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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 Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Leadership styles and their role in enhancing the intellectual capital Field research in the Ministry of Foreign
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This study has taken into consideration two vital variables (leadership, leadership styles and intellectual capital). The research aim through the relations between the leadership styles and intellectual capital, to building conceptual frame for the variables of study and exploring the nature of correlation relations between these variables and their effects in enhancing intellectual capital.

      The research was conducted at the Ministry of foreign in Iraq, and included a sample of leaders and subordinates amounted to (186), has been using the questionnaire as a key tool to collect data on the sample.

      For the dealing with

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Publication Date
Mon Jun 20 2022
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
SEQUENCE STRATIGRAPHY AND PALEOENVIRONMENT OF AALIJI FORMATION IN BAI HASSAN OIL FIELD IN KIRKUK PROVINCE, NORTHERN IRAQ
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The Aaliji Formation in wells (BH.52, BH.90, BH.138, and BH.188) in Bai Hassan Oil Field in Low Folded Zone northern Iraq has been studied to recognize the palaeoenvironment and sequence stratigraphic development. The formation is bounded unconformably with the underlain Shiranish Formation and the overlain Jaddala Formation. The microfacies analysis and the nature of accumulation of both planktonic and benthonic foraminifera indicate the two microfacies associations; where the first one represents deep shelf environment, which is responsible for the deposition of the Planktonic Foraminiferal Lime Wackestone Microfacies and Planktonic Foraminiferal Lime Packstone Microfacies, while the second association represents the deep-sea environme

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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
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
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
Reflective Mercifulness and its Implications for Social Cohesion / field study in Baghdad Governorate
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Mercifulness is a trait of civilization, humanity, and a moral value in society, because it has an impact on social life and its role in spreading interdependence, joint liability, and solidarity among people. Mercifulness means spreading mercy, synergy, sympathy, and cooperation. Generally, a society that enjoys strong ties tends to have a kind of stability and development, as well as, is able to face the economic, political, and security crises. Conversely, a weak society leads to weak social cohesion and weak community infrastructure that is more vulnerable to social, economic, and political instability. Thus, this is the aim of the research that has used a social survey method applied to a sample of respondents who have reached (300)

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning premarital screening of sexual transmitted disease on Student's Knowledge at Baghdad University
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Objectives: To identify the effectiveness of instructional program concerning premarital screening of sexual transmitted disease on student's knowledge at Baghdad University and examine the relationship between students' knowledge and certain studied variables. And hypothesis for this study; There is a difference in university student’s knowledge toward premarital screening between pre and posttests of instructional program. Methodology: A quasi-experimental design (pretest-posttest approach) was conducted at six colleges and its college of education ibn rushd, college of political science, college of law, college of literatur

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Comparing the effectiveness of using three different re-mineralizing pastes on remineralisation of artificially induced white spot lesion
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Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Comparing the effectiveness of using three different re-mineralizing pastes on remineralisation of artificially induced white spot lesion
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Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were divi

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Statistical Design based on Response Surface Methodology to Optimize the Production of a Yellow Pigment by Streptomyces thinghirensis AF7
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Although its wide utilization in microbial cultures, the one factor-at-a-time method, failed to find the true optimum, this is due to the interaction between optimized parameters which is not taken into account. Therefore, in order to find the true optimum conditions, it is necessary to repeat the one factor-at-a-time method in many sequential experimental runs, which is extremely time-consuming and expensive for many variables. This work is an attempt to enhance bioactive yellow pigment production by Streptomyces thinghirensis based on a statistical design. The yellow pigment demonstrated inhibitory effects against Escherichia coli and Staphylococcus aureus and was characterized by UV-vis spectroscopy which showed lambda maximum of

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