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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
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Predictors of poor first trimester outcome in asymptomatic women : the value of embryonic heart rate , mid sac diameter / yolk sac ratio & mid sac diameter / crown rump length
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Background:  Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several  criteria have been established  to predict  the pregnancy outcome particularly in symptomatic women .

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
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Publication Date
Mon Mar 07 2022
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Publication Date
Thu Sep 15 2022
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The Degree of Commitment of Social Workers Who Work in the ‎Ministry of Social Development to the Professional Principles of ‎the Social Work Profession under the Corona Pandemic
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Publication Date
Thu Jun 15 2017
Journal Name
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Prevalence and localization of the posterior superior alveolar artery in relation to the floor of the maxillary sinus and alveolar crest among sample of Iraqis using computed tomography
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Publication Date
Mon Jun 01 2020
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Publication Date
Sun Sep 07 2014
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Baghdad Science Journal
Organic Content in the Sediments of Tigris and Diyala Rivers, south of Baghdad, and its Relationship with some Environmental factors, Benthic Invertebrates Groups and Values of Diversity Indices
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Publication Date
Wed Jan 23 2019
Journal Name
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The study has tackled three important variables on the strategic and organizational level, that are : (Administrative skill, strategic Entrepreneurship  and organizational flexibility). Through the statistical analysis is, the research hers have sought to identify the relation among them. The study has been applied on a sample of (44) private banks in Iraq. A questionnaire, which has been designed according to a number of international standards, has been used. It's made of (29) items that cover the three variables to test their hypotheses. A number of statistical tools have been used A number of conclusion have been reached and recommendations have also been suggested.

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Publication Date
Tue Dec 29 2020
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The impact of the activities of the national poverty reduction strategy On achieving the sustainable development goals An applied research in the Ministry of Labor and Social Affairs
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Sun Jul 20 2025
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