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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 Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis and Biological Effectiveness of Some new Azo Compounds as Derivatives of Nitrogen Bases
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In this study the new azo compounds (3compounds) for nitrogen bases (Adenine and Cytosine) are synthesized through two reaction steps (formation of diazonium salt and coupling reaction). The compounds have been characterized by FTIR, melting point, and ultra-violate (UV) spectra. All synthesized compounds have been estimated in vitro for their antimicrobial activities against two species of bacteria(E.coli, S.aureus)and one kind of fungi ( Aspergillus flavus) .The results show that these compounds have very good antibacterial and antifungal activities especially compounds 1 and 3.To study the effect of these compounds were making some physiological tests on rats are made ,the results of hematological study showed decreasing level of

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Publication Date
Mon Dec 30 2024
Journal Name
Iraqi Journal Of Science
The Impact of Fear and Anti-Predator Behavior on the Dynamics of Stage-Structure Prey–Predator Model With a Harvesting
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In this paper, an ecological model with stage-structure in prey population, fear, anti-predator and harvesting are suggested. Lotka-Volterra and Holling type II functional responses have been assumed to describe the feeding processes . The local and global stability of steady points of this model are established. Finally, the global dynamics are studied numerically to investigate the influence of the parameters on the solutions of the system, especially the effect of fear and anti-predation.

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Publication Date
Sun Dec 01 2019
Journal Name
Indian Journal Of Ecology
Evaluation of maize hybrids, their inbred lines and estimation of genetic divergence based on cluster analysis
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Publication Date
Sat Sep 30 2017
Journal Name
Al-khwarizmi Engineering Journal
Influence of Nanoreinforced Particles (Al2O3) on Fatigue Life and Strength of Aluminium Based Metal