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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
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Clinical Evaluation of the Levels of CEA,CA15-3 and AlphaFeto Protein in Malignant and Benign Pleural Effusion
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Background: Pleural effusion is a common clinical
problem.
Objective: The aim of the study was to evaluate the
diagnostic utility of Carcino embryonic antigen
(CEA), CA 15- 3, and alpha-feto protein ( AFP ) as
a tumor markers in serum and pleural effusion and
evaluate the value of combining them as a diagnostic
tools that are complementary to cytology in the
diagnosis of malignancies .
Methods: Forty patients (18 malignant and 22 benign
pleural effusion) were included in this study .The
serum and effusion levels of CEA, CA 15 – 3 and
AFP were measured using immunoradiometric assay
Results: from the 40 effusions studied 26 were
exudates and 14 were transudates. The level of
pleural effusions

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Publication Date
Mon Jul 18 2022
Journal Name
International Journal Of Early Childhood Special Education
The effectiveness of a proposed teaching strategy according to The Common Knowledge Construction Model in Mathematical Proficiency for middle school student
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This research aims to know the effectiveness of teaching with a proposed strategy according to the common Knowledge construction modelin mathematical proficiency among students of the second middle class. The researchers adopted the method of the experimental approach, as the experimental design was used for two independent and equal groups with a post-test. The experiment was applied to a sample consisting of (83) students divided into two groups: an experimental comprising (42) students and a control group, the second comprising (41) students., from Badr Shaker Al-Sayyab Intermediate School for Boys, for the first semester of the academic year (2021-2022), the two groups were rewarded in four variables: (chronological age calculated in mo

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Publication Date
Sun Sep 01 2013
Journal Name
International Journal Of Computer Applications
Concise Architecture of a Remote Network based Controller
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The development of microcontroller is used in monitoring and data acquisition recently. This development has born various architectures for spreading and interfacing the microcontroller in network environment. Some of existing architecture suffers from redundant in resources, extra processing, high cost and delay in response. This paper presents flexible concise architecture for building distributed microcontroller networked system. The system consists of only one server, works through the internet, and a set of microcontrollers distributed in different sites. Each microcontroller is connected through the Ethernet to the internet. In this system the client requesting data from certain side is accomplished through just one server that is in

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Applied Pharmaceutical Science
The role of angiotensin converting enzyme (insertion)/(deletion) and angiotensin II type 1 receptor (A1166C) gene polymorphisms in antiproteinuric effect of ACE inhibitors in type 2 diabetic Iraqi patients
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The angiotensin converting enzyme (ACE) I\D gene polymorphism influences the blood ACE enzyme activity. Renoprotective effect of ACE inhibitors (ACEIs) varies among patients due to genetic variation, particularly in Renin-Angiotensin-Aldosterone System genes. This study investigates the genetic variations of ACE I\D and AGT1RA1166C gene polymorphisms in the antiproteinuric effect of ACEI therapy in type 2 diabetes mellitus (T2DM) patients. This is a cross-sectional study that included 76 T2DM patients who are ACEI users, divided into two groups: T2DM without diabetic kidney disease (DKD) included 31 patients, and T2DM with DKD included 45 patients. Urine samples were taken for measurement of urine albumin and creatinine, then calcul

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Publication Date
Sat Dec 30 2023
Journal Name
Wasit Journal For Pure Sciences
Honeywords Generation Technique based on Meerkat Clan Algorithm and WordNet
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The efficiency of the Honeywords approach has been proven to be a significant tool for boosting password security. The suggested system utilizes the Meerkat Clan Algorithm (MCA) in conjunction with WordNet to produce honeywords, thereby enhancing the level of password security. The technique of generating honeywords involves data sources from WordNet, which contributes to the improvement of authenticity and diversity in the honeywords. The method encompasses a series of consecutive stages, which include the tokenization of passwords, the formation of alphabet tokens using the Meerkat Clan Algorithm (MCA), the handling of digit tokens, the creation of unique character tokens, and the consolidation of honeywords. The optimization of t

