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Cost-effectiveness of on-demand rFVIIa vs prophylactic emicizumab in hemophilia a with inhibitors: clinical, QoL, and ICER-based field insights
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Abstract<sec> <title>Objective

To evaluate the cost-effectiveness of emicizumab compared to recombinant activated factor VII (rFVIIa) in Iraqi patients with hemophilia A and inhibitors.

Method

A retrospective cost-effectiveness analysis was conducted on 46 male patients with hemophilia A and inhibitors treated at a public children’s hospital in Baghdad. Data collection was conducted between November 2024 and March 2025. Clinical and economic data were retrospectively collected for a 12-month follow-up for each of rFVIIa and then emicizumab, including bleeding episodes, emergency visits, treatment costs, and health-related quality of life assessed via EQ-5D-5L (adults) and EQ-5D-Y-3 L proxy (children). Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios were calculated.

Results

Emicizumab improved mean utility scores from 0.10 to 1.00 in children and from 0.32 to 0.89 in adults, corresponding to an incremental cost of –$2726.36 and –$4304.78 per QALY, respectively (indicating cost savings). Annual bleeding episodes dropped from 8.70 to 0, saving $282.04 per episode. Hospitalization costs decreased significantly, resulting in a total saving of $286650.41 per hospitalization prevented. Use of emicizumab also reduced overall healthcare resource utilization, eliminating emergency department visits, and minimizing diagnostic procedures.

Conclusion

Emicizumab delivers substantial clinical and economic benefits over rFVIIa. Its capacity to enhance quality of life while reducing treatment costs positions it as a cost-effective option for adults and children with hemophilia A and inhibitors in resource-constrained settings. Health authorities should prioritize emicizumab over rFVIIa for patients with hemophilia A and inhibitors, due to its superior efficacy and cost-effectiveness.

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical significance of Osteoprotegerin, Vitamin D, Obestatin and some biochemical variables in Kidney failure Patients
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Chronic kidney disease (CKD) is described as an abnormalities of renal function, existing for a long period of time. By reason of the early grades of Chronic kidney disease can be experiences no symptoms, its premature identification is strenuous. initial stage CRD can cause various complications, such as anemia, matabolyic disorders of bone mineral. The study was done to assess the effect the chronic renal disease stage on the Osteoprotegerin, 1,25 dihydroxyvitamin D, Obestatin levels and some biochemical parameters in patients not undertaken dialysis therapy. In this case-control study fifty-five patients with Kidney failure and fourty healthy people were examined. Circulating concentrations of Osteoprotegerin, 1,25 dihydroxyvitamin D

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Publication Date
Thu Sep 01 2016
Journal Name
Injury Prevention
972 The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

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Publication Date
Sun Mar 02 2014
Journal Name
Baghdad Science Journal
The Effect of Vitamin A on Testis Weight and Sexual Glands on Albino Male Mice Treated with Hexavalent Chromium
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This study was conducted to determine the effect of vitamin A ( 10 mg/kg ) on avearage testis weight and sexual glands ( Prostate and Seminal Vesicle ) for albino male mice treated with Hexavalent chromium ( 1000 ppm ) .The current study 40 mice were divided into fife groups : 1st group treated with distilled water and considered an control group (C) / the 2nd group treated with sesame oil ( T1) / 3rd group was givin hexavalent chromium ( 1000 ppm ) (T2) / 4th group treated with vitamin A ( 10 mg / kg ) and exposed to hexavalent chromium ( 1000 ppm ) (T3) / 5th group treated with vitamin A ( 10 mg kg ) (T4) . The expermint lasted 35 day . the results showed a significant ( P ? 0.05 ) decrease in avearage testis weight and sexual glan

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Publication Date
Thu Jun 01 2023
Journal Name
Journal Of Engineering
On the Laser Micro Cutting: Experimentation and Mathematical Modeling based on RSM-CCD
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The laser micro-cutting process is the most widely commonly applied machining process which can be applied to practically all metallic and non-metallic materials. While this had challenges in cutting quality criteria such as geometrical precision, surface quality and numerous others. This article investigates the laser micro-cutting of PEEK composite material using nano-fiber laser, due to their significant importunity and efficiency of laser in various manufacturing processes. Design of experiential tool based on Response Surface Methodology (RSM)-Central Composite Design (CCD) used to generate the statistical model. This method was employed to analysis the influence of parameters including laser speed,

