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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
Mon Mar 15 2021
Journal Name
Al-academy
The effectiveness of media communication and its problems in the contemporary theatrical presentation: راسل كاظم عوده-سلمان خلف حسين
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The theater can be considered a media that the effectiveness of its tools and the perceptions it produces cannot be abandoned according to patterns or aesthetic artistic trends, and at the same time it carries a large amount of information that can be worked on activating it with conscious directions within the elements of the theatrical performance, and these can be counted The study is an attempt to trace the functioning of the communication and media elements in the structure of the theatrical performance, as the study included: An introduction that defines the research problem and its importance, which crystallized around the following question: Does the media communication through theatrical presentation form its desired effectivene

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of The Knowledge Management Processes in Insurance Service Performance: An Applied Research at The National Insurance Company
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The research aims to measure the relationship and the impact of knowledge management processes to achieve the performance of insurance service, as well as analysis of the reality of the National Insurance Company to identify the level of overall performance, and to achieve this goal, it has been the selection of knowledge management processes according to the survey prepared a supplement to the study (Qubaisi, 2002), and of the four operations (knowledge generation, and storage of knowledge, and the distribution of knowledge, and application of knowledge), which represented the independent variable, and the performance has been the use of quantitative and qualitative measures, (sales growth, customer satisfaction), which represented the

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Publication Date
Sun Dec 22 2024
Journal Name
Baghdad Science Journal
Thioflavin T Production in Coelastrella saipanensis LC752948.1: Impact of Sodium Chloride, growth phases, and their effect on growth parameters
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The present study aimed to investigate the possible production of Thioflavin T and the effect of NaCl concentrations and growth phases on the growth rate, doubling time and proline of C. saipanensis N. Hanagata (Scenedesmaceae, Shaerophleales). The alga was cultured in BG 11 medium and six NaCl concentrations were used in the experiments during different growth phases. The results have unveiled the presence of Triflavin T in the alga. The study results showed a growth rate decrease at all NaCl concentrations except in control treatment, while the doubling time, was recorded highest value (14 days) at the NaCl concentration of 0.08 M. The highest value of Proline (0.509 mg. Lˉ¹) was recorded at the treatment of 0.08 M of NaCl and recorded

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Publication Date
Fri Dec 01 2023
Journal Name
Agbioforum
The Role of the Digital Economy, Business Synergy, and Trade Policies on Global Economic Prosperity in India and China
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The necessity of addressing global economic prosperity has garnered significant attention from recent studies and policymakers. This article analyses the effects of the digital economy, business synergies, and trade policies on the economic prosperity of China and India. The study examines the impact of political support on the digital economy, business synergies, trade policies, and global economic prosperity in China and India. The study collects data from prominent economists in India and China using questionnaires. The article utilised the SPSS-AMOS software to analyse the relationship between variables. The results showed that the digital economy, business synergies, and trade policies are positively linked to global economic prosperit

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Publication Date
Sun Mar 04 2018
Journal Name
Iraqi Journal Of Science
Effect of maternal exposure of silver nanoparticles on the histogenesis of cerebellum in post-implantation of albino rats embryos
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Publication Date
Thu Dec 15 2022
Journal Name
Romanian Neurosurgery
Mobilization of the temporal pole as integrated step in microsurgical clipping of pure posteriorly directed posterior communicating artery aneurysm
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A pure posteriorly posterior communicating artery (PCoA) aneurysm represents a surgical challenge. This is mainly when there is a need for good exposure of the aneurysmal neck, sac, PCoA, and anterior choroidal arteries. Ruptured pure posteriorly directed PCoA aneurysm imposes significantly extra challenge as the surgeon undergoes dissection through a tight brain. Even with measures commonly used to attain brain relaxation like the lumbar drain and cisternal fenestration. Here, we describe a technique for posterior temporal pole mobilization (TPM) as an integrated part of microsurgical clipping of ruptured pure posteriorly directed PCoA aneurysms. This technique is implicated in twenty-three successive cases of ruptured PCoA aneurys

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Publication Date
Wed Sep 01 2021
Journal Name
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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The experiment has been carried out in the Syrian National Commission of Biotechnology, during the growing season 2018/2019, to study the effect of abiotic stresses (salinity and osmotic stresses) on the activity of some antioxidant enzymes and biochemical traits in Catharanthus roseus. The experiment has been laid according to (CRD) with three replications. The seeds have been sterilized by NaOCl solution (0.5% v/v), then planted on MS medium. Plantlets have been moved to MS medium enriched with NAA (1 mg.L-1) and BA (2 mg.L-1). The callus has been initiated from leaves using MS medium containing NAA (1 mg L-1) and KIN (2 mg.L-1). After 60 days, callus

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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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The study involved 45 male and 45 females of diabetic patients type- ?? aged from 40-69years , and with the same numbers of males and females for control , all the patients and controls were without any periodontal diseases and without any systemic disease. Diabetic patients were divided in to three groups according to the degree of periodontitis , and the inflamed gingiva of all groups of diabetic patients were treated with the dried fruits powder (crude) of medicinal plants Quercus robur , Thuja occidenalis , Terminalia chebula, Anethum graveolens , respectively and mixture. Some immunological and antimicrobial factors (IgA, Lactoferrin , Lysozyme ) , were detected in serum and saliva of diabetic patients and the control

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Publication Date
Sun Dec 27 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Limitation of liability and reinsurance and its role in increasing production insurance: بحث أستطلاعي في شركة التامين العراقية العامة
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The liability limit liability limit and reinsurance re factors insurance are important in influencing the achievement of company's competitive goals and achieve success and excellence in the market and because the limit of liability and reinsurance aimed to increase output with the stability of inputs leading to increased insurance business and increase profits. The study was based on two variables presidents interact with each other to form the intellectual and philosophical framework has two ( the limit of liability and reinsurance ) . The study was launched from a problem expressed by a number of targeted questions answered from the elucidation of theoretical philosophy and intellectual goals of these variables and highlight the impor

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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
An Evaluation of the Activity of Prepared Zinc Nanoparticles with Extracted Alfalfa Plant in the Treatment of Heavy Metals
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The alfalfa plant, after harvesting, was washed, dried, and grinded to get fine powder used in water treatment. We used the alfalfa plant with ethanol to make the alcoholic extract characterized by using (GCMass, FTIR, and UV) spectroscopy to determine active compounds. Alcoholic extract was used to prepare zinc nanoparticles. We characterized Zinc nanoparticles using (FTIR, UV, SEM, EDX Zeta potential, XRD, AFM). Zinc nanoparticle with Alfalfa extract and alfalfa powder were used in the treatment of water polluted with inorganic elements such as Cr, Mn, Fe, Cu, Cd, Ag by (Batch processing). The batch process with using alfalfa powder gets treated with Pb (51.45%), which is the highest percentage of treatment. Mn (13.18%), which is the lowe

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