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bijps-1538
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
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Oral health status among kindergarten children in Karbala city\Iraq
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Back ground: Dental caries and periodontal disease followed by enamel defect were the most common and widely spread diseases affecting children. Aim of this study is the assessment of the occurrence and severity of dental caries, dental plaque, gingivitis and enamel anomalies among 4-5 years old children in Karbala city-Iraq. Materials and methods: A sample of 658 children (350 males, 308 females) aged four and five years old was selected randomly from the fourteenth kindergartens in Karbala city. Diagnosis and recording of dental caries and enamel anomalies were followed the criteria of WHO 1987, WHO1997 respectively. Dental plaque was assessed using plaque index of Silness and Loe,1964. Gingival health condition was assessed using gingiv

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Mon Apr 30 2012
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Journal Of Planner And Development
RAPID LAND TENURE ASSESSMENT OF BAGHDAD CITY IN IRAQ 2010
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Thu Jan 04 2024
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Journal Of Accounting And Financial Studies ( Jafs )
Creative accounting practices for supply contracts and the role of internal audit in reducing them: An exploratory study on a sample of industrial companies in Iraq
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Publication Date
Tue Jan 07 2020
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Journal Of Xian University Of Architecture & Technology
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Publication Date
Thu Mar 30 2017
Journal Name
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Publication Date
Sat Apr 01 2023
Journal Name
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Evaluation of Some Heavy Metals, Their Fate and Transportation in Water, Sediment, and Some Biota within AL-Musayyib River, Babylon Governorate, Iraq
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This study estimated seven heavy metals (Fe, Cu, Zn, Pb, Ni, Cd, Cr) in water (dissolved and particulate phase), sediments and some aquatic organisms including two species from aquatic plants (Ceratophyllum demersum&Phragmites australis); one species of clam (Psedontopeses euphratics) and two species from fish (Oreochromis aureus& Leuciscus vorax)in four sites within Mashroo AL- Musayyib channel project/ branch  of Euphrates river, Babylon , medial of Iraq . This aims to show the concentration of these elements, their fate and the mechanisms of their transmission through the food chain in this lotic aquatic system ; also in addition to examining  some physicochemical properties of ri

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Fri Sep 30 2022
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Tue Jul 01 2014
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Publication Date
Mon Apr 27 2020
Journal Name
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Wed Mar 05 2025
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The Construction of Al-Sultaniyyah City and Its Most Important Urban Manifestations During the Ilkhanid Mongol Period (651-756 AH/ 1253-1355 AD)
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