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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 25 2019
Journal Name
Al-academy
The Dialectic of the Living Body (the actor) and the Dead Body (the Sinography Item) in the Construction of the Staged Image of the Play: جاسم كاظم عبد - عماد هادي عباس
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The current research deals with the dialectical relationship resulting from the conflict in the violent combination and construction of the living ( the actor)and the dead (the item) in the structure of the Sinography construction and the emergence of the theatrical play space , which can be summed up by the following question: what is the nature of the dialectical relationship between the living (the actor) and the dead( the item) in the Sinography creation, which limited the research in a central objective : to identify the controversy of the living (actor) and the dead (item) in the performance unit of the theatrical scene . The research, in its objective limits set forth in its methodological framework, analyzes this controversy in o

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Publication Date
Fri Dec 08 2023
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Iraqi Journal Of Science
Determination of Atenolol in pharmaceutical formulations by continuous flow injection analysis via turbidimetric (T180o) and scattered light effect at two opposite position (2N90o ) using Ayah 4SW-3D-T180 -2N90 -Solar - CFI
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A simple, rapid and sensitive method for the analysis of Atenolol in pure and pharmaceutical preparation as an alternative analytical procedure were developed by continuous flow injection analysis via turbidimetric (T180o) and scattered light effect at two opposite position (2N90o). The method is based upon the formation of white precipitate for the ion pair compound by phosphomolybidic acid with Atenolol in aqueous medium. The precipitate is measured via the attenuation of incident light and scattering of the incident light in two opposite direction namely +90o and -90o angle were measured. Chemical and physical parameters were investigated. The linearity of Atenolol is ranged from (0.1-11) mmol.L-1, with correlation coefficient r=0.993

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Mon Jun 05 2023
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Adsorption of Chromium (Vi) from Aqueous Solutions using Low Cost Adsorbent: Equilibrium and Regeneration Studies
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Mon Dec 25 2017
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Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Extraction, Identification and Isolation of B-sitosterol from Iraqi Wild Awsaj plant (Lycium barbarum) Using UAE (Probe and Bath) and two isolation technique (HPTLC and PHPLC): B-sitosterol in Iraqi Awsaj plant
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Sun Jan 01 2012
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(OLIGO-X) the effect of salinity of irrigation water and magnetisation and soaking Alalascorbek acid and extracted sea Your protected agriculture. DALIA in germination and growth of seedlings seeds of hybrid option
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Fri Feb 21 2025
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The Effect of Plasma Treatment on Shear Bond Strength of High Impact Acrylic Resin Denture Base Lined with Two Types of Soft Lining Materials after Immersion in Distilled Water and Denture Cleanser
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Publication Date
Sun Jun 02 2019
Journal Name
Journal Of The College Of Languages
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Mon May 20 2024
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Effect of Thermal Neutron Radiation Dose on Density of Local and Extended Energy States in Se<inf>55</inf>S<inf>20</inf>Sb<inf>15</inf>Sn<inf>10</inf> Alloy
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Scopus (1)
Scopus
Publication Date
Sun Jun 02 2019
Journal Name
Journal Of The College Of Languages (jcl)
Religious Discourse of Biblical Intertextuality in Abraham Regelson Works: Selected Samples from the Collection "House of Brightness": הנאום הדתי של האינטרטקסטואליות התנ''כית ביצירותיו של אברהם רגלסון סיפורים נבחרים מקובץ "בית הניצוץ"
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This research display a selected sample of Regelson's texts, there were interrelations and interactions unfolded so as to show his creativity in the employment of religious texts. In the story "In the Youth of Moses", he inter-texted the episode of the Prophet Moses from the Torah, the Source of legislation, to signify a legislative issue needed by the community. As for the story of "Samson, One of the Falling", he originated the character of The Judge Samson by alluding to the Book of the Judges, which is the Book which reminded of the defeat and slavery of the Palestinians by a Jewish leader, as is related in Jewish religious texts. Further, and the story of "And Haman Said", he chose the story of the Queen Esther from the Book of Esth

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Publication Date
Fri Jun 30 2023
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Iraqi National Journal Of Nursing Specialties
Evaluations of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis
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