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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 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Applied Spatial Data Analysis Technique on Petrophysical Properties of MA Unit of Mishrif Formation / Noor Field
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Noor oil field is one of smallest fields in Missan province. Twelve well penetrates the Mishrif Formation in Noor field and eight of them were selected for this study. Mishrif formation is one of the most important reservoirs in Noor field and it consists of one anticline dome and bounded by the Khasib formation at the top and the Rumaila formation at the bottom. The reservoir was divided into eight units separated by isolated units according to partition taken by a rounding fields.

In this paper histograms frequency distribution of the porosity, permeability, and water saturation were plotted for MA unit of Mishrif formation in Noor field, and then transformed to the normal distribution by applying the Box-Cox transformation alg

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Publication Date
Tue Oct 01 2019
Journal Name
Biochemical And Cellular Archives
THE EFFECT OF TWIST EXPRESSION ON THE DEVELOPMENT OF CERVICAL CARCINOMA IN A GROUP OF IRAQI WOMEN INFECTED WITH HPV
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Cervical carcinoma represent the second predominant cancer in female and there is a strong correlation between cervical cancer and the infection with high-risk types of HPV and expression the viral oncogenes. EMT is viewed as a vital advance in carcinoma development and ensuing metastasis. To evaluate correlation between the expression of Twist and HPV16 infection in a group of Iraqi patients with cervical carcinoma. A total of forty paraffin blocks included in this study which were divided into 30 sample of cervical cancer infected with HPV16and 10 sample of normal cervical tissues. The samples were subjected to immunohistochemical technique using Anti-Twist2 polyclonal antibody. The obtained data from this study indicate that majority of

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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Design of Nonlinear PID Neural Controller for the Speed Control of a Permanent Magnet DC Motor Model based on Optimization Algorithm
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In this paper, the speed control of the real DC motor is experimentally investigated using nonlinear PID neural network controller. As a simple and fast tuning algorithm, two optimization techniques are used; trial and error method and particle swarm optimization PSO algorithm in order to tune the nonlinear PID neural controller's parameters and to find best speed response of the DC motor. To save time in the real system, a Matlab simulation package is used to carry out these algorithms to tune and find the best values of the nonlinear PID parameters. Then these parameters are used in the designed real time nonlinear PID controller system based on LabVIEW package. Simulation and experimental results are compared with each other and showe

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Strategic Management of Cost of Production Operations In the 0il Fields: بحث تطبيقي في شركة نفط الوسط (شركة عامة)
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The use of the entrance diffraction hexagon continuous improvement of operations in order to achieve the rationalization of activities, costs and efficiency in the use of available resources and reduce the incidence of damage and waste and recycling, as the accounting information system does not meet the surface production processes oil fields cost management requirements in the measurement and evaluation of the costs of each activity and development of indicators to evaluate the efficiency and effectiveness of production processes and to cover the shortcomings of currently approved by the company so cost accounting system has Find addressed the use of strategic cost management techniques, including the entrance diffraction hexagon for c

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Influence of the Surrounding Plants by Rapeseed Field on Population Density of Cabbage Aphid (Brevicoryne brassicae L.) and its Biological Enemies
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The result revealed that the peak of population density of cabbage aphid Brevicoryne brassicae was 523.20 individuals/plant on 21 March in edges of rapeseed field and was 1141.67 individuals/plant in center of the field. Results revealed that population density of cabbage aphid in rapeseed fields surrounded by cover crops significantly were low compared with that of monoculture rapeseed. The location of rapeseed plants (in edges or in center) significantly affected (p<0.05) the tested pest density, e.g. optimum density was 146.69 individuals/plant in the center of the field. Whereas was 93.32 in the edges. Effect of the interaction between location and surrounding vegetation was significant on aphid density, which their population densit

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Publication Date
Tue Apr 09 2019
Journal Name
Journal Of The College Of Education For Women
The Role of Civil Society Institutions for the Care of Young People in Iraq ( Possibilities and constraints): A Field Study from the Point of view of University Students
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Besides the role of state institutions that come in the forefront of their priorities and obligations to provide security and development of the economy and reduce the unemployment rate and the reduction of inflation and improving education, health and others, the Community Partnership At frames what has become known as the institutions of society civil-with the state does not eliminate the role, but rather complements its role ; it is the role of civil society partner and an extension of the role of the state in the face of challenges and crises, but it may be sometimes a race role in addressing social, political and economic issues of the role played by the state, not complementary.
The highlighting the specificity of the relationsh

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Publication Date
Sun Feb 12 2017
Journal Name
World J Exp Biosc
Detection and sequencing of blaVEB-1 gene in clinical isolates of Proteus mirabilis Isolates from Baghdad City`s hospitals
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In Present study, 25 clinical isolates of Proteus spp. of clinical samples, urine, wounds and burns collected from different hospitals in Baghdad city, all isolates were identified as Proteus mirabilis using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifying as P. mirabilis. The susceptibility of P. mirabilis isolates to cefotaxime was 66.6 %, while to ceftazidime was 20%. Extended spectrum β-lactamses producing Proteus was 30.7 %. DNA of 5 isolates of P. mirabilis was extracted and detection for blaVEB-1 gene by using multiplex polymerase chain reaction (PCR). Results showed that the presence of this gene in all tested isolates, as an important indicator for increas

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Synthesis, Characterizations, and Recent Applications of the Silica-based Mobil Composition of Mesoporous Material: A Review
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Silica-based mesoporous materials are a class of porous materials with unique characteristics such as ordered pore structure, large surface area, and large pore volume. This review covers the different types of porous material (zeolite and mesoporous) and the physical properties of mesoporous materials that make them valuable in industry. Mesoporous materials can be divided into two groups: silica-based mesoporous materials and non-silica-based mesoporous materials. The most well-known family of silica-based mesoporous materials is the Mesoporous Molecular Sieves family, which attracts attention because of its beneficial properties. The family includes three members that are differentiated based on their pore arrangement. In this review,

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive Conflict Strategy in Comprehending Reading Among the Fifth Literary Students in the Subject of Literature and Texts
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The aim of the current study is to identify the effectiveness of cognitive conflict strategy in comprehending reading among literary fifth students in literature and literature texts. The researcher uses experimental method with partial control. The sample consisted of (80) students distributed into control and experimental groups. The scientific material, the behavioral goals, the teaching plans, and the instrument of the research have been prepared (reading comprehension test) by the researcher.

The instrument's validity and reliability have been calculated and then applied to the sample. After treating the data statistically by using SPSS, the results have revealed that there is a statistically significant difference at the si

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Publication Date
Tue Jan 12 2016
Journal Name
Wireless Networks
Low communication cost (LCC) scheme for localizing mobile wireless sensor networks
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In recent years, the number of applications utilizing mobile wireless sensor networks (WSNs) has increased, with the intent of localization for the purposes of monitoring and obtaining data from hazardous areas. Location of the event is very critical in WSN, as sensing data is almost meaningless without the location information. In this paper, two Monte Carlo based localization schemes termed MCL and MSL* are studied. MCL obtains its location through anchor nodes whereas MSL* uses both anchor nodes and normal nodes. The use of normal nodes would increase accuracy and reduce dependency on anchor nodes, but increases communication costs. For this reason, we introduce a new approach called low communication cost schemes to reduce communication

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