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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
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Multi-Stage Hydraulic Fracturing Completion Design Based on Ball-and-Sleeve Method
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This paper proposes a completion that can allow fracturing four zones in a single trip in the well called “Y” (for confidential reasons) of the field named “X” (for confidential reasons). The steps to design a well completion for multiple fracturing are first to select the best completion method then the required equipment and the materials that it is made of. After that, the completion schematic must be drawn by using Power Draw in this case, and the summary installation procedures explained. The data used to design the completion are the well trajectory, the reservoir data (including temperature, pressure and fluid properties), the production and injection strategy. The results suggest that multi-stage hydraulic fracturing can

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Arabic Speech Classification Method Based on Padding and Deep Learning Neural Network
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Deep learning convolution neural network has been widely used to recognize or classify voice. Various techniques have been used together with convolution neural network to prepare voice data before the training process in developing the classification model. However, not all model can produce good classification accuracy as there are many types of voice or speech. Classification of Arabic alphabet pronunciation is a one of the types of voice and accurate pronunciation is required in the learning of the Qur’an reading. Thus, the technique to process the pronunciation and training of the processed data requires specific approach. To overcome this issue, a method based on padding and deep learning convolution neural network is proposed to

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
Human Face Recognition Based on Local Ternary Pattern and Singular Value Decomposition
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There is various human biometrics used nowadays, one of the most important of these biometrics is the face. Many techniques have been suggested for face recognition, but they still face a variety of challenges for recognizing faces in images captured in the uncontrolled environment, and for real-life applications. Some of these challenges are pose variation, occlusion, facial expression, illumination, bad lighting, and image quality. New techniques are updating continuously. In this paper, the singular value decomposition is used to extract the features matrix for face recognition and classification. The input color image is converted into a grayscale image and then transformed into a local ternary pattern before splitting the image into

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
The Necessity of Teaching Diabetic Patients the Correct way of Insulin Administration: A Clinical Trial to Improve Glycemic Control
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Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
The Necessity of Teaching Diabetic Patients the Correct way of Insulin Administration: A Clinical Trial to Improve Glycemic Control
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Background: It is important to achieve good glycemic control to avoid long-term diabetic complications. It has been largely debated about the role of correct way of insulin administration to get the desired glycemic control.
Objective: To evaluate the effect of teaching diabetic patients who are on insulin therapy the correct way of injecting insulin and its effect on glycemic control.
Methods: A non randomized clinical trial with 820 diabetic patients on insulin therapy on whom A1 c estimation was performed before and after three months of teaching them the right injection technique.
Results : Sixty seven patients (8.17%) had A1 c 6.5% before they were enrolled in the study while the majority (753 patents, 91.82%) had A1 c 6.5%

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Publication Date
Sat Sep 23 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients
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Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measure the effectiveness of the Balanced Scorecard strategic performance management in public institutions of Jordan )An Empirical Study on the Social Security Corporation – Irbid(
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The goal of this research to identify a set of criteria that can be measured on the basis of which the effectiveness of the application of the Balanced Scorecard in the Jordanian Public Institutions in order to identify the basic requirements to ensure the application of balanced performance measures. The study population consisted of the staff of the Public Institution for Social Security - Irbid of directors of departments and heads of departments and administrative staff, was the use of a random sample of (50) an employee and the employee. The questionnaire was used as a tool to collect data, and as a result of subjecting these standards for the field test and the use of statistical analysis tools to the results of the study c

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Publication Date
Thu Jun 18 2020
Journal Name
Biochem. Cell. Arch.
NEW DERIVATIVE OF CHITOSAN BASED ON EPICHLOROHYDRNE, SYNTHESIS, CHARACTERIZATION, ANTIBACTERIAL ACTIVITY AND SWELLING STUDY
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A novel series of chitosan derivatives were synthesized via reaction of chitosan with carbonyl compounds and grafted it’s by with different amine compounds substituted hydrogen. The produced polymers were characterized by different analyses FTIR, 1HCNMR, XRD, DSC and TGA. Solubility in water as well as many solvent was investigated, antibacterial activity of chitosan and its derivatives against two types of bacteria E. coli and S. aureus was also investigated. The results showed that derivatives sort of have antibacterial activities against Esherichia coli (Gram negative) better than chitosan whilst compound IX has better antibacterial against Staphylococcus aureus (Gram positive). SEM analysis showed that increase of surface roughness wi

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Publication Date
Tue Sep 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Pre-Processing and Surface Reconstruction of Points Cloud Based on Chord Angle Algorithm Technique
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Abstract

Although the rapid development in reverse engineering techniques, 3D laser scanners can be considered the modern technology used to digitize the 3D objects, but some troubles may be associate this process due to the environmental noises and limitation of the used scanners. So, in the present paper a data pre-processing algorithm has been proposed to obtain the necessary geometric features and mathematical representation of scanned object from its point cloud which obtained using 3D laser scanner (Matter and Form) through isolating the noised points. The proposed algorithm based on continuous calculations of chord angle between each adjacent pair of points in point cloud. A MATLAB program has been built t

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Publication Date
Wed Jan 01 2020
Journal Name
Biochemical And Cellular Archives
New derivative of chitosan based on epichlorohydrne, synthesis, characterization, antibacterial activity and swelling study
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A novel series of chitosan derivatives were synthesized via reaction of chitosan with carbonyl compounds and grafted it’s by with different amine compounds substituted hydrogen. The produced polymers were characterized by different analyses FTIR, 1HCNMR, XRD, DSC and TGA. Solubility in water as well as many solvent was investigated, antibacterial activity of chitosan and its derivatives against two types of bacteria E. coli and S. aureus was also investigated. The results showed that derivatives sort of have antibacterial activities against Esherichia coli (Gram negative) better than chitosan whilst compound IX has better antibacterial against Staphylococcus aureus (Gram positive). SEM analysis showed that increase of surface roughness wi

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