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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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Thu Oct 01 2015
Journal Name
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The Attitudes of School Teachers and Principals at Regular Government Basic Schools toward Inclusion of Disabled Students in Ajloun Governorate
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This study aimed to identify the attitudes of school teachers and principals at basic government schools in Ajloun governorate towards the inclusion of disabled students at basic schools, and investigate how they will accept the merger. To achieve the purpose of this study, a questionnaire containing 35 items was administered to school teachers and principals to measure their attitudes toward the inclusion of disabled students in regular schools. The sample of this study consisted of 43 male teachers and (74) female teachers and principals. The frequency, normal distribution, arithmetic means and t-test were used to analyze the data of present study.          The findings showed that there

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Sat Jan 02 2021
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Methods of computer word formation in the modern Russian language: Способы словообразования в сфере компьютерных неологизмов в современном русском языке
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Sat Jul 18 2020
Journal Name
College Of Islamic Sciences
Research on the book observatories walls in doctrinal issues Written by Imam Sana Allah bin Ali bin Khalil (1137 AH)
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The topic of the research on the Observatory of the Walls on Jurisprudential Matters in the Hanafi Fiqh, by Imam San’a Allah bin Ali bin Khalil Al-Ala’iyya Wai al-Naqshbandi, al-Rumi, who died in 1137 AH, which includes seven chapters, the first section of it concerning division and related matters, and the second section in the adaptation It is the apportionment of benefits in common objects, the third section, which pertains to lines, surfaces, and bodies, the fourth section, which concerns the inclined wall and certification, and the fifth section, which concerns the provisions of the walls and its claims, and the sixth section, which concerns the door of roads and doors, the opening of the skylight, the sails of the wing, the can

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Publication Date
Mon Mar 15 2021
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Effect of Teaching Competencies in Enhancing Self-Confidence among Students of Department of Art Education during Application: كنعان غضبان حبيب
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Publication Date
Mon Dec 28 2020
Journal Name
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Academic Boredom in the Light of some Variables of Academically Excellent Intermediate Stage Students: زهراء سعد العبودي , انتصار كمال العاني
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Mon Oct 01 2018
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Educational and Psychological perceptions of Ibn Khaldun Thought Educational and psychological view s in The Thought of Ibn Khaldun Descriptive
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Publication Date
Sun Feb 10 2019
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The Female Characters In The Pre-Raphaelite Novel: M.E. Braddon’s Lady Audley’s Secret (An Extracted Research of Master Degree Letter)
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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Nursing Education Scholarship
Incivility among Arabic-speaking nursing faculty: testing the psychometric properties of the Arabic version of incivility in nursing education-revised
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Civil environment in nursing education enhances achieving learning outcomes. Addressing incivility can be crucial to improve academic achievements. The purpose of this study was examining the psychometric properties of the Arabic version of the Incivility in Nursing Education-Revised scale regarding nursing faculty.

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Publication Date
Sun Apr 01 2018
Journal Name
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Publication Date
Mon May 06 2019
Journal Name
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Designing Teaching Aids and Their Effects on Learning and Retaining Diving and Cartwheel on Floor Exercises in Women’s’ Artistic Gymnastics
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Designing Teaching Aids and Their Effects on Learning and Retaining Diving and Cartwheel on Floor Exercises in Women’s’ Artistic Gymnastics

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