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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 Jun 04 2017
Journal Name
Baghdad Science Journal
Studying the Electron Energy Distribution Function (EEDF) and Electron Transport Coefficients in SF6 – He Gas Mixtures by Solving the Boltzmann Equation
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The Boltzmann equation has been solved using (EEDF) package for a pure sulfur hexafluoride (SF6) gas and its mixtures with buffer Helium (He) gas to study the electron energy distribution function EEDF and then the corresponding transport coefficients for various ratios of SF6 and the mixtures. The calculations are graphically represented and discussed for the sake of comparison between the various mixtures. It is found that the various SF6 – He content mixtures have a considerable effect on EEDF and the transport coefficients of the mixtures

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Situation of Refugees and Displaced Women in Arab Countries during Conflicts According to the Perspective of the Arab Women's Organization
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Abstract

The scope of the humanitarian tragedies in the Arab region has widened after the conflicts that erupted over the past years, exacerbation to include educational, cultural, and social dimensions, economic and moral aspects of the displaced families, especially after the emergence of terrorist organizations and sectarian conflicts which overthrew human and led to various political and demographic changes, forcing citizens to leave their homes, fleeing with their families from the danger of murder, terrorism, and violation to other safer areas inside or outside their countries. Women and children were the vast majority of the displaced who were subjected to great pressures, The host communities bore the pro

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Planning the Production of the Electrical Distribution Converter (400KV/11) Using Time Series Methods and Goal Programming in the Fuzzy Environment
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This Paper aims to plan the production of the electrical distribution converter (400 KV/11) for one month at Diyala Public Company and with more than one goal for the decision-maker in a fuzzy environment. The fuzzy demand was forecasting using the fuzzy time series model. The fuzzy lead time for raw materials involved in the production of the electrical distribution converter (400 KV/11) was addressed using the fuzzy inference matrix through the application of the matrix in Matlab, and since the decision-maker has more than one goal, so a mathematical model of goal programming was create, which aims to achieve two goals, the first is to reduce the total production costs of the electrical distribution converter (400 KV/11) and th

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Dynamic Behavior of Pb(II) and Cr(III) Biosorption onto Dead Anaerobic Biomass in Fixed-Bed Column, Single and Binary Systems
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The biosorption of lead (II) and chromium (III) onto dead anaerobic biomass (DAB) in single and binary systems has been studied using fixed bed adsorber. A general rate multi- component model (GRM) has been utilized to predict the fixed bed breakthrough curves for single and dual- component system. This model considers both external and internal mass transfer resistances as well as axial dispersion with non-liner multi-component isotherm (Langmuir model). The effects of important parameters, such as flow rate, initial concentration and bed height on the behavior of breakthrough curves have been studied. The equilibrium isotherm model parameters such as maximum uptake capacities for lead (II) and chromium (III) were found to be 35.12 and

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Publication Date
Thu Jun 29 2017
Journal Name
College Of Islamic Sciences
Fundamental graduation of man-made provisions in the jurisprudence of the companion Abdullah bin Amr, may God be pleased with them
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In The Name of Allah Most Gracious Most Merciful

The fundamentals of jurisprudence have a great role in facilitating the ways to know the Shari’a rulings for everything that takes place between people in terms of relationships, and the actions that are issued by them, because without it, the sources from which the rulings were taken are not known, and the methods used by the imams of ijtihad in taking these rulings from those sources are not understood. The foundations on which they followed in the interpretation of texts and its rules, and Muslim scholars in different eras celebrated this science and gave it great care: with what they wrote in it from the works of different directions, but of course the complexity printed many

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The aesthetics of abstract expressionism and its representations in the artistic productions of the students of the Department of Art Education
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The research section tagged (Aesthetics of Abstract Expressionism and its Representations in the Artistic Products of Students of the Department of Art Education) into four chapters and it included in..
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Publication Date
Mon Jan 01 2018
Journal Name
البحوث التربوية والنفسية
The effectiveness of educational design according to Herman's whole brain theory In the learning styles of fifth-grade science female students
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Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
the role of senior management commitment to total quality in the implementation of knowledge management processes_Asurvey of asample of civil colleges
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Occupies total quality management applications play a key role in the development of institutions of higher education performance and achieve its strategic objectives through the commitment of senior management and their employees to continuous improvement of the quality of performance in the various areas of work, and can be integrated knowledge management processes, which means identifying information of value and how to take advantage. The data were collected using the style of the questionnaire for the purpose of analyzing their results on a sample composed of 83 member of the administrative leadership in colleges as representing the decision-making centers in those colleges . 

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Publication Date
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Premiums and compensations and their impact on the financial solvency of insurance companies: applied research in the Iraqi General Insurance Company
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The collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.

Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.

In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t

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Publication Date
Sat Feb 12 2022
Journal Name
Journal Of Education College Wasit University
The Role of Picture Books in Raising Children's Understanding of English Literature and Life Science Concepts: Selected Stories by Eric Carle
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Abstract The current study is a theoretical study that aims to underline the role of picture books as a serious genre of children's literature in raising children's understanding of English literature and life concepts; especially for non-English speakers. Unfortunately, most Iraqi people have developed a social phobia of learning English since childhood. This phobia is resulted from the heavy traditional reading and writing assignments as well as hard exams. Therefore, this study suggests incorporating more interesting literary material like picture books that would bring pleasure and help in raising children's love and cognition of English Language. More significantly, it calls to replace the old curriculum with a more vital one

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