Document Type : Research articles

Author

Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran; Department of Pharmacoeconomics and Management, School of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran ; Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran

Abstract

Background: The COVID-19 pandemic has caused many economic problems worldwide, in Iran as well, causing Hospitals to face many financial problems.
Objectives: Based on documented data on pharmacotherapy, costs, and its effectiveness, this study aimed to analyze the costs and outcomes of hospitalized patients with COVID-19 under pharmacotherapy in Iran.
Methods: This research was a retrospective analytical descriptive study. Relevant data of the COVID-19 hospitalized patients were extracted from the Hospitals Medical Records Department. All items of direct medical costs, such as visits, nursing services, consuming materials, laboratories, imaging, medical operations, medications, and beds, were extracted by reviewing COVID-19 hospitalized patients files in different wards of the Shohada Ashayer Hospital in Khorramabad city in 2021.
Results: A total of 399 patients were examined in this study. The total direct medical costs per patient was 338.63 US$. Of note, the highest cost was related to medicine (32.56%), more than the cost of bed (22.77%). The most commonly used drugs were Lopinavir (95%) and Azithromycin (90%), and the highest medicine cost per patient was related to Immunoglobulin (64.32 US$) and Remdesivir (46.91 US$).
Conclusion: Medicine and hospitalization costs accounted for the largest share of the total treatment costs of patients. Therefore, reducing bed costs requires home treatments and outpatient injections. Furthermore, due to rising drug costs, prescriptions should be based on standard treatment protocols.

Keywords

  1. Chowdhury R, Heng K, Shawon MSR, Goh G, Okonofua D, Ochoa-Rosales C, et al. Dynamic interventions to control COVID-19 pandemic: a multivariate prediction modelling study comparing 16 worldwide countries. Eur J Epidemiol. 2020;
  2. (5):389-99. doi: 10.1007/s10654-020-00649-w. [PubMed: 32430840].
  3. WHO. Coronavirus disease (COVID-19): weekly epidemiological. World Health Organization; 2020.
  4. Pan X, Dong L, Yang L, Chen D, Peng C. Potential drugs
  5. for the treatment of the novel coronavirus pneumonia
  6. (COVID-19) in China. Virus Res. 2020;286:198057. doi: 10.1016/j.virusres.2020.198057. [PubMed: 32531236].
  7. Cost KT, Crosbie J, Anagnostou E, Birken CS, Charach A, Monga S, et al. Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents. Eur Child Adolesc Psychiatry. 2022;31(4):671-84. doi: 10.1007/s00787-021-01744-3. [PubMed: 33638005].
  8. McKee M, Stuckler D. If the world fails to protect the economy, COVID-19 will damage health not just now but also in the future. Nat Med. 2020;26(5):640-2. doi: 10.1038/s41591-020-0863-y. [PubMed: 32273610].
  9. Congly SE, Varughese RA, Brown CE, Clement FM, Saxinger L. Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis. Sci Rep. 2021;11(1):1-7. doi: 10.1038/s41598-021-97259-7. [PubMed: 34493774].
  10. Yamin M. Counting the cost of COVID-19. Int J Inf Technol. 2020;12(2):311-7. doi: 10.1007/s41870-020-00466-0. [PubMed: 32412538].
  11. Carta A, Conversano C. Cost utility analysis of Remdesivir and Dexamethasone treatment for hospitalised COVID-19 patients-a hypothetical study. BMC Health Serv Res. 2021;21(1):1-12. doi: 10.1186/s12913-021-06998-w. [PubMed: 34537034].
  12. Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC, et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med. 2020;383(6):517-25. doi: 10.1056/NEJMoa2016638. [PubMed: 32492293].
  13. Docherty A, Harrison E, Green C, Hardwick H, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;
  14. :m1985. doi: 10.1136/bmj.m1985. [PubMed: 32444460].
  15. WHO. Case-based payment systems for hospital funding in Asia an investigation of current status and future directions: an investigation of current status and future directions. OECD Publishing; 2015.
  16. Yigezu A, Zewdie SA, Mirkuzie AH, Abera A, Hailu A, Agachew M, et al. Cost-analysis of COVID-19 sample collection, diagnosis, and contact tracing in low resource setting: The case of Addis Ababa, Ethiopia. PloS One. 2022;17(6):e0269458. doi: 10.1371/journal.pone.0269458. [PubMed: 35679290].
  17. Thant PW, Htet KT, Win WY, Htwe YM, Htoo TS. Cost estimates of COVID-19 clinical management in Myanmar. BMC Health Serv Res. 2021;21(1):1-10. doi: 10.1186/s12913-021-07394-0. [PubMed: 34961536].
  18. Memirie ST, Yigezu A, Zewdie SA, Mirkuzie AH, Bolongaita S, Verguet S. Hospitalization costs for COVID-19 in Ethiopia: Empirical data and analysis from Addis Ababa’s largest dedicated treatment center. PloS One. 2022;17(1):e0260930. doi: 10.1371/journal.pone.0260930. [PubMed: 35061674].
  19. Hayati H. Comparison of the Unit Cost of Diagnostic Imaging Services Before and During the COVID-19 Pandemic Using the Activity-Based Costing (ABC) Method. Iran J Radiol. 2022;19(3):e123781.
  20. Hayati H, Kebriaeezadeh A, Ehsani MA, Nikfar S, Sari AA, Mehrvar A, et al. Cost-Utility of protocols of BFM-ALL and UK-ALL for treatment of children with acute lymphoblastic leukemia in Iran. Iran J Public Health. 2018;47(3):407-12. [PubMed: 29845029].
  21. Jin H, Wang H, Li X, Zheng W, Ye S, Zhang S, et al. Economic burden of COVID-19, China, January–March, 2020: a cost-of-illness study. Bull World Health Organ. 2021;99(2):112-24. doi: 10.2471/BLT.20.267112. [PubMed: 33551505].
  22. Hayati H, Kebriaeezadeh A, Ehsani M-A, Nikfar S. Cost-Analysis of Treatment of Childhood Acute Lymphoblastic Leukemia Based on UKALL Protocol. Iran J Pediatr. 2018;28(6):e7985. doi: 10.5812/ijp.7985.
  23. Rahati M, Fakharian E, Yousefianarani A, Omidvar A, Nazemi-bidgoli Z. Treatment Cost of COVID-19 in Hospitals
  24. affiliated to Kashan University of Medical Sciences: Time-Driven Activity-Based Costing. MSHSJ. 2021;5(4):1-13. doi: 10.18502/mshsj.v5i4.5808.
  25. Sinha P. Tocilizumab cost effective in reducing COVID-19-related deaths. PharmacoEcon Outcomes News. 2021;879(1):28-9. doi: 10.1007/s40274-021-7751-7. [PubMed: 34075294].
  26. Jiang Y. Remdesivir cost effective for severe COVID-19 in China. PharmacoEcon Outcomes News. 2021;877(1):17-1. doi: 10.1007/s40274-021-7666-3. [PubMed: 33948076].
  27. Rae M, Claxton G, Kurani N, McDermott D, Cox C. Potential costs of coronavirus treatment for people with employer coverage. Peterson Kaiser FF. 2020;13:1-13.
  28. Yaghoubi M, Salimi M, Meskarpour-Amiri M, Hosseini_shokouh SM. COVID-19-related absenteeism and presenteeism among healthcare workers. Iran Red Crescent Med J. 2022;
  29. (10):e1785. doi: 10.32592/ircmj.2022.24.10.1785.