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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 27 2019
Journal Name
Al-academy
Improvisation Effectiveness in the Performance of the Actor in the Theatrical Show: مصطفى عباس خلف
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Improvisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t

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Publication Date
Wed Feb 26 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Cost and Quality of Documentary Credit in achieving the Competitive Advantage in Banks: An Applied Research in North Bank for Finance and Investment and The United Bank for Investment
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Documentary Credit passes through many practical phases starting from Opening credit and matching documents and payment of the amount of credit……etc.  It is worthy to mention that there are several aspects that are varied and differed from Bank to another one which can offer Competitive Advantage for the bank …This will be shown in this research.

For the purpose of achieving the objective of this research within the theoretical aspect, the researcher had seen and briefed several books and researches which are mainly related to the subject of the research.

As for the practical aspect, has included Questionnaire which included many questions that are fit and suitable to the hypotheses.

Research sample has

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Publication Date
Sun Sep 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of target cost technology in reducing product costs: Applied Study in the General Company for Soft Drinks Industry
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The Research dealt with the role of the target costs in reducing the cost of products in the General Company for soft drinks. One the modern approaches reduce costs and thus increase the ability and continuity to compete in the market. Where the problem of research in identifying the shortcomings in the traditional method used in the company sample research. Which led to a weak control of the cost and the researcher relied on data and costs of the company. The research recommended that the target cost of the company should be applied to the research sample. Training the employees. In addition, preparing training courses for them. He stressed the need to address obstacles that prevent the existence of an effective cost system. Including t

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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
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
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
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
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
Tue Dec 01 2015
Journal Name
Journal Of Engineering
Digital Image Authentication Algorithm Based on Fragile Invisible Watermark and MD-5 Function in the DWT Domain
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Using watermarking techniques and digital signatures can better solve the problems of digital images transmitted on the Internet like forgery, tampering, altering, etc. In this paper we proposed invisible fragile watermark and MD-5 based algorithm for digital image authenticating and tampers detecting in the Discrete Wavelet Transform DWT domain. The digital image is decomposed using 2-level DWT and the middle and high frequency sub-bands are used for watermark and digital signature embedding. The authentication data are embedded in number of the coefficients of these sub-bands according to the adaptive threshold based on the watermark length and the coefficients of each DWT level. These sub-bands are used because they a

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