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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
Sun Jan 14 2018
Journal Name
Journal Of Engineering
A Nonlinear MIMO-PID Neural Controller Design for Vehicle Lateral Dynamics model based on Modified Elman Neural Network
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This paper presents a new design of a nonlinear multi-input multi-output PID neural controller of the active brake steering force and the active front steering angle for a 2-DOF vehicle model based on modified Elman recurrent neural. The goal of this work is to achieve the stability and to improve the vehicle dynamic’s performance through achieving the desired yaw rate and reducing the lateral velocity of the vehicle in a minimum time period for preventing the vehicle from slipping out the road curvature by using two active control actions: the front steering angle and the brake steering force. Bacterial forging optimization algorithm is used to adjust the parameters weights of the proposed controller. Simulation resul

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Publication Date
Mon Aug 30 2021
Journal Name
Al-kindy College Medical Journal
Clinical Course and Disease`s Outcome Aspects of COVID-19 Pediatric Patients in Ibn Al-Khateeb Isolation Hospital
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Background: Corona virus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified in December 2019 in Wuhan, China, and has since spread globally, leading to an ongoing pandemic.

Aim of study: to review the clinical, lab investigation and imaging techniques, in pediatric age group affected COVID-19 to help medical experts better understand and supply timely diagnosis and treatment.

Subjects and methods: this study is a retrospective descriptive clinical study. The medical records of patients were analyzed. Information’s recorded include demographic data, exposure history, symptoms, signs, laboratory findin

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Publication Date
Mon Jul 04 2022
Journal Name
International Journal Of Health Sciences
The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients
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The present study was set to investigate the potential association between the level of Interleukin-6 (IL-6), as a key component of the pro-inflammatory response, with different thalassemia’s biological and clinical features. For this purpose, one hundred fifty blood samples were collected from 100 beta-thalassemia patients, who attended the Genetic Hematology Centre at Ibn Al- Baladi Hospital in Baghdad, Iraq, and 50 healthy subjects who were employed as a control group. IL-6 levels were estimated using an ELISA Kit, whereas other thalassemia-related clinical features (such as HbA, HbF, ferritin, blood transfusions, splenectomy status, and the history of frequent infection) were additionally assessed. The results of the present s

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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Geological Journal
Advanced Geostatistical Techniques for Building 3D Geological Modeling: A Case Study from Cretaceous Reservoir in Bai Hassan Oil Field
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A 3D Geological model was generated using an advanced geostatistical method for the Cretaceous reservoir in the Bai Hassan oil field. In this study, a 3D geological model was built based on data from four wells for the petrophysical property distribution of permeability, porosity, water saturation, and NTG by using Petrel 2021 software. The geological model was divided into a structural model and a property model. The geological structures of the cretaceous reservoir in the Bai Hassan oil field represent elongated anticline folds with two faults, which had been clarified in the 3D Structural model. Thirteen formations represent the Cretaceous reservoir which includes (Shiranish, Mashurah, U.kometan, Kometan Shale, L. Kometan, Gulnen

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics
Effect of fungal microbiota on RANKL and sclerostin in patients with Crohn's disease
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The etiology of Crohn's disease (CD) is still unknown. However, many factors, including a dysregulated immune system, altered microbiota, inheritance, and environmental factors, have been implicated. This work was conducted to estimate the effect of fungal microbiota on two bone mineral density markers, RANKL and sclerostin, in addition to the correlation between these markers and vitamin B12, D3, and zinc in CD patients, along with their potential effect on fungal microbiota and vice versa. Peripheral blood and carry-Blair Stool samples were collected from 88 participants (60 newly diagnosed with CD without treatment and 28 healthy controls) to detect serum levels of RANKL and sclerostin, and culture media were used to grow, isolat

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Publication Date
Mon Sep 15 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Impact of oral hygiene instructions on cytokines in smokers and vapers with gingivitis
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Background: Cigarette smoking (CS) is a periodontal disease risk factor, affecting clinical parameters such as bleeding on probing (BOP), plaque index (PI), gingival index (GI) and proinflammatory cytokines level. This study examines the impact electronic cigarette use on proinflammatory cytokines and periodontal parameters. Methods: In this non-randomized study, ninety participants diagnosed with gingivitis were assigned into three groups. examined the effect of oral hygiene instructions on periodontal parameters and inflammatory biomarkers. Thirty CS (n=30) vaping electronic-cigarettes (e-cig) (n=29), and non-smoker (NS) (n=31) was included. Clinical parameters including PI, BOP, and GI were recorded at baseline and after 3 weeks

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Publication Date
Sun Aug 30 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Kernel estimation of returns of retirement funds of employers based on monetary earnings (subscriptions and compensation) via regression discontinuity in Iraq
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Regression Discontinuity (RD) means a study that exposes a definite group to the effect of a treatment. The uniqueness of this design lies in classifying the study population into two groups based on a specific threshold limit or regression point, and this point is determined in advance according to the terms of the study and its requirements. Thus , thinking was focused on finding a solution to the issue of workers retirement and trying to propose a scenario to attract the idea of granting an end-of-service reward to fill the gap ( discontinuity point) if it had not been granted. The regression discontinuity method has been used to study and to estimate the effect of the end -service reward on the cutoff of insured workers as well as t

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Publication Date
Sat Aug 01 2020
Journal Name
Heat Transfer
A parametric study of a photovoltaic panel with cylindrical fins under still and moving air conditions in Iraq
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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Estimation of the average sample size and defective ratio In a finite individualized inspection with a practical application
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The purpose of this research is to find the estimator of the average proportion of defectives based on attribute samples. That have been curtailed either with rejection of a lot finding the kth defective or with acceptance on finding the kth non defective.

The MLE (Maximum likelihood estimator) is derived. And also the ASN in Single Curtailed Sampling has been derived and we obtain a simplified Formula All the Notations needed are explained.

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Publication Date
Thu Jun 30 2022
Journal Name
International Review Of Mechanical Engineering (ireme)
Field Study of Absorbent Media Effect on the Yield of Solar Desalination for Iraqi Marsh Water
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Fresh water production from saline or waste water utilizing solar stills is the secured future approach in water industry with low cost and no environmental pollution accompanied with low productivity. In this work, the effect of inserting different available materials in a passive Single Slope Solar SSS stills on their productivity is accomplished. Side by side tests are performed on a conventional still, and three SSS stills inserted with carbon filter media, Copper wire mesh, and Cellulose sheets. All these stills are symmetrical in dimensions with 0.5 m2 base area tested for 20mm water level. The stills have been manufactured, instrumented, and tested in July 2021 under DhiQar-Iraq climate conditions (latitude 31.2° N, longitude 46.34

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