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Publication Date
Tue Jun 23 2020
Journal Name
Baghdad Science Journal
Anomaly Detection Approach Based on Deep Neural Network and Dropout
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   Regarding to the computer system security, the intrusion detection systems are fundamental components for discriminating attacks at the early stage. They monitor and analyze network traffics, looking for abnormal behaviors or attack signatures to detect intrusions in early time. However, many challenges arise while developing flexible and efficient network intrusion detection system (NIDS) for unforeseen attacks with high detection rate. In this paper, deep neural network (DNN) approach was proposed for anomaly detection NIDS. Dropout is the regularized technique used with DNN model to reduce the overfitting. The experimental results applied on NSL_KDD dataset. SoftMax output layer has been used with cross entropy loss funct

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Publication Date
Tue Aug 24 2021
Journal Name
Conference: The 5th International Multi-conference On Artificial Intelligence Technology (mcait 2021).
Text Encryption Based on DNA Cryptography, RNA, and Amino Acid
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To achieve safe security to transfer data from the sender to receiver, cryptography is one way that is used for such purposes. However, to increase the level of data security, DNA as a new term was introduced to cryptography. The DNA can be easily used to store and transfer the data, and it becomes an effective procedure for such aims and used to implement the computation. A new cryptography system is proposed, consisting of two phases: the encryption phase and the decryption phase. The encryption phase includes six steps, starting by converting plaintext to their equivalent ASCII values and converting them to binary values. After that, the binary values are converted to DNA characters and then converted to their equivalent complementary DN

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Publication Date
Fri Oct 01 2021
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Color image compression based on spatial and magnitude signal decomposition
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<p>In this paper, a simple color image compression system has been proposed using image signal decomposition. Where, the RGB image color band is converted to the less correlated YUV color model and the pixel value (magnitude) in each band is decomposed into 2-values; most and least significant. According to the importance of the most significant value (MSV) that influenced by any simply modification happened, an adaptive lossless image compression system is proposed using bit plane (BP) slicing, delta pulse code modulation (Delta PCM), adaptive quadtree (QT) partitioning followed by an adaptive shift encoder. On the other hand, a lossy compression system is introduced to handle the least significant value (LSV), it is based on

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Publication Date
Fri Jan 10 2025
Journal Name
International Journal Of Scientific Research In Science, Engineering And Technology
Image Cryptography Based on Chebyshev Polynomials and Transposition- Substitution Transformations
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The confirming of security and confidentiality of multimedia data is a serious challenge through the growing dependence on digital communication. This paper offers a new image cryptography based on the Chebyshev chaos polynomials map, via employing the randomness characteristic of chaos concept to improve security. The suggested method includes block shuffling, dynamic offset chaos key production, inter-layer XOR, and block 90 degree rotations to disorder the correlations intrinsic in image. The method is aimed for efficiency and scalability, accomplishing  complexity order for n-pixels over specific cipher rounds. The experiment outcomes depict great resistant to cryptanalysis attacks, containing statistical, differential and brut

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Publication Date
Mon May 11 2020
Journal Name
Baghdad Science Journal
Towards Accurate Pupil Detection Based on Morphology and Hough Transform
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 Automatic recognition of individuals is very important in modern eras. Biometric techniques have emerged as an answer to the matter of automatic individual recognition. This paper tends to give a technique to detect pupil which is a mixture of easy morphological operations and Hough Transform (HT) is presented in this paper. The circular area of the eye and pupil is divided by the morphological filter as well as the Hough Transform (HT) where the local Iris area has been converted into a rectangular block for the purpose of calculating inconsistencies in the image. This method is implemented and tested on the Chinese Academy of Sciences (CASIA V4) iris image database 249 person and the IIT Delhi (IITD) iris

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