector machine (SVM) for the classification of axial

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Publication Date
Fri Dec 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Descriptive, Prospective Observational Study- Studying Possible Prediction Factors for Disease Severity and Progression among a Sample of COVD 19 Patients in Iraq
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Coronavirus has affected many people around the world and caused an increase in the number of hospitalized patients and deaths. The prediction factor may help the physician to classify whether the patient needs more medical attention to decrease mortality and worsening of symptoms. We aimed to study the possible relationship between C reactive protein level and the severity of symptoms and its effect on the prognosis of the disease. And determine patients who require closer respiratory monitoring and more aggressive supportive therapies to avoid poor prognosis. The data was gathered using medical record data, the patient's medical history, and the onset of symptoms, as well as a blood sample to test the

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Publication Date
Thu Jan 07 2021
Journal Name
Journal Of Craniofacial Surgery
Management of Maxillofacial Trauma in Attempt Suicide Patients During COVID-19 Pandemic
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