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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
Fri Sep 29 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of The Effect of Fisetin against Cyclophosphamide-Induced Myelosuppression and Oxidative Stress in Male Albino Rats
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Myelosuppression is a serious disease that is related to the malfunction of blood cells production that leads to cytopenia which is the most serious hematologic toxicity of cancer chemotherapies including cyclophosphamide, which is a strong oxazaphosphorine [a nitrogen mustard alkylating agent] that can be used alone or combined with other chemotherapeutic agents for the treatment of different malignant diseases. It induces severe bone marrow suppression by damaging hematopoietic stem cells through the generation of oxidative stress. Fisetin is a hydrophobic polyphenolic compound with a wide range of pharmacological properties such as antioxidant, anti-inflammatory, antimicrobial, osteoprotective, antidiabetic, and anti-carcinogenic activit

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Publication Date
Thu Feb 01 2024
Journal Name
Surface Engineering And Applied Electrochemistry
Synthesis of New 1,2,4-Triazole Containing Copolymers and Their Corrosion Inhibition оf Mild Steel in Acidic Medium
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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Applying Social Stories in Developing Social Interaction Skills among Children with Autism Spectrum Disorder
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The current research aims to identify the effectiveness of social stories in increasing social interaction among children with an autism spectrum disorder. The researcher used the single-subject design methodology (Single Subject Designs, SSD) with

 (A-B) design to answer the research questions. The study sample consisted of (3) children with autism spectrum disorder enrolled in a transit daycare center in the Asir region, Saudi Arabia. The results of the study showed that there is a positive functional relationship between social stories and play to increase social interaction among children with autism spectrum disorder, which contributed to the acquisition and generalization of this behav

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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Estimation of Immunoglobulins and complements and Using Enzyme linked Immuno sorbant Assay in Identification of Vulvovaginal candidiasis
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This study was conducted to determine the Immuno – globulins and complements quantitatively. The result revealed that the concentration of Immunoglobulin M(IgM) was increased significantly in patient group comparing with control group . The concentration of complement protein C4 was increased significantly in patient group comparing with control group.IgG of Candida albicans was detected by using ELISA Technique, the result indicated also that this antibody was found in 628% of the women who infected with Vulvovaginal Candidiasis. The sensitivity and specificity of the test were 63% and 89% respectively.

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Publication Date
Mon Dec 20 2021
Journal Name
Baghdad Science Journal
Impact of Denial-of-Service Attack on Directional Compact Geographic Forwarding Routing Protocol in Wireless Sensor Networks
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Directional Compact Geographic Forwarding (DCGF) routing protocol promises a minimal overhead generation by utilizing a smart antenna and Quality of Service (QoS) aware aggregation. However, DCGF was tested only in the attack-free scenario without involving the security elements. Therefore, an investigation was conducted to examine the routing protocol algorithm whether it is secure against attack-based networks in the presence of Denial-of-Service (DoS) attack. This analysis on DoS attack was carried out using a single optimal attacker, A1, to investigate the impact of DoS attack on DCGF in a communication link. The study showed that DCGF does not perform efficiently in terms of packet delivery ratio and energy consumption even on a sin

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Publication Date
Sat Feb 01 2014
Journal Name
World Journal Of Pharmaceutical Sciences
Detection of JAK2V617F Mutation and Serum Levels of Alkaline Phosphatase and Lactate Dehydrogenase in Chronic Myelogenous Leukemia.
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Chronic myelogenous leukemia (CML) is a myeloproliferative neoplasm arises from Bcr-Abl gene translocation (called Ph chromosome) in hematopoietic stem cells (HSCs). This genetic abnormality results in constitutive activation of tyrosine kinase and subsequent uncontrol growth and multiplication of granulocytes. The cornerstone in treatment of CML are tyrosine kinase inhibitors, of which imatinib is the most effectively used. JAK2V617F mutation is an acquired single nucleotide polymorphism (SNP) occurs in JAK2 gene and is associated with many hematological malignancy other than CML. It was thought that the two genetic abnormalities (Bcr-Abl and JAK2V617F) occur mutually; however, growing body of evidences suggested the reverse. This study a

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Publication Date
Tue Jan 09 2018
Journal Name
Research Journal Of Pharmacy And Technology
Sequencing of Mitochondrial COI gene in new Iraqi record Paropeas achatinaceum L. P. Feiffer, 1846, Gastropoda: Subulinidea
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Fifty snails of Paropeas achatinaceum specimens were collected and classified from four areas in Baghdad-Iraq from the period between June and July, 2017. The snails were divided into two groups (each group contain 25 snails). Two environment conditions were used in this study. Natural environment considered as control and experimental environment contains Citrus sinensis (L.) roots as snail’s source food. The comparison result between snail weights in the nature and experimental environment was not significant (0.497, 95% confidence interval [CI] 0.01209–0.02309). Also, the comparison between snail weights in the nature environment and the food mean weight was significant (0.014, 95% confidence interval [CI] 0.00591-0.04109), while the

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
Relationship between the central government and local governments in the light of the centralized and decentralized administrative
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Gaining the relationship between the central government and local governments is great importance especially after the expanded functions of the central government and became unable to carry out their works without all that delegate or transfer parts of its powers to lower levels.

The aims of the research is  to determine the relationship of the central government with the local government in accordance with the principle of administrative decentralization with the presentation of the competent authorities, the control of local governments, according to the Provincial Council Act No. 21 of 2008 amended.

The research has a problem that has been the relationship of the central

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Publication Date
Mon Nov 01 2010
Journal Name
Iraqi Journal Of Physics
Characterization of Quartz and Calcite Particle size Presents in Local Dust Fell on Baghdad on June 2009
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Dust samples have been collected from three areas in Baghdad during dust storm occurred in 18th of June 2009 to characterize elemental particle size and composition by different techniques. The x-ray diffraction detected six minerals those are calcite, and quartz, present as a major components, dolomite, kaolinite, gypsum and plagioclase present as miner components .EDX detected some normal elements presented in local soil except traces of lead , nickel, and chromium. The particle size analysis by a set of sieves have revealed that the majority particle distribution was between (32 and 45)μm . To isolate the aerosol size, PM10 buoyancy method of powder in water showed a signifying amounts of particulate size .Scheerer’s method was app

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Publication Date
Tue Sep 15 2020
Journal Name
Al-academy
The Constant and the Variable in the Kurdish Singing between the Past and Present: كونا قادر محمد
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  This research is interested in studying the constant and the variable within the signing reality in Iraqi Kurdistan region, and the researcher tries to tackle the importance of this topic within a search that serves the Kurdish culture, and contribute to its intellectual settlement, and introducing it to centers concerned with studying singing and music science in any civilized environment, whether inside or outside the territory of Kurdistan region. We see that this research which dealt with the topic (the constant and the variable in the Kurdish signing between the past and the present) deserves research and investigation for all its causes, being one of the academic necessities that contribute in identifying the historic artist

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