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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
Sat Jul 01 2023
Journal Name
International Journal Of Computing And Digital Systems
Human Identification Based on SIFT Features of Hand Image
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Publication Date
Tue Feb 01 2011
Journal Name
Iop Conference Series: Materials Science And Engineering
Contour extraction of echocardiographic images based on pre-processing
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In this work we present a technique to extract the heart contours from noisy echocardiograph images. Our technique is based on improving the image before applying contours detection to reduce heavy noise and get better image quality. To perform that, we combine many pre-processing techniques (filtering, morphological operations, and contrast adjustment) to avoid unclear edges and enhance low contrast of echocardiograph images, after implementing these techniques we can get legible detection for heart boundaries and valves movement by traditional edge detection methods.

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Publication Date
Fri May 17 2013
Journal Name
International Journal Of Computer Applications
Fast Lossless Compression of Medical Images based on Polynomial
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In this paper, a fast lossless image compression method is introduced for compressing medical images, it is based on splitting the image blocks according to its nature along with using the polynomial approximation to decompose image signal followed by applying run length coding on the residue part of the image, which represents the error caused by applying polynomial approximation. Then, Huffman coding is applied as a last stage to encode the polynomial coefficients and run length coding. The test results indicate that the suggested method can lead to promising performance.

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Publication Date
Thu Apr 25 2019
Journal Name
Engineering And Technology Journal
Improvement of Harris Algorithm Based on Gaussian Scale Space
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Features is the description of the image contents which could be corner, blob or edge. Corners are one of the most important feature to describe image, therefore there are many algorithms to detect corners such as Harris, FAST, SUSAN, etc. Harris is a method for corner detection and it is an efficient and accurate feature detection method. Harris corner detection is rotation invariant but it isn’t scale invariant. This paper presents an efficient harris corner detector invariant to scale, this improvement done by using gaussian function with different scales. The experimental results illustrate that it is very useful to use Gaussian linear equation to deal with harris weakness.

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Clinical Learning and Training Environment for Maternal and Child Health Nursing Students
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Objective: To assess the clinical learning environment and clinical training for students' in maternal and child
health nursing.
Methodology: A descriptive study was conducted on non probability sample (purposive) of (175) students' in
Nursing College/ University of Baghdad for the period of June 19th to July 18th 2013. A questionnaire was used as a
tool of data collection to fulfill with objective of the study and consisted of three parts, including demographic,
clinical learning environment and clinical training for students' in maternal and child health nursing. Descriptive
statistical analyses were used to analyze the data.
Results: The results of the study revealed that the 65.1% of student at age which ranged b

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Publication Date
Mon Jan 01 2024
Journal Name
Polski Merkuriusz Lekarski
Design, synthesis, insilco study and biological evaluation of new isatin-sulfonamide derivatives by using mono amide linker as possible as histone deacetylase inhibitors
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Aim: To evaluate the cytotoxic activity of newly synthesized a series of novel HDAC inhibitors comprising sulfonamide as zinc binding group and Isatin derivatives as cap group joined by mono amide linker as required to act as HDAC inhibitors. Materials and Methods: The utilization of sulfonamide as zinc binding group joined by N-alkylation reaction with ethyl-bromo hexanoate as linker group that joined by amide reaction with Isatin derivatives as cap groups which known to possess antitumor activity in the designed of new histone deacetylase inhibitors and using the docking and MTT assay to evaluate the compounds. Results: Four compounds have been synthesized and characterized successfully by ART-FTIR, NMR and ESI-Ms. the compounds w

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Publication Date
Mon May 31 2021
Journal Name
Iraqi Geological Journal
Mechanical Rock Properties Estimation for Carbonate Reservoir Using Laboratory Measurement: A Case Study from Jeribe, Khasib and Mishrif Formations in Fauqi Oil Field
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Estimation of mechanical and physical rock properties is an essential issue in applications related to reservoir geomechanics. Carbonate rocks have complex depositional environments and digenetic processes which alter the rock mechanical properties to varying degrees even at a small distance. This study has been conducted on seventeen core plug samples that have been taken from different formations of carbonate reservoirs in the Fauqi oil field (Jeribe, Khasib, and Mishrif formations). While the rock mechanical and petrophysical properties have been measured in the laboratory including the unconfined compressive strength, Young's modulus, bulk density, porosity, compressional and shear -waves, well logs have been used to do a compar

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Publication Date
Thu Sep 30 2021
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Development a Statistical Relationship between Compressional Wave Velocity and Petrophysical Properties from Logs Data for JERIBE Formation ASMARI Reservoir in FAUQI Oil Field
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   The Compressional-wave (Vp) data are useful for reservoir exploration, drilling operations, stimulation, hydraulic fracturing employment, and development plans for a specific reservoir. Due to the different nature and behavior of the influencing parameters, more complex nonlinearity exists for Vp modeling purposes. In this study, a statistical relationship between compressional wave velocity and petrophysical parameters was developed from wireline log data for Jeribe formation in Fauqi oil field south Est Iraq, which is studied using single and multiple linear regressions. The model concentrated on predicting compressional wave velocity from petrophysical parameters and any pair of shear waves velocity, porosity, density, and

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Publication Date
Thu Sep 30 2021
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Development a Statistical Relationship between Compressional Wave Velocity and Petrophysical Properties from Logs Data for JERIBE Formation ASMARI Reservoir in FAUQI Oil Field
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   The Compressional-wave (Vp) data are useful for reservoir exploration, drilling operations, stimulation, hydraulic fracturing employment, and development plans for a specific reservoir. Due to the different nature and behavior of the influencing parameters, more complex nonlinearity exists for Vp modeling purposes. In this study, a statistical relationship between compressional wave velocity and petrophysical parameters was developed from wireline log data for Jeribe formation in Fauqi oil field south Est Iraq, which is studied using single and multiple linear regressions. The model concentrated on predicting compressional wave velocity from petrophysical parameters and any pair of shear waves velocity, porosity, density, a

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A Proposed Framework to Developing the Auditor's Reporting in Iraq in Accordance With the International Standards on Auditing
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The international reporting auditor witness rapidly developed over the past years, where profession began give attention to the development of auditor reporting and improve its informational report through the issuance and amendment of some relevant international auditing standards. The reality of the situation refers to the failure to inform the auditor in Iraq in  many areas, including: Clearly defined management responsibility for the preparation of financial and auditor's responsibility to express an opinion on these statements and Amendment of opinion when the financial statements as a whole is free from material misstatement based on the evidence is sufficient and appropriate audit, or not to build the auditor's ability to obt

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