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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 04 2012
Journal Name
Baghdad Science Journal
Evaluation of cellular immune response in Golden Hamsters experimentally infected with Leishmania donovani comparing with cellular immune response against chicken Red Blood Cells.
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Wed Oct 17 2018
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Tue Apr 29 2025
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Dominican Roots in Julia Alvarez’s How the Garcia Girls Lost Their Accents الجذور الدومينيكانية في رواية جوليا الفاريز "كيف فقدت فتيات غارسيا لكنتهن"
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Sun Jan 01 2023
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The role of Modulation Complexity Score (MCS) of the VMAT and IMRT techniques in the treatment planning of left non-small lung cancer
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Publication Date
Thu Oct 12 2017
Journal Name
Iraqi Journal Of Agricultural Sciences
THE BIOLOGICAL EFFECTIVENESS OF GIBBERELLIC ACID SEEDS SOAKING AND FOLIAR TO ABSCISIC ACID IN THE GROWTH , ANISE OIL YIELD AND ITS CHEMICAL CONTENT
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A field experiment was carried out during two winter season 2013, 2014 at the field of the Department of Field Crops, College of Agriculture, University of Baghdad, to study the effect of seeds soaking with Gibberellic acid and foliar with Abscisic Acid on the growth, yield, and content of Anise oil seeds using factorial experiment within RCBD design with three replicates. The seeds was treated within GA3 were soaked with two concentrations of  30, and 60 mg. litter-1 in addition to without soaking and the code has been B0 , B1 , B2 overlapped these transactions with two concentrations of Abscisic Acid  3, and 6 mg. litter-1 in addition to without foliar A0 , A1 , A2The seeds to be treated  with GA3 are soaked for 24 hours prior

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Publication Date
Wed Sep 30 2020
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The strategic recovery of the insurance service and its reflection on achieving the strategic goals: research My application in the National Insurance Company
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Publication Date
Fri Jan 19 2024
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Possible protective anticancer effect of chloroform fraction of Iraqi <i>Hibiscus tiliaceus L.</i> leaves extract on diethylnitrosamine-induced hepatocarcinogenesis in male rats
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We aimed to examine the potential protective effects of Iraqi H. tiliaceus L. chloroform leaves extract on DEN-induced HCC in male Wistar Albino rats.

Method

Rats were assigned to four groups, six in each group. Group I: rats were administered a daily oral dose of 1 mL/kg/day of distilled water. Group II: rats were intraperitoneally injected with 70 mg/kg DEN once per week for 10 conse

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Publication Date
Wed Nov 19 2025
Journal Name
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Immunohistochemical expression of D2-40, VEGF and PCNA as biological markers of lymphangiogenesis, angiogenesis and proliferation in pleomorphic adenoma of salivary gland origin
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Background: Pleomorphic adenoma is the most common benign salivary gland tumor and shows a pronounced morphological complexity and diversity; for this The immunoprofiles and clinical course of PA differed according to cellular differentiation. Therefore, it is important to assess potential biomarkers in diagnostic and therapeutic trials. This study evaluates the immunohistochemical expression of D2-40, VEGF and PCNA as markers of lymphangiogenesis, angiogenesis and proliferation of PA and their correlation with clinicpathological parameters and with each other. Materials and Methods: Twenty five formalin – fixed, paraffin – embedded tissue blocks were included in this study. After histopathological reassessment of haematoxylin & eosin

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Publication Date
Sun Apr 01 2012
Journal Name
Arpn
Effect of friction stir welding parameters (rotation and transverse) speed on the transient temperature distribution in friction stir welding of AA 7020-t53
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Three-dimensional nonlinear thermal numerical simulations are conducted for the friction stir welding (FSW) of AA 7020-T53. Three welding cases with tool (rotational and travel) speeds of 900rpm-40mm/min, 1400rpm-16mm/min and 1400rpm-40mm/in are analyzed. The objective is to study the variation of transient temperature in a friction stir welded plate of 5mm workpiece thickness. Based on the experimental records of transient temperature at several specific locations during the friction stir welding process for the AA 7020-T53, thermal numerical simulation is developed. The numerical results show that the temperature field in the FSW process is symmetrically distributed with respect to the welding line, increasing travel speed decreasing tran

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