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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 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
Sun Apr 19 2015
Journal Name
Wireless Networks
Design and evaluation of distributed and dynamic mobility management approach based on PMIPv6 and MIH protocols
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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
Mon Aug 01 2022
Journal Name
Baghdad Science Journal
Influence of Cold Plasma on Sesame Paste and the Nano Sesame Paste Based on Co-occurrence Matrix
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The aim of the research is to investigate the effect of cold plasma on the bacteria grown on texture of sesame paste in its normal particle and nano particle size. Starting by using the image segmentation process depending on the threshold method, it is used to get rid of the reflection of the glass slides on which the sesame samples are placed.  The classification process implemented to separate the sesame paste texture from normal and abnormal texture. The abnormal texture appears when the bacteria has been grown on the sesame paste after being left for two days in the air, unsupervised k-mean classification process used to classify the infected region, the normal region and the treated region. The bacteria treated with cold plasma, t

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Publication Date
Mon Jan 01 2024
Journal Name
Current Chemistry Letters
Synthesis and characterisation of novel metal-organic frameworks (MOFs) based on zirconium and bicinchoninic acid
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Metal-organic frameworks (MOFs) are a relatively new class of materials of unique porous structures and exceptional properties. Currently, more than 110,000 types of MOFs have been reported among the countless possibilities. In this study, we have synthesised a novel MOF using zirconium chloride as the metal source and 4,4'-dicarboxy-2,2'-biquinoline (bicinchoninic acid disodium salt) as the linker, which reacted in N,N-Dimethylformamide (DMF) solvent. Three preparation methods were employed to prepare five types of the MOF, and they were compared to optimize the synthesis conditions. The resulting MOFs, named Zr-BADS, were characterised using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), microscopy, and

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Re-engineering management processes and its impact on the strategic decision-making process Field study on the College of Education / University of Mustansiriya / Iraq
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The aim of the research is to identify both the re-engineering of management processes and the strategic decision-making process in the research community and determine the nature of the correlation between the two variables and know the relationship between them to achieve the research goal. The researcher used a descriptive and analytical method. The research community consists of a group of professors and staff of the College of Education affiliated to the University of Mustansiriya in Baghdad, which their number were (45),  the researcher has distributed the forms to all members of the sample,  only (3) forms were excluded for invalidity and thus the number of forms approved in the analysis were (42) forms. The rese

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Engineering
Outdoor Testing of a Zig-Zag Solar Air heater with and without Artificial Roughness on Absorber Plate
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In this paper, thermal performance of a zig-zig solar air heater (ZZSAH) with and without using steel wire mesh on the absorber plate of the collector is experimentally investigated. The experimental work includes four inclination angles of the collector 20o, 30o, 45o, and 60o and four air mass flow rates of 0.03, 0.04, 0.06, and 0.08 kg/s under varieties of operating conditions of a geographic location of  Baghdad. New correlation equations of Nusselt number are obtained from experimental results for both types of collectors where the effect of varying of the inclination angle of collector taken into consideration in the experiment. The correlations show good agreement wi

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Publication Date
Thu Feb 01 2018
Journal Name
Iet Signal Processing
Signal compression and enhancement using a new orthogonal‐polynomial‐based discrete transform
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Publication Date
Wed Mar 01 2023
Journal Name
Journal Of Engineering
A An Authentication and Access Control Model for Healthcare based Cloud Services
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Electronic Health Record (EHR) systems are used as an efficient and effective method of exchanging patients’ health information with doctors and other key stakeholders in the health sector to obtain improved patient treatment decisions and diagnoses. As a result, questions regarding the security of sensitive user data are highlighted. To encourage people to move their sensitive health records to cloud networks, a secure authentication and access control mechanism that protects users’ data should be established. Furthermore, authentication and access control schemes are essential in the protection of health data, as numerous responsibilities exist to ensure security and privacy in a network. So, the main goal of our s

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analytical Study Compared Between Poisson and Poisson Hierarchical Model and Applied in Healthy Field
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Through this research, We have tried to evaluate the health programs and their effectiveness in improving the health situation through a study of the health institutions reality in Baghdad to identify the main reasons that affect the increase in maternal mortality by using two regression models, "Poisson's Regression Model" and "Hierarchical Poisson's Regression Model". And the study of that indicator (deaths) was through a comparison between the estimation methods of the used models. The "Maximum Likelihood" method was used to estimate the "Poisson's Regression Model"; whereas the "Full Maximum Likelihood" method were used for the "Hierarchical Poisson's Regression Model

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