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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 Feb 23 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the Ministry of Health Center
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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness Of the Poetic Text Between the Presence and Absence in Abu Firas al_Hamdani Romyate
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Abu Firas al- Hamdani is one of the most prominent abbasid poets Who characterized their poetry with high artistic quality especially in his Romyate which blended the quality of feelings of grief, sorrow, longing and nostalgia that makes sensitive self conflict that stems with time from one hand and with place on the other hand. Because we are dealing with a poet lived west spatial coercive which it has been hurt him within a time conflict swinging between despair and some times patience and hope other times between the present and his painful reality also between the past and the beautiful times.
This researcher is to stand on this Romyat by monitoring effectiveness of the poetic text based on conflict between the presenc

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Publication Date
Wed Mar 16 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive Behavioral Program in Reducing Stuttering and Social Anxiety among High-School Students
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The current study aims to assess the effectiveness of the cognitive-behavioral programs in reducing stuttering and social anxiety among high-school students. The researchers used the experimental design. The sample consists of (20) male students who reported the highest score on the stuttering severity scale and social anxiety scale. The sample was divided into experimental and control groups (each group consists of 10 participants). The researcher used the type and severity of stuttering scale developed by Onslow et al (2003), translated by Mahmoud Ismail and the social anxiety scale was prepared by the authors. The results showed that there are statistically significant differences in pre-post and follow-up tests amongst the experiment

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Publication Date
Sat Dec 03 2022
Journal Name
Tikrit Journal Of Pure Science
A Pixel Based Method for Image Compression
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The basic solution to overcome difficult issues related to huge size of digital images is to recruited image compression techniques to reduce images size for efficient storage and fast transmission. In this paper, a new scheme of pixel base technique is proposed for grayscale image compression that implicitly utilize hybrid techniques of spatial modelling base technique of minimum residual along with transformed technique of Discrete Wavelet Transform (DWT) that also impels mixed between lossless and lossy techniques to ensure highly performance in terms of compression ratio and quality. The proposed technique has been applied on a set of standard test images and the results obtained are significantly encourage compared with Joint P

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Publication Date
Tue Feb 01 2022
Journal Name
Int. J. Nonlinear Anal. Appl.
Finger Vein Recognition Based on PCA and Fusion Convolutional Neural Network
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Finger vein recognition and user identification is a relatively recent biometric recognition technology with a broad variety of applications, and biometric authentication is extensively employed in the information age. As one of the most essential authentication technologies available today, finger vein recognition captures our attention owing to its high level of security, dependability, and track record of performance. Embedded convolutional neural networks are based on the early or intermediate fusing of input. In early fusion, pictures are categorized according to their location in the input space. In this study, we employ a highly optimized network and late fusion rather than early fusion to create a Fusion convolutional neural network

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering Science And Technology
HYBRID CIPHERING METHOD BASED ON CHAOS LOGISTIC MAP AND FINGERPRINT INFORMATION
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In modern era, which requires the use of networks in the transmission of data across distances, the transport or storage of such data is required to be safe. The protection methods are developed to ensure data security. New schemes are proposed that merge crypto graphical principles with other systems to enhance information security. Chaos maps are one of interesting systems which are merged with cryptography for better encryption performance. Biometrics is considered an effective element in many access security systems. In this paper, two systems which are fingerprint biometrics and chaos logistic map are combined in the encryption of a text message to produce strong cipher that can withstand many types of attacks. The histogram analysis o

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Publication Date
Fri May 16 2014
Journal Name
International Journal Of Computer Applications
Lossless Image Compression based on Predictive Coding and Bit Plane Slicing
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Publication Date
Mon Feb 28 2022
Journal Name
Journal Of Educational And Psychological Researches
Goal Conflict among Twelfth-Grade Students based on Gender and Major
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The aim of the current study is to identify the level of goal conflict with twelfth-grade students in South Sharqiah/ Sultanate of Oman according to gender and specialization. The study used the descriptive method. A scale of (28) items was developed and divided into six dimensions: time pressure, goal achievement, limit of power, limit of budget, incompatible strategies, and unclear task. To validate the scale, it was piloted (40) students. The scale was administered to a sample of (402) students (209) males in the Governorate of South Sharqiah. The results showed that the conflict level was high in “unclear task”, and an average conflict level in “limit of power”. Other dimensions (goal achievement, time pressure, limit of powe

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Publication Date
Tue Jun 01 2021
Journal Name
Ieee Systems Journal
Intelligent Traffic Management and Load Balance Based on Spike ISDN-IoT
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An intelligent software defined network (ISDN) based on an intelligent controller can manage and control the network in a remarkable way. In this article, a methodology is proposed to estimate the packet flow at the sensing plane in the software defined network-Internet of Things based on a partial recurrent spike neural network (PRSNN) congestion controller, to predict the next step ahead of packet flow and thus, reduce the congestion that may occur. That is, the proposed model (spike ISDN-IoT) is enhanced with a congestion controller. This controller works as a proactive controller in the proposed model. In addition, we propose another intelligent clustering controller based on an artificial neural network, which operates as a reactive co

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Publication Date
Tue Jan 01 2019
Journal Name
Ieee Access
Speech Enhancement Algorithm Based on Super-Gaussian Modeling and Orthogonal Polynomials
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