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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
Sun Mar 19 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of the Self-Questioning Strategy on the Achievement of the Fourth Grade and Their Reflective Thinking in Physics
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Wed Jun 19 2019
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Impact of Self-Assessment on Income and Sale Tax Collection' From the Point View of Income Tax Auditors in Jordan
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Wed Jul 01 2020
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Plant Archives
INVESTIGATING THE ABILITY TO USE NATURAL IRAQI MATERIAL "CRUSHED PORCELANITE ROCKS" IN GREYWATER FILTRATION, AND COMPARE IT WITH SAND FILTER
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Fri Dec 01 2023
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Influence of Water Stress on Expression of the X95950 Gene and Several Cellular Callus Components in Violet-Treated Sunflower Varieties
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Tue Nov 01 2016
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The Impact of the Financial Reporting of Liabilities and Assets of Deferred Income Tax in the quality of Accounting Information
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Sun Jul 01 2001
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Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIELD EFFICACY OF THREE TYPES OF INSECTICIDES AGAINST LARVAE OF MUSCADOMESTICABREEDING IN EQUINE MANURE AND THEIR EFFECTS ON PREDATORY MITES
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with Ficam. The populations of predator mites were not affected due to insecticidal
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Publication Date
Sun Jun 02 2019
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Journal Of The College Of Languages (jcl)
European Loanwords in Modern Persian: واژه های اروپائی دخیل در زبان فارسی نوین ( بحث و بررسی در حوزه¬های معنایی )
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Publication Date
Thu Dec 28 2023
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The Self and the Other in the Dogmatic Discourse: The Cognitive and Emotional Structure of the Authoritarian and Destructive Personality
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The Effectiveness of Management Information Systems (MIS) and its impact on Governmental Organization Performance in Jouf Region of Saudi Arabia
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Mon Mar 15 2021
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Variables related to the performance styles of batik art to achieve linear tactile effects in the printmaking: نجلاء المرضوف السعدي
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The art of batik is one of the ancient arts that has a long history in East Asian countries, especially in Indonesia, where it was considered a traditional craft with which many Indonesian tribes lived. This art began to move to other continents and develops and progresses due to the artist’s connection to the surrounding technological and intellectual development, as art became more outgoing and liberated, it helped the artist to create and innovate in his designs. In this research, he focuses on modern performance methods through which print paintings can be produced through design elements, especially calligraphy, to create aesthetic and creative effects in the productive work. The current research aims to identify the various perfo

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