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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 01 2014
Journal Name
Baghdad Science Journal
The construction of Complete (kn,n)-arcs in The Projective Plane PG(2,5) by Geometric Method, with the Related Blocking Sets and Projective Codes
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A (k,n)-arc is a set of k points of PG(2,q) for some n, but not n + 1 of them, are collinear. A (k,n)-arc is complete if it is not contained in a (k + 1,n)-arc. In this paper we construct complete (kn,n)-arcs in PG(2,5), n = 2,3,4,5, by geometric method, with the related blocking sets and projective codes.

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Thu Apr 01 2021
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Impacts of Starvation Stress on Biofilm Formation and expression of Virulence Genes in Mono-and Mixed-species cultures of Pseudomonas Aeruginosa and Staphylococcus aureus
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Mon Mar 15 2021
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Making use of economical design techniques and materials in implementing cosmetic supplements to the interior spaces of the dwelling: رانيه علي احمد عبد الرحمن
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Publication Date
Tue Dec 20 2022
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Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF THE LARGE-BILLED CROW CORVUS MACRORHYNCHOS WAGLER, 1827 PREDEATING ON THE VULNERABLE INDIAN ROOFED TURTLE PANGSHURA TECTA (GRAY, 1831) IN INDIA
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Publication Date
Sat Aug 21 2021
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Open Access Macedonian Journal Of Medical Sciences
Immunohistochemical Expression of Retinoblastoma Gene Product and p53 Protein in Transitional Cell Carcinoma of the Urinary Bladder and its Relationship to Different Clinicopathological Parameters
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Tue Sep 15 2015
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Wed Jun 19 2019
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Scientific Reports
Environmental microcystin targets the microbiome and increases the risk of intestinal inflammatory pathology via NOX2 in underlying murine model of Nonalcoholic Fatty Liver Disease
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Mon May 27 2019
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Revival of the Heritage Using Porcelain Units Inspired by Traditional Sadou Decoration and Kufic Calligraphy in Fashion Design: تهاني ناصر العجاجي ---وجدان محمد الفليج
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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of an Educational Program upon Academic Nurses’ Practice Concerning Documentation of Nursing Sheets in the Medical and Surgical Teaching Hospitals of Sulaimani Governorate
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Objectives: The study objectives are to determine the impact of education program upon the academic nurses'
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Publication Date
Sat Jan 01 2022
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The slenderness ratio effect on the response of closed-end pipe piles in liquefied and non-liquefied soil layers under coupled static-seismic loading
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