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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
Wed Nov 14 2018
Journal Name
Fiber And Integrated Optics
Design Investigation of 2 × 2 Mach–Zehnder Optical Switch Based on a Metal–Polymer–Silicon Hybrid Plasmonic Waveguide
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In this paper, a miniaturized 2 × 2 electro-optic plasmonic Mach– Zehnder switch (MZS) based on metal–polymer–silicon hybrid waveguide is presented. Adiabatic tapers are designed to couple the light between the plasmonic phase shifter, implemented in each of the MZS arms, and the 3-dB input/output directional couplers. For 6 µm-long hybrid plasmonic waveguide supported by JRD1 polymer (r33= 390 pm/V), a π-phase shift voltage of 2 V is obtained. The switch is designed for 1550 nm operation wavelength using COMSOL software and characterizes by 2.3 dB insertion loss, 9.9 fJ/bit power consumption, and 640 GHz operation bandwidth

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Publication Date
Wed Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Design of a Kinematic Neural Controller for Mobile Robots based on Enhanced Hybrid Firefly-Artificial Bee Colony Algorithm
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The paper present design of a control structure that enables integration of a Kinematic neural controller for trajectory tracking of a nonholonomic differential two wheeled mobile robot, then  proposes a Kinematic neural controller to direct a National Instrument mobile robot (NI Mobile Robot). The controller is to make the actual velocity of the wheeled mobile robot close the required velocity by guarantees that the trajectory tracking mean squire error converges at minimum tracking error. The proposed tracking control system consists of two layers; The first layer is a multi-layer perceptron neural network system that controls the mobile robot to track the required path , The second layer is an optimization layer ,which is impleme

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Publication Date
Sat Jul 08 2017
Journal Name
Neural Computing And Applications
A new algorithm of modified binary particle swarm optimization based on the Gustafson-Kessel for credit risk assessment
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Publication Date
Mon Jan 01 2024
Journal Name
Infocommunications Journal
On the Performance of Metamaterial based Printed Circuit Antenna for Blood Glucose Level Sensing Applications: A Case Study
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Due to the urgent need to develop technologies for continuous glucose monitoring in diabetes individuals, poten tial research has been applied by invoking the microwave tech niques. Therefore, this work presents a novel technique based on a single port microwave circuit, antenna structure, based on Metamaterial (MTM) transmission line defected patch for sensing the blood glucose level in noninvasive process. For that, the proposed antenna is invoked to measure the blood glu cose through the field leakages penetrated to the human blood through the skin. The proposed sensor is constructed from a closed loop connected to an interdigital capacitor to magnify the electric field fringing at the patch center. The proposed an tenna sensor i

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Publication Date
Sat Jul 08 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Effect of Coumarin Derivatives(compounds) on the Vibrio cholerae Isolates from Different Clinical Iraqi Sources
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From a large number of bacterial samples collected from different hospital in Iraq in central  health laboratory ,only ten isolates were identified primary as Vibrio. A number of  morphology and biochemical test were carried out to complete this identification that showed all bacterial isolates were related to Vibrio cholerae .In this study  all Vibrio isolates were investigated for Bio typing and the result showed that all (10) isolate were related to (Eltor biotypes) .Also, the susceptibility test towards eight antibiotics were carried  out .

Results shows that  ciprofloxacin , Norfloxacin, Erythromycin, Ampicillin,  ceftriaxone  and Amikacin were the most effective

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Publication Date
Thu Jan 01 2026
Journal Name
Iraqi Journal Of Science
Impact the Some Antibiotic on Gene Expression Efflux Pump of Klebsiella pneumoniae Isolated from Clinical Sources
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Publication Date
Thu Nov 14 2024
Journal Name
Journal Of Emergency Medicine, Trauma And Acute Care
Isolation, optimization, and redesigning of phages of methicillin-resistant Staphylococcus aureus from clinical hospital isolates in Baghdad
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Background: A global health concern is methicillin-resistant Staphylococcus aureus (MRSA). The use of bacteriophages is one of the many novel control strategies against MRSA that are frequently sought. However, it is quite challenging to isolate enough lytic anti-MRSA phages. In order to extract, optimize, and remodel anti-MRSA phages, this study sought novel approaches.

Methods: Two ATCC MRSA strains and nine clinical MRSA isolates were used to isolate wild anti-MRSA phages from hospital settings, dirt, and sewage. The wild phages were optimized using plaque-based biokinetic techniques. Usi

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Publication Date
Sat Oct 03 2026
Journal Name
Al–bahith Al–a'alami
The Impact of Means of Communication on Electoral Behavior and its Relationship to the Political Disparity of the Family (A Field Study of an Audience of the University of Baghdad’s Students)
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Iraq has seen many changes at the social, economic and political levels. This led to cause many shifts in the structure of its society and imposed great challenges reflected in the behavior and awareness of that society in general and youth in particular.

Those changes made the Iraqi society undergoing the transformation of value and culture aspects formed a political awareness that caused cultural and political diversity within the family and society. A greater openness to the outside world caused by the communication revolution, as the world has witnessed during the past two decades, has helped in making that change. Iraq had its share of media and political openness, which were included after the US occupation in 2003. As a re

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
A Comparison Between the Theoretical Cross Section Based on the Partial Level Density Formulae Calculated by the Exciton Model with the Experimental Data for (_79^197)Au nucleus
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In this paper, the theoretical cross section in pre-equilibrium nuclear reaction has been studied for the reaction  at energy 22.4 MeV. Ericson’s formula of partial level density PLD and their corrections (William’s correction and spin correction) have been substituted  in the theoretical cross section and compared with the experimental data for  nucleus. It has been found that the theoretical cross section with one-component PLD from Ericson’s formula when  doesn’t agree with the experimental value and when . There is little agreement only at the high value of energy range with  the experimental cross section. The theoretical cross section that depends on the one-component William's formula and on-component corrected to spi

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Natural Science, Biology And Medicine
Effectiveness of Frenulum Subcutaneous Injection of Botox in the Treatment of Premature Ejaculation
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