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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
Mon Nov 24 2025
Journal Name
2025 13th International Conference On Control, Mechatronics And Automation (iccma)
Modeling Twisting and Coiling Actuators with Regression-Based Learning: Application to Neck Rehabilitation
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Twisting and coiling actuators (TCAs) are lightweight artificial muscles that can produce large linear contractions while lifting heavy loads with low power. A TCA consists of two or more strings connected to a rotational motor and a load. When activated, the strings twist and coil, causing contraction. This study presents a data-driven framework for modeling TCA behavior using experimental data. Polynomial regression, Support Vector Regression (SVR), and symbolic regression were applied using the motor angle and payload weight as inputs. The models were evaluated under various loads and implemented in a neck-rehabilitation prototype. SVR showed the highest accuracy (RMSE: 6.17 mm upward, 4.98 mm downward); however, it lacks a closed-form e

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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
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Audio Classification Based on Content Features
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Audio classification is the process to classify different audio types according to contents. It is implemented in a large variety of real world problems, all classification applications allowed the target subjects to be viewed as a specific type of audio and hence, there is a variety in the audio types and every type has to be treatedcarefully according to its significant properties.Feature extraction is an important process for audio classification. This workintroduces several sets of features according to the type, two types of audio (datasets) were studied. Two different features sets are proposed: (i) firstorder gradient feature vector, and (ii) Local roughness feature vector, the experimentsshowed that the results are competitive to

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Watermark Based on Singular Value Decomposition
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Watermarking operation can be defined as a process of embedding special wanted and reversible information in important secure files to protect the ownership or information of the wanted cover file based on the proposed singular value decomposition (SVD) watermark. The proposed method for digital watermark has very huge domain for constructing final number and this mean protecting watermark from conflict. The cover file is the important image need to be protected. A hidden watermark is a unique number extracted from the cover file by performing proposed related and successive operations, starting by dividing the original image into four various parts with unequal size. Each part of these four treated as a separate matrix and applying SVD

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Publication Date
Fri Apr 01 2022
Journal Name
Baghdad Science Journal
Iron (II) Determination in Lipstick Samples using Spectrophotometric and Microfluidic Paper-based Analytical Device (µPADs) Platform via Complexation Reaction with Iron Chelator 1, 10-phenanthroline: A Comparative Study
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This study was undertaken to introduce a fast, accurate, selective, simple and environment-friendly colorimetric method to determine iron (II) concentration in different lipstick brands imported or manufactured locally in Baghdad, Iraq. The samples were collected from 500-Iraqi dinars stores to establish routine tests using the spectrophotometric method and compared with a new microfluidic paper-based analytical device (µPAD) platform as an alternative to cost-effective conventional instrumentation such as Atomic Absorption Spectroscopy (AAS). This method depends on the reaction between iron (II) with iron(II) selective chelator 1, 10-phenanthroline(phen) in the presence of reducing agent hydroxylamine (HOA) and sodium acetate (NaOAc) b

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Publication Date
Sat Oct 03 2026
Journal Name
Journal Of Studies And Researches Of Sport Education
The effectiveness of the use of yoga exercises and its impact on the reactions of the two Alvesologih nervous and respiratory systems in the correction of antenna pistol shooting accuracy
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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education Program on Health Care Providers’ Knowledge toward Immunization of Children at Primary Health Care Centers in Kirkuk City
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Objectives: The study aims to evaluate effectiveness of health education program on health care providers’ knowledge toward immunization of children at primary health care centers in Kirkuk city.

 

Methodology: A quasi –experimental study design two- group (pre-test, post-test 1 and post-test 2) conducted at primary health care centers in Kirkuk city during the period from 28 October 2019 to 10 August 2020. By collecting (50) samples divided into two groups, each one (25) participant as control & study group. The study group exposed to the education program only.

 

Results: Results showed a clear positive

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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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