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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
Fri Jun 30 2006
Journal Name
Al-kindy College Medical Journal
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
clinical problems that confront the maxillofacial
surgeon and radiologist alike. Middle third facial
fractures are diagnosed primarily on the bases of
clinical examination and plain radiographs than can
result in much preoperative speculation.
Objective: To assess the advantages of spiral
computerized tomography over conventional
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
(42.1%) were zygomatic fractures, 8 (21.1%) were

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Publication Date
Tue Dec 05 2023
Journal Name
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Cytotoxic Activities, Determining Toxin, and Molecular Docking of Ovary Pufferfish (Tetraodon leiurus) in Singkarak Lake as Cancer Chemoprevention Candidate
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High Tumor Levels of Ki-67, VEGF and Endostatin Are Associated with Progression of Breast Cancer in Iraqi Women
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Thu Jan 11 2024
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Application of Taguchi orthogonal array in optimization of the synthesis and crystallinity of metal organic framework 5 (MOF 5)
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Fri Dec 01 2017
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Effect of Exemplar of Wettli On Acquiring Grammatical Concepts Among Basic 7th Class Female Students in Kurdish Language Grammar
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The current paper aims at knowing the effect of  Exemplar of Wettli On Acquiring Grammatical Concepts Among Basic 7th Class Female Students in Kurdish Language Grammar.

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Thu Dec 28 2023
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Identification of Lateritic Nickel Deposits Potential in the Kokoe Area, Kabaena Island, Central Buton Regency, Southeast Sulawesi Province, Indonesia
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Effect of Blue and Red LED Light and some Plant Extract on Lettuce Growth and Yield in NFT Technique
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