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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 Jan 01 2025
Journal Name
International Journal Of Body, Mind And Culture
Effectiveness of the Benson Relaxation Technique in Reducing Pain During Femoral Artery Sheath Removal Following Percutaneous Coronary Intervention: A Randomized Controlled Trial
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Objective: This study aimed to evaluate the effectiveness of the Benson Relaxation Technique (BRT) in reducing pain during femoral artery sheath removal after percutaneous coronary intervention (PCI). Methods and Materials: A randomized controlled trial was conducted at three cardiac centers in Iraq. A total of 58 patients undergoing therapeutic PCI were randomly assigned into two groups: intervention (n=27) and control (n=31). The intervention group received BRT for 10 minutes before and after sheath removal. Pain was assessed using the Visual Analogue Scale (VAS) immediately after the procedure. Demographic data and clinical variables were collected. Data were analyzed using SPSS v26 and non-parametric tests (Mann-Whitney U, Krus

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Publication Date
Thu Sep 01 2016
Journal Name
Radiology Case Reports
Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings
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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Preparation, characterization, antioxidant activity of 1-(2-furoyl) thiourea derivatives and study the molecular docking of them as potent inhibitors of Urease enzyme
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In this work, we synthesized thirteen compounds of 1-(2-furoyl)thiourea derivatives 1-13 by conversion of 2-furoyl chloride to 2-furoyl isothiocyanate by reacting it with potassium thiocyanate in dry acetone in a quite short reflux time then, in the same pot, different of (primary and secondary amines) were added individually to achieve thiourea derivatives. The products were characterized spectroscopically using (FT-IR, 1H NMR and 13C NMR) techniques. Some of them were evaluated as antioxidant agents using DPPH radical scavenging method, and all were examined theoretically as enzyme inhibitors against Bacillus pasteurii urease (pdb id: 4ubp) and  by studying  molecular docking using Autodock (4.2.6) software.

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
The Effectiveness of the Symbol in Iraqi Monodrama Texts: محمد علي ابراهيم
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This research studies the effectiveness of the symbol in the Iraqi monodrama texts. The methodological framework is devoted to the research problem and the need for conducting it, its importance, the purpose of research, and the definition of the most important terms. The research problem dealt with the concept of the effectiveness of the symbol, the monodrama, and the working levels of the symbol in the monodrama texts of the author, in addition to the disclosure of the artistic vision embodied by the playwright in the use of the symbol within the literary product, as well as the development of the creative process. The research problem was defined by the following question: How effective is the symbol in the Iraqi Monodrama texts?
T

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Publication Date
Thu Jun 01 2023
Journal Name
Results In Engineering
Effectiveness of embedded through-section technique in strengthening reinforced concrete spandrel beams
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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Evaluation the Effectiveness of Impregnated Net in Reducing Leishmaniasis Incidence: Diala-Iraq
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Background: Leishmaniasis is important public
health problem owing to its impact on morbidity
and mortality and difficulties in application of
effective control measures.
Objective: The aim of the study is to evaluate the
using of impregnate bed nets in the control of
leishmaniasis.
Methods: The study was conducted throughout
the years 2004 and 2005, in Diala Governorate
(about 60km north-east Baghdad). This is the first
study in Iraq for evaluation of the impregnated bed
net in control of leishmaniasis. Two villages were
selected to achieve this aim. The nets were
distributed for the first village to be used by their
population. The second village was served as
control.

Results: The

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Publication Date
Mon May 01 2017
Journal Name
Journal Of Nuclear Medicine
Capability of a novel small field of view hybrid gamma camera (HGC) for sentinel lymph node and small organ imaging
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Objectives: Small field of view gamma detection and imaging technologies for monitoring in vivo tracer uptake are rapidly expanding and being introduced for bed-side imaging and image guided surgical procedures. The Hybrid Gamma Camera (HGC) has been developed to enhance the localization of targeted radiopharmaceuticals during surgical procedures; for example in sentinel lymph node (SLN) biopsies and for bed-side imaging in procedures such as lacrimal drainage imaging and thyroid scanning. In this study, a prototype anthropomorphic head and neck phantom has been designed, constructed, and evaluated using representative modelled medical scenarios to study the capability of the HGC to detect SLNs and image small organs. Methods: An anthropom

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Engineering
A Review on Expansive Soils Stabilized with Different Pozzolanic Materials
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Soils that cause effective damages to engineer structures (such as pavement and foundation) are called problematic or difficult soils (include collapsible soil, expansive soil, etc.). These damages occur due to poor or unfavorited engineering properties, such as low shear strength, high compressibility, high volume changes, etc. In the case of expansive soil, the problem of the shrink-swell phenomenon, when the soil reacts with water, is more pronounced. To overcome such problems, soils can be treated or stabilized with many stabilization ways (mechanical, chemical, etc.). Such ways can amend the unfavorited soil properties. In this review, the pozzolanic materials have been selected to be presented and discussed as chem

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Research on Emotion Classification Based on Multi-modal Fusion
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Nowadays, people's expression on the Internet is no longer limited to text, especially with the rise of the short video boom, leading to the emergence of a large number of modal data such as text, pictures, audio, and video. Compared to single mode data ,the multi-modal data always contains massive information. The mining process of multi-modal information can help computers to better understand human emotional characteristics. However, because the multi-modal data show obvious dynamic time series features, it is necessary to solve the dynamic correlation problem within a single mode and between different modes in the same application scene during the fusion process. To solve this problem, in this paper, a feature extraction framework of

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
The Immunological Effectiveness of Some Common Plants
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Three plant species were picked randomly and their alcoholic extracts have been screened to know their effects on the phagocytic capability and intracellular killing of yeast by human peripheral macrophages. Macrophage cultures were incubated with different concentration of each plant extract: for 15 min., 30 min .and 45 min. The phagocytes activity in Iresine herbstii extract was significantly (p?0.05) increased with increasing dose and time of incubation. In Mentha piperita extract, increasing in dose and time of incubation leads to elevate phagocytic capbility, especially in the dose of 20% and 25% of plant extract, perhaps because the antimicrobial and antiviral activities of this plant, as well as strong antioxidant and antitumor act

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