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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 May 08 2022
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Sport Tk-revista Euroamericana De Ciencias Del Deporte
Effect of using the simultaneous electronic presentations strategy in teaching basic skills of basketball to second-grade intermediate students
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The primary aim of this study was to identify the effect of using the simultaneous electronic presentations strategy in teaching basic skills of basketball to second-grade intermediate students. The present study had a parallel group, pre-post experimental design. In the present study the students of the Salah al-Din Intermediate School for the academic year 2020-2021 constituted the research community. A total of 75 students were present in the research community. Out of 75 students 16 students were selected as the participants for the study. The students falling within the age group of 13-14 years were recruited as the study participants, making up a percentage of 21.33 of the total number. Based on the results of th

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Effect of Exemplar of Wettli On Acquiring Grammatical Concepts Among Basic 7th Class Female Students in Kurdish Language Grammar
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The current paper aims at knowing the effect of  Exemplar of Wettli On Acquiring Grammatical Concepts Among Basic 7th Class Female Students in Kurdish Language Grammar.

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Thu Jan 04 2024
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Strategic control and its impact on the performance of the insurance company: Applied research in the Iraqi insurance company
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Sun Apr 02 2017
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Journal Of Educational And Psychological Researches
Improving performance of the heads of academic departments at the University of Wasit in light of the administrative functions
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Publication Date
Mon Apr 03 2023
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Challenges Faced by Families of Children with Intellectual Disabilities and Its Effect on the Psychological Health in the Asir
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This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin

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Publication Date
Mon Dec 05 2022
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An Evaluation of the Activity of Prepared Zinc Nanoparticles with Extracted Alfalfa Plant in the Treatment of Heavy Metals
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The Sources and Effects of Risks of Forms of Islamic Financing in the Islamic Branches of the Commercial Bank
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Proved Islamic banks in many countries where they are present, whether Muslim or non-Muslim in the wake of the global financial crisis, it is more efficient, profitable, and stable compared with the conventional banks, so went many of the worlds towards providing Islamic banking through Islamic windows to Besides financial services and products offered by the traditional, or the initiative to enter formulas Islamic finance is fully compliant with the principles and rules of Islamic law and is Brokerage basic function of conventional banks and Islamic alike ) and that means working on the mobilization of savings from surplus units and directed towards the financial units of the fiscal deficit) , which operates commercial banks

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Sat Apr 01 2023
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Physiological and Hormonal Effects of Titanium Dioxide Nanoparticles on Thyroid Function and the Impact on Bodyweight in Male Rats
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