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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
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Effect of Granulocyte-colony stimulating factor with or without Moxifloxcacin therapy on capsulated Staphylococcus aureus infection in neutropenic mice
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Twenty bacterial isolates were identified as Staphylococcus aureus collected from wounds and catheters related infections. A capsulated S. aureus isolate was chosen after performing serum soft agar test, for this study Neutropenic mice were challenged with capsulated S. aureus ,and the effect of G-CSF with or without moxifloxacin was studied. The results indicated that the addition of G-CSF to moxifloxacin therapy have a synergistic effect in the killing of the bacteria, while when each G-CSF and moxifloxacin were used seperately have a similar effect on bacterial killing. It was found that the moxifloxacin has the same activity as G_CSF but is less costly than the latter one.

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Publication Date
Wed Sep 01 2021
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Baghdad Science Journal
Effect of Salt and Osmotic Stresses on the Activity of Some Antioxidant Enzymes and Biochemical Traits in Catharanthus roseus
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Publication Date
Sun Mar 04 2018
Journal Name
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Tue Jan 01 2019
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Iraqi Journal Of Agricultural Sciences
Effect of magnetic field on the growth, multiplication and concentration of the volatile oil of rosemary officinalis in vitro
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Wed Nov 01 2017
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The impact of marketing orientation on improving the quality of service applied research in some Iraqi mobile phone companies
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The research discusses two variables are important, orientation marketing and quality of service, and that the purpose of the research is to see whether the telecom companies applied orientation marketing or not and to what extent is keen to apply it to suit the Iraqi environment as it has been applied research in kork Telecom company and Asia Cell Telecom are sectors service job in the business sector in Iraq, The information was obtained through the design of the questionnaire compatible runway Likert, and distribution (92) questionnaire, which (50) for the company Korek Telecom and (42) of the Asia-Cell, research population sample included a number of staff in the departments and units in the two companies, it has been support

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Effect of Some Medicinal Plants on the Activity of Some Immunological Factors in Saliva and Serum of Type –?? Diabetics
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Publication Date
Fri Jun 30 2006
Journal Name
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The Use of Spiral Computerized Tomography in the Diagnosis of Middle –Third Facial Fractures as Compared to Plain Radiography
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Background: Trauma is one of the most common
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Objective: To assess the advantages of spiral
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radiography in the pre-surgical evaluation of middle
third facial fractures.
Methods: Thirty patients with thirty-eight facial
fractures were studied, all patients were examined
clinically, by plain radiography and then by spiral CT.
Results: Of the 38 middle-third fractures, 16
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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Transfer Of Training In Framework Of Supporting The Work Environment Characteristics (Filed Research of The Generals lnspectors Offices)
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The  transfer of  training  process occupies a great importance in achieving the ultimate goal of participating in the training programs , it  is sure that this does not take place without the support of the working environment for trainees,  and The research aims to personification role the work environment characteristics  of supporting the transfer of training.                                    

The research problem is the weakness transfer of training to the work en

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