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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
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Female Students’ Knowledge toward Premenstrual Syndrome in Secondary Schools in Third Al- Rusafa Education Directorate, Iraq
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Objective: To evaluate the effectiveness of educational program on female students’ knowledge toward premenstrual syndrome.
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Publication Date
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
Contradiction oppositon al ruwia and al fatwa and his impact in different jurists in personal status and transactions and adomment
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المقدمة

 الحمد لله رب العالمين، وأفضل السلام وأتم التسليم على سيدنا محمد، وعلى آله وصحبه، أجمعين، وعلى من تبعهم بإحسان إلى يوم الدين، أما بعد.

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Visions in the poetry of Yahiya Ibn Hakam AL- Chazali: Visions in the poetry of Yahiya Ibn Hakam AL- Chazali
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Conclusion and results
1. The research concluded through considering the rhetorical visions,
appropriate relationships between utterances with a language derived
from the reality of the social, religious, and, cultural life.
2. The poet compound between realism and the documentation of the
poetic structure, its depth, and the conjugation of its symbolic
metaphors, and also between its phonetic music and the right artistic
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Haikal concluded that the tried to com up with something better than
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Publication Date
Sun Mar 01 2020
Journal Name
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Evaluation of Sex Hormone Levels in Benign Prostatic Hyperplasia Patients Treated with 5 Alpha-Reductase Inhibitor (Finasteride) in Amara city/Iraq
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The present study aimed to determine the serum sex hormone levels among Benign Prostatic Hyperplasia (BPH) patients before and after 3 months of oral administration of 5-α reductase inhibitor(finasteride). Forty BPH patients and 40 healthy men from Amara city were involved in this study, their ages were between 40-59 year. They were all subjected  to direct estimation of hormones by MinVidas method including Testosterone (T), Estradiol (E2), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Prolactin (PRL), and Dihydrotestosterone (DHT) before and after 3 months of treatment with 5α-reductase inhibitor (finasteride) (the healthy individuals didn’t take finasteride).The results showed that T level was significantly lo

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Tue Feb 04 2014
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Self Medication Practice among Iraqi Patients in Baghdad City
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Fri Nov 10 2017
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The main idea of this research is that the researcher believes that media research remains useless unless its goals and results are achieved by using the correct scientific tools. The researcher chooses 100 research papers of about 35% of the published ones, 10 of them are excluded because they are outside media. We use a simple and randomized sample including the three departments of media: journalism, television and radio journalism and public relations. The researcher adopts statistical methods such as Fay coefficient, correlation coefficient, Pearson correlation coefficient and straight line equation.
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Sun Aug 17 2025
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Publication Date
Mon Feb 04 2019
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Some Methodological Notes on Ibn Al-Jezri Book: Ghayat Al-Nihaya (The Aim of the End): Some Methodological Notes on Ibn Al-Jezri Book: Ghayat Al-Nihaya (The Aim of the End)
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Abstract
Dame Ngaio Edith Marsh (1899-1982), a writer of detective fiction, was born
at Christchurch, New Zealand. Her hero, Chief Detective Inspector Roderick Alleyn,
appears in her first novel, A Man Lay Dead (1934), and in subsequent novels
including Death and the Dancing Footman (1942). She wrote twenty detective novels.
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radio where William lay dead after being killed by his brother, Nicholas,
provides the most suspected guest at Highfold with badly needed alibi. The murderer,
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Sun Mar 02 2014
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