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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
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Classification of fetal abnormalities based on CTG signal
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The fetal heart rate (FHR) signal processing based on Artificial Neural Networks (ANN),Fuzzy Logic (FL) and frequency domain Discrete Wavelet Transform(DWT) were analysis in order to perform automatic analysis using personal computers. Cardiotocography (CTG) is a primary biophysical method of fetal monitoring. The assessment of the printed CTG traces was based on the visual analysis of patterns that describing the variability of fetal heart rate signal. Fetal heart rate data of pregnant women with pregnancy between 38 and 40 weeks of gestation were studied. The first stage in the system was to convert the cardiotocograghy (CTG) tracing in to digital series so that the system can be analyzed ,while the second stage ,the FHR time series was t

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Publication Date
Thu Dec 24 2020
Journal Name
Psychology And Education
A Proposed Programme Based On Sensory Integration Theory For Remediating Some Development Learning Disabilities Among Children
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The current research aims to prepare a proposed Programmebased sensory integration theory for remediating some developmental learning disabilities among children, researchers prepared a Programme based on sensory integration through reviewing studies related to the research topic that can be practicedby some active teaching strategies (cooperative learning, peer learning, Role-playing, and educational stories). The Finalformat consists of(39) training sessions.

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Assessing road networks properties based on GIS techniques: Al-Karrada Region/Baghdad as a case study
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Transportability refers to the ease with which people, goods, or services may be transferred. When transportability is high, distance becomes less of a limitation for activities. Transportation networks are frequently represented by a set of locations and a set of links that indicate the connections between those places which is usually called network topology. Hence, each transmission network has a unique topology that distinguishes its structure. The most essential components of such a framework are the network architecture and the connection level. This research aims to demonstrate the efficiency of the road network in the Al-Karrada area which is located in the Baghdad city. The analysis based on a quantitative evaluation using graph th

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Publication Date
Mon May 01 2017
Journal Name
2017 Ieee International Conference On Electro Information Technology (eit)
A high-performance non-isolated DC-DC buck converter design based on wide bandgap power devices
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Publication Date
Sun May 01 2016
Journal Name
Iraqi Journal Of Science
Efficient text in image hiding method based on LSB method principle
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The steganography (text in image hiding) methods still considered important issues to the researchers at the present time. The steganography methods were varied in its hiding styles from a simple to complex techniques that are resistant to potential attacks. In current research the attack on the host's secret text problem didn’t considered, but an improved text hiding within the image have highly confidential was proposed and implemented companied with a strong password method, so as to ensure no change will be made in the pixel values of the host image after text hiding. The phrase “highly confidential” denoted to the low suspicious it has been performed may be found in the covered image. The Experimental results show that the covere

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Publication Date
Wed Aug 31 2022
Journal Name
International Journal Of Intelligent Engineering And Systems
Performance Evaluation Based on Multi-UAV in Airborne Computer Network System
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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
Effect of D-Mannose on Gene Expression of Neuraminidase Produced from Different Clinical Isolates of Pseudomonas aeruginosa
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The present work aimed to investigate the neuraminidase (nan1) gene expression in 32 different clinical isolates of Pseudomonas aeruginosa to explore the role of the enzyme in different types of infection and might give a better understanding of host cell-pathogens interaction. In addition, the effect of monosaccharide D-mannose on neuraminidase gene expression in eight isolates was studied by utilizing a reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The results demonstrated that the highest expression of nan1 gene was in otitis samples (208,913.81) which were significantly higher than that from other infections (P < 0.01). While, the concentrations of gene copies obtained from urin

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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 27 2020
Journal Name
Journal Of The College Of Education For Women
Problems Facing Working Women in the Labor Market (The Mall) as a Model:a Field Study in Al-RusafaArea/ Baghdad
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Most studies and research have tried to shed light on unemployment and employment in general, with less focus on the problems facing working women and the resulting social and economic consequences that threaten their human and professional lives. For women, working is one of the basic necessities for the sustainability of human life, and it constitutes an essential axis for both sexes and through it. It also gives a person the status and social status where the individual finds a ready opportunity to practice his intentions and desires, test his abilities and talents, and achieve his ambitions. The availability of full employment in general and the joining of women to the labor market is an important and fundamental factor in the sustai

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Publication Date
Fri Jun 23 2023
Journal Name
Cumhuriyet Dental Journal
The effectiveness of continuous versus sequential chelation in the removal of smear layer and their influence on push-out bond strength of Bio-C sealer (An in vitro study)
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Objectives: Successful endodontic treatment outcome requires effective shaping and cleaning of root canals. This study aims to evaluate the smear layer removal after continuous chelation (CC) ) NaOCL\HEDP( and sequential chelation (SC) )NaOCL\EDTA( and their influence on the push-out bond strength (POBS) of Bio-C sealer. Materials and Methods: Palatal roots of the maxillary first molar (n=72) were divided into four groups (n=18) as follows: 3% NaOCL, SC: 3% NaOCL followed by 17% EDTA, CC: 3% NaOCL \9% HEDP and Distilled water. Thirty-two roots (n=8/group) were split longitudinally for smear layer evaluation using SEM. Forty roots were obturated with Guttapercha and Bio-C sealer using a single cone technique. Thre

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