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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
Sat Jan 01 2022
Journal Name
Open Engineering
Producing low-cost self-consolidation concrete using sustainable material
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Abstract<p>The disposal of the waste material is the main goal of this investigation by transformation to high-fineness powder and producing self-consolidation concrete (SCC) with less cost and more eco-friendly by reducing the cement weight, taking into consideration the fresh and strength properties. The reference mix design was prepared by adopting the European guide. Five waste materials (clay brick, ceramic, granite tiles, marble tiles, and thermostone blocks) were converted to high-fine particle size distribution and then used as 5, 10, and 15% weight replacements of cement. The improvement in strength properties is more significant when using clay bricks compared to other activated waste </p> ... Show More
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Publication Date
Sat Jan 01 2022
Journal Name
Open Engineering
Producing low-cost self-consolidation concrete using sustainable material
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Abstract<p>The disposal of the waste material is the main goal of this investigation by transformation to high-fineness powder and producing self-consolidation concrete (SCC) with less cost and more eco-friendly by reducing the cement weight, taking into consideration the fresh and strength properties. The reference mix design was prepared by adopting the European guide. Five waste materials (clay brick, ceramic, granite tiles, marble tiles, and thermostone blocks) were converted to high-fine particle size distribution and then used as 5, 10, and 15% weight replacements of cement. The improvement in strength properties is more significant when using clay bricks compared to other activated waste </p> ... Show More
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Publication Date
Tue Sep 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Low Cost Heart Rate Monitor Using Led-Led Sensor
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A high sensitivity, low power and low cost sensor has been developed for photoplethysmography (PPG) measurement. The PPG principle was applied to follow the dilatation and contraction of skin blood vessels during the cardiac cycle. A standard light emitting diodes (LEDs) has been used as a light emitter and detector, and in order to reduce the space, cost and power, the classical analogue-to-digital converters (ADCs) replaced by the pulse-based signal conversion techniques. A general purpose microcontroller has been used for the implementation of measurement protocol. The proposed approach leads to better spectral sensitivity, increased resolution, reduction in cost, dimensions and power consumption. The basic sensing configuration prese

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Publication Date
Fri Feb 09 2001
Journal Name
Molecular Crystals And Liquid Crysta
Synthesis and characterization of symmetrical liquid crystalline compounds based on oxazole and thaizole rings
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Twelve compounds containing a sulphur- or oxygen-based heterocyclic core, 1,3- oxazole or 1,3-thiazole ring with hydroxy, methoxy and methyl terminal substituent, were synthesized and characterized. The molecular structures of these compounds were performed by elemental analysis and different spectroscopic tequniques. The liquid crystalline behaviors were studied by using hot-stage optical polarizing microscopy and differential scanning calorimetry. All compounds of 1,4- disubstituted benzene core with oxazole ring display liquid crystalline smectic A (SmA) mesophase. The compounds of 1,3- and 1,4-disubstituted benzene core with thiazole ring exhibit exclusively enantiotropic nematic liquid crystal phases.

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of Educational And Psychological Researches
Test the effectiveness of Method EMDR
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Our country faced lots of crises specially Wars and still living under the traumatic events. This would result in psychological disorder specially the Acute Stress Disorder (ASD). That’s if not treated, it will turn to be over Post Traumatic Stress Disorder(PTSD). Also not mentioning the shortage of recourses speaks about war and crises. That treat with its inflections psychologically and sociologically theses cases if happened.

The importance of this study arise through it is objective to introduce a program for EMDR which give benefit for treat in health, social, educational institutes.

Aims:

The objective of this Study is the identification of a Test the effectiveness of Eye Movement Desensi

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Publication Date
Tue Jan 01 2019
Journal Name
Aip Conference Proceedings
Improvement of electrical features of SnO2 based varistor doped with Al2O3
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One of the important objectives of the varistor is for a sustainable environment and reduce the pollution resulting from the frequent damage of the electrical devices and power station waste. In present work, the influence of Al2O3 additives on the non –linear electrical features of SnO2 varistors, has been investigated, where SnO2 ceramic powder doped with Al2O3 in three rates (0.005, 0.01, and 0.05), the XRD test improved that SnO2 is the primary phase, while CoCr2O4, and Al2O3 represent the secondary phases. The electrical tests of all prepared samples confirmed that the increasing of Al2O3 rates and sintering temperature improves and increase the electrical features, where the best results obtained at Al2O3 (0.05) and 1000℃, the non

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Publication Date
Fri Mar 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
Efficiency of osseodensification versus screw expansion technique for augmentation of narrow alveolar ridges: A comparative clinical study
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Background: Alveolar ridge expansion is proposed when the alveolar crest thickness is ≤5 mm. The screw expansion technique has been utilized for many years to expand narrow alveolar ridges. Recently, the osseodensification technique has been suggested as a reliable technique to expand narrow alveolar ridges with effective width gain and as little surgical operating time as possible. The current study aimed to compare osseodensification and screw expansion in terms of clinical width gain and operating time. Materials and methods: Forty implant osteotomies were performed in deficient horizontal alveolar ridges (3–5 mm). A total of 19 patients aged 21–59 years were randomized into two groups: the screw expansion group, which invo

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract

    Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma. 

    This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthm

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Publication Date
Thu Jun 25 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Evaluating the Clinical Outcomes of Three Medication Regimens for Treating a Sample of Iraqi Persistent Asthmatic patients
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Abstract     Asthma is a complex disease defined by chronic airway inflammation and airflow limitation causing variable respiratory symptoms which include shortness of breath (SOB), wheezing, chest tightness and cough. Asthma guidelines advocate adding a second long acting bronchodilator to medium doses of inhaled corticosteroids (ICS) rather using high doses of ICS alone to control moderate to severe persistent asthma. The aim of this study was to evaluate the clinical outcomes of three medication regimens indicated for Iraqi patients suffering from persistent asthma.      This study was interventional randomized clinical study conducted on a sample of adult Iraqi asthmatic patients in Baghdad City. The study com

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical

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