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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
Sat Jul 01 2017
Journal Name
Journal Of Physical Education
Special Exercises According to Refereeing and It's Effect on Developing Some Physical Abilities Of First Class Basketball Referees in Baghdad
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Basketball is one of the most popular and popular games that have a large audience both globally and locally because of the magic it contains in terms of performance. For this sport to be a success, fundamental factors must exist and these factors is the referee. The referee plays a large and important role in the success of the game and the establishment and application of rules.The research aimed at identifying the effect of special on the development of referee's physical abilities. The researcher used the experimental method. The subjects were (12) first class basketball referees. The researcher recommended using special exercises due to their great role in developing the physical abilities of first class basketball referees

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Wed Jul 01 2020
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Investigating the ability to use natural iraqi material ⇜crushed porcelanite rocks⇝ in greywater filtration, and compare it with sand filter
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Sun Jun 02 2013
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Extraction and Determination of Amygdaline in Iraqi Plant Seeds Using the Combined Simple Extraction Procedure and High-Performance Liquid Chromatography
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Thu Jan 02 2020
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Journal Of The College Of Languages (jcl)
The personality of the woman and her role in the products of Agnon: דמותה ותפקידה של האישה ביצירותיו של עגנון
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  Shmuel Yosef Agnon, a well-known Jewish writer, wrote many literary works, including poetry, story, etc. In the field of story, this writer used two areas: the first: a simple exterior, and the second: an inner full of secrets and mysteries. This area is common when Agnon is affected by his symbolic method of purpose. In his productions, we find the political and historical significance embodied in his characters, where there is almost no story without it.

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Thu Jun 01 2017
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Publication Date
Sun Dec 15 2019
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Detection of some major elements and protein in Fusarium wilt disease infected tomato(Lycopersicon esculentum) treated with Arbuscular mycorrhizal fung
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Thu May 31 2018
On the Use of 6th-Order Tunable Complementary Metal-Oxide-Semiconductor Varactor based Filter in Ultra-Wideband Low Noise Amplifier
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The plethora of the emerged radio frequency applications makes the frequency spectrum crowded by many applications and hence the ability to detect specific application’s frequency without distortion is a difficult task to achieve.

Objective:

The goal is to achieve a method to mitigate the highest interferer power in the frequency spectrum in order to eliminate the distortion.

Method:

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The Effect of Silybum marianum L. aquatic crude extracts on the cancer cell lines and normal cell line in vitro
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