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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
Fri Sep 01 2017
Journal Name
Gulf Journal Of Oncology
Clinical and Pathological Characteristics of Triple Positive Breast Cancer among Iraqi Patients
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Background: Breast cancer is the most common malignancy affecting the Iraqi population and the leading cause of cancer related mortality among Iraqi women. It has been well documented that prognosis of patients depends largely upon the hormone receptor contents and HER-2 over expression of their neoplasm. Recent studies suggest that Triple Positive (TP) tumors, bearing the three markers, tend to exhibit a relatively favorable clinical behavior in which overtreatment is not recommended. Aim: To document the different frequencies of ER/PR/HER2 breast cancer molecular subtypes focusing on the Triple Positive pattern; correlating those with the corresponding clinico-pathological characteristics among a sample of Iraqi patients diagnosed with th

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Publication Date
Tue Dec 12 2017
Journal Name
Al-khwarizmi Engineering Journal
Model Reference Adaptive Control based on a Self-Recurrent Wavelet Neural Network Utilizing Micro Artificial Immune Systems
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Abstract 

This paper presents an intelligent model reference adaptive control (MRAC) utilizing a self-recurrent wavelet neural network (SRWNN) to control nonlinear systems. The proposed SRWNN is an improved version of a previously reported wavelet neural network (WNN). In particular, this improvement was achieved by adopting two modifications to the original WNN structure. These modifications include, firstly, the utilization of a specific initialization phase to improve the convergence to the optimal weight values, and secondly, the inclusion of self-feedback weights to the wavelons of the wavelet layer. Furthermore, an on-line training procedure was proposed to enhance the control per

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Publication Date
Wed Jun 10 2009
Journal Name
Iraqi Journal Of Laser
Real Time Quantum Bit Error Rate Performance Test for a Quantum Cryptography System Based on BB84 protocol
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In this work, the performance of the receiver in a quantum cryptography system based on BB84 protocol is scaled by calculating the Quantum Bit Error Rate (QBER) of the receiver. To apply this performance test, an optical setup was arranged and a circuit was designed and implemented to calculate the QBER. This electronic circuit is used to calculate the number of counts per second generated by the avalanche photodiodes set in the receiver. The calculated counts per second are used to calculate the QBER for the receiver that gives an indication for the performance of the receiver. Minimum QBER, 6%, was obtained with avalanche photodiode excess voltage equals to 2V and laser diode power of 3.16 nW at avalanche photodiode temperature of -10

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Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Energy Storage
A critical review on phase change materials (PCM) based heat exchanger: Different hybrid techniques for the enhancement
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English

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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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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Obscene speech in the Qur'anic perspective An objective study based on the verses and interpretation of the Noble Qur’an in diagnosis and treatment
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t:

The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.

What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Mechanical Engineering Research And Developments
Real-time control of robotic hand by human hand at low cost
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Publication Date
Wed Sep 16 2020
Journal Name
International Journal Of Dentistry And Oral Science
Attitude and Knowledge of Orthodontics among General Dentists and Non-Orthodontic Specialists: A Questionnaire Based Survey
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Aim: This study aimed to assessing orthodontic knowledge and attitude among general dentists and non-orthodontic specialists. Background: Early detection of orthodontic disorders is essentialin motivating patients to intervene prior to long term complications when the disorders are not recongised. Methods: A questionnaire was distributed amongst dentistsother than orthodontists. This questionnaire consisted of three sections. The first one aimed to collect demographic, educational level and practice type information. Further two sections consisted of closed-end questions designed to evaluateknowledge and attitude of orthodontics. Results: A total of 313 responses to the survey were submitted. No significant correlation was observed, e

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Publication Date
Mon Aug 05 2024
Journal Name
Food And Bioprocess Technology
Development of an Innovative Reinforced Food Packaging Film Based on Corn Starch/Hydroxypropyl Methylcellulose/Nanocrystalline Cellulose Incorporated with Nanogel Containing Quercetin
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Publication Date
Thu Dec 14 2023
Journal Name
4th International Conference Of Modern Technologies In Agricultural Sciences
A study of the Effect of Diesel Oil Contamination with Glycol on the Performance of a Diesel Engine
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The performance of a diesel engine was tested with diesel oil contaminated with glycol at the engineering workshop/Department of Agricultural Machines and Equipment / College of the Agricultural Engineering Sciences at the University of Baghdad. To investigate the impact of different concentrations of glycol on the performance of a diesel engine, an experimental water-cooled four-stroke motor was utilized, with oil containing 0, 100, and 200 parts per million (ppm). Specific fuel consumption, thermal efficiency, friction power, and exhaust gas temperature were examined as performance indicators. To compare the significance of the treatments, the study employed a full randomization design (CRD), with three replicates for each treatment at th

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