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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 Apr 01 2023
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Journal Of Engineering
Minimum Instream Environmental Flow in Shatt Al-Hillah River
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Tue Oct 04 2022
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College Of Islamic Sciences
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Sun Dec 31 2017
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College Of Islamic Sciences
Salah Al-Abad In stating the purposes of belief
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Worshipersrighteousness in declaration of purposes of belief

Laith Salman Dawood

Iraqi Sunni Affairs/Department of Religious and Charity Institutions

Abstract

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The research here presents to the question of standing on the purpose of belief and its importance, which corresponds to going into the purposes of the Sharia acts and Worship, which are no less important and perhaps the most important. The health of belief is the only way to correct work and worship. The research first dealt with the definition of the doctrine and its pil

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Tue Feb 05 2019
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The science of semiotics cares Pettmvsal indications and forms of circulation, and is made form the semantic patterns , and pattern of production , and methods of functioning . Stop quite a few specialists and critics and researchers at Dalia ignorant poet and knight known ( Duraid bin embolism Jashmi ) ; it rep

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Sun Dec 01 2013
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Multi-pages structure for Six Sigma performance matrix based on the technical characteristics of balanced performance and methodology Al-Sigma for measuring corporate performance: Suggestion vision
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Sat Jul 22 2023
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The Characteristics of the Traditional Urban Configuration of ArabIslamic Cities through Form and Moral Values: Al-Kadhimiya as a Case Study
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This paper studies the main characteristics of the traditional urban configuration of Arab cities, as an important built heritage, discussing the approach adopted with such configuration at the local level, and examines its ability to preserve the character of the city, as well as, its responsiveness to the recent  requirements of its society that constantly change; in order to reach the appropriate procedures to deal with the traditional urban configuration of the Iraqi city to achieve a vital cultural communication with the vernacular built heritage, by dealing with the Form-Moral Values structure. Due to its importance within other traditional Iraqi cities, the research chose Al-Kadhimiya as a case study, so it discusses and compares

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Publication Date
Thu Dec 30 2021
Journal Name
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The omission of letters according to Zakaria al-Ansari in his book (Fath al-Rahman by revealing what is ambiguous in the Qur’an)
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Summary

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Sun Sep 30 2012
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Grammar Lesson in  The Book of Al-Zahir in My Meanings         Words of the people to Abu Bakr al-Anbari (d. 328 AH
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Sun May 22 2022
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The effectiveness of the electronic public relations of Al- Shuhadaa Establishment: an analytical study of the website contents, the official social networking sites of Al- Shuhadaa Establishment
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public relations at Al-Shuhadaa Establishment: an analytical study of social networking sites and the website) came to know and monitor the contents of social networking sites for Al-Shuhadaa Establishment, the research problem was represented by the main question: (What is the effectiveness of social networking sites and the website of Al-Shuhadaa Establishment) ,This research was classified within the descriptive research, and the two researchers adopted the survey method in order to achieve the objectives of the research, and they used the tool: content analysis as a research tool, the analysis of the contents included the official website of the establishment (Instagram page), and other social networking sites that Al-Shuhadaa Establish

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