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Physics: Conference Series
Influence of grid-orientation effect on modeling of Iraqi oil field: case studies
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Abstract<p>Reservoir simulation models are utilized by oil and gas companies with a purpose to develop fields. Expansions and improvements in simulation software have lessened the time to develop a model. Simulating the reservoir aims to realize fluid flow, physical, and chemical procedures happening in a hydrocarbon reservoir adequately well for the reason of improving hydrocarbon recovery under various working stipulations. Grid-orientation effects are complicated problem in numerical reservoir simulation. These influences were coming when utilized of numerical utilization mechanism to conditions characterizing physically inconstant displacement procedure. These impacts happen in an assortment</p> ... Show More
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Publication Date
Mon Jan 01 2024
Journal Name
Kuwait Journal Of Science
The effect of magnetic field variations on the spectral properties of tornado plasma
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At atmospheric pressure and at a frequency of 9.1 kHz, a constructed magnetically stabilized tornado gliding arc discharge (MSGAD) system was utilized in this study to generate a non-thermal plasma with an alternating voltage source from 2,4,6,8 to 10 kV. Argon gas was used to generate the arc plasma with an adjustable flow rate using a flow meter regulator to stabilize the gas flow rate to 2 L/min. A gliding plasma discharge is achieved by a magnetic field for the purpose of a planned investigation. The influence of the magnetically stabilized tornado gliding arc discharge parameters such as magnetic field and applied voltage on microscopic tornado plasma parameters was studied. The electron temperature1was measured using a Boltzmann plot

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Publication Date
Sat Feb 25 2017
Journal Name
International Journal On Advanced Science, Engineering And Information Technology
A Novel DNA Sequence Approach for Network Intrusion Detection System Based on Cryptography Encoding Method
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A novel method for Network Intrusion Detection System (NIDS) has been proposed, based on the concept of how DNA sequence detects disease as both domains have similar conceptual method of detection. Three important steps have been proposed to apply DNA sequence for NIDS: convert the network traffic data into a form of DNA sequence using Cryptography encoding method; discover patterns of Short Tandem Repeats (STR) sequence for each network traffic attack using Teiresias algorithm; and conduct classification process depends upon STR sequence based on Horspool algorithm. 10% KDD Cup 1999 data set is used for training phase. Correct KDD Cup 1999 data set is used for testing phase to evaluate the proposed method. The current experiment results sh

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Publication Date
Thu Oct 14 2021
Journal Name
Kufa Medical Journal
The Relationship between Knowledge and Practice in Clinical Breast Examination among Women in Baghdad, Iraq
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Aim: This study aims to determine both the level  of knowledge, attitude, and practice  in clinical breast examination in women and the relationship between knowledge and practice.Data collection was performed within a three-month period starting from February 2019 on.  Subjects and Method: A cross-sectional analytical study included 657 non-randomly selected women visiting primary health care centers in Baghdad city with an average of age between (20-59) years old.  Results: Only 51.8% ever heard of clinical breast examination. The mean knowledge score for clinical breast examination was (51.2±44). Only 5.5% of women performed regular clinical breast examinations. Participants who adequately practice clinical breast examinatio

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Publication Date
Thu Oct 03 2024
Journal Name
Heat Transfer
Field study of a cubical integrated solar collector storage tank under Baghdad province
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Abstract<p>A new, easy‐to‐manufacture, and low‐cost integrated cubical solar collector tank for domestic usage is concerned in this work. Three models are prepared, side by side, and tested to point out their seasonal performance. Tank Model I has three vertical sides, black painted and glazed to act as an absorber; the other sides are insulated. Tank Model II has two black painted and glazed sides, with four insulated surfaces. The models are south‐oriented at different positions and tested versus the conventional tank (Model III) to validate and assess their performance in summer and winter. In summer, the temperatures in Models I and II are lower than those for Model III since they have insulated sid</p> ... Show More
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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
A Hyperbolic Potential Field Model for Designing an Einzel Lens of Low Aberrations
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An analytical model in the form of a hyperbolic function has been suggested for the axial potential distribution of an electrostatic einzel lens. With the aid of this hyperbolic model the relative optical parameters have been computed and investigated in detail as a function of the electrodes voltage ratio for various trajectories of an accelerated charged-particles beam. The electrodes voltage ratio covered a wide range where the lens may be operated at accelerating and decelerating modes. The results have shown that the proposed hyperbolic field has the advantages of producing low aberrations under various magnification conditions and operational modes. The electrodes profile and their three-dimensional diagram have been determined whi

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