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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 Sep 01 2020
Journal Name
Al-khwarizmi Engineering Journal
UAV Control Based on Dual LQR and Fuzzy-PID Controller
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This paper presents the design of a longitudinal controller for an autonomous unmanned aerial vehicle (UAV). This paper proposed the dual loop (inner-outer loop) control based on the intelligent algorithm. The inner feedback loop controller is a Linear Quadratic Regulator (LQR) to provide robust (adaptive) stability. In contrast, the outer loop controller is based on Fuzzy-PID (Proportional, Integral, and Derivative) algorithm to provide reference signal tracking. The proposed dual controller is to control the position (altitude) and velocity (airspeed) of an aircraft. An adaptive Unscented Kalman Filter (AUKF) is employed to track the reference signal and is decreased the Gaussian noise. The mathematical model of aircraft

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Publication Date
Wed Oct 30 2024
Journal Name
Iraqi Journal Of Science
Effectiveness of Eucalyptus camaldulensis Leaves Oil in Upregulating exoU expression in Pseudomonas aeruginosa
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Results of the current study demonstratedthat out of eighty-three isolatesof Pseudomonas aeruginosa,only twenty-five isolateswere resistant to five different antibiotics (of different classes) that were consequentlyconsideredmultidrug resistant isolates.These isolates developed variable susceptibility toward Eucalyptuscamaldulensisleavesoil (ECO). GC-MS analysis of ECOrevealed that the aromatic oil eugenol is the major constituent.However, the most frequent MIC was 0.39 µg/ml, while the lowest frequent MIC was 3.125 µg/ml.Moreover, this oil at ½ MIC (0.195µg/ml) increased the gene expression of exoU. Itis concluded from the outcomes of the studythat ECOmay cause severe damagewhen used to treat infections caused by P. aeruginosa.

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Clinical Evaluation of Some Biochemical Parameters from Patients in Heamodialysis Room
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As a marker of systemic inflammation, raised (C-reactive protein (CRP)) concentrations which are still within the normal range have been associated with an increased inflammation of chronic renal diseases (CRD). The current study aimed to establish potential determinats of raised CRP concentrations in patients who treated in Heamodialysis room,then study the relationship between CRP& some biochemical parameters related CRD We used a CRP latex reagents Kit which is based on an immunological reaction between CRP antisera bounded to the biologically inert latex particles or with CRP in the test specimens of 19 patients with (CRD) mean age 48 years ,range = 30?65 & in 21 healthy subjects as control group their age range = 30 ?45 years. The

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Publication Date
Fri May 31 2024
Journal Name
Research Journal Of Biotechnology
The Utility of SHBG Assay in Clinical Biochemistry for Iraqi Women
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Polycystic ovarian syndrome, additionally called PCOS is the most widespread endocrine illness amongst women. The aetiology of PCOS is attributed to a multi-factorial interplay among environmental and genetic effects. The overarching goal evaluates the correlation among blood concentrations of total testosterone, sex-hormone-binding globulin (SHBG), estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in ladies with PCOS and the impact of obesity, age, marital popularity on the obtained results. This study was conducted at the National Center for Educational Laborites /Medical City/ Baghdad. The study comprised of a sample of 83 women, elderly between 17 -45 years, who had been selected in a random manner

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Role of the Clinical Pharmacist in Reducing Preventable Adverse Drug Events
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According to so many previous studies, lack of sufficient information during prescribing steps may lead to medication errors. Thus, the presence of the clinical pharmacist during routine rounding process in the ward with intervention of patient care plan may reduce the probability of adverse drug events (ADEs).This study evaluate role of the clinical pharmacists, as a member of medical team with the physician, on ADEs and report their interventions in the internal medicine unit. This study was designed to compare between two groups of patients, those receiving care from a rounding team (physician, nurse, and clinical pharmacist) (study or intervention group with 51 patient); and those receiving c

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Publication Date
Sat Dec 30 2023
Journal Name
Al-kindy College Medical Journal
Is the Clinical Diagnosis of Cutaneous Leishmaniasis Justified in Endemic Regions?
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Leishmaniasis is a transmissible infection brought about by an obligatory intracellular protozoan from the genus Leishmania.  It occurs worldwide in tropical and subtropical regions and can be burdensome in resource-constrained countries. The infection ranges in severity from mild cutaneous lesions to more severe and sometimes life-threatening visceral and distorting mucocutaneous sicknesses. Importantly, cutaneous leishmaniasis (CL) is prevalent in the Middle East with a pooled prevalence of 12%. It imposes a significant health and socioeconomic burden

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Publication Date
Thu Dec 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Analysis of Four Maternity Deaths in Iraq by COVID-19
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This study aims to identify maternal death cases caused by Coronavirus infection 2019 pneumonia, including disease progression, fetal consequences, and the fatality cause.

Patients and methodology: A retrospective case collection of Iraqi pregnant women in their second and third trimesters diagnosed with COVID-19 pneumonia and died due to it.

The four cases were all of a young age, had a brief complaint period, and had no comorbidities. Fever, dyspnea, and fatigue were the most common symptoms. Hypoxia was present in all cases and was the cause of mortality in three cases, with thromboembolism being a potential cause in the fourth. Prelabour membrane breakup, fetal growth restriction, and fetal death are al

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Publication Date
Sun Mar 04 2018
Journal Name
Baghdad Science Journal
Genotyping of fusA Gene from Clinical Isolates Acinetobacter baumannii in Baghdad
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This study aims at detecting the differences in genotyping of coding region fusA gene in clinical isolates of Acinetobacter baumannii from Baghdad, Iraq. Collected two hundred clinical samples (50 samples from urine, 50 samples from wound, 50 samples from sputum and 50 samples from otitis infections). Laboratory diagnosis for bacterial isolates carried out by some biochemical tests and confirmed by using VITEK- 2 compact system. The results appeared that twenty isolates of Acinetobacter baumannii in all these samples. Genotyping study was performed of coding region fusA gene of the extracted genome of all bacterial isolates and used specific primers in achieved amplification process of this target gene. DNA sequencing of this gene and alig

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The reality of the application of cost accounting system in the contracting institutions in the kingdom of Saudi Arabia
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The study aimed to identify the reality of the application of cost accounting system in the contracting institutions in Saudi Arabia, and the extent of the reflection of the application of this system on the effectiveness and efficiency of the general performance of these institutions. Where the research community consists of the contracting institutions operating in the Saudi Arabia, and then a suitable random sample was selected from seventy one institutions. The researchers used the historical method to track the previous studies as well as the descriptive approach to conducting the field study. The study data were analyzed by SPSS statistical program.

The results of this study conclude that there is a

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF TARGET COST MANAGEMENT APPROACH IN REDUCING COSTS FOR THE ACHIEVEMENT OF COMPETITIVE ADVANTAGE AS A MEDIATOR: AN APPLIED STUDY OF THE IRAQI ELECTRICAL INDUSTRY
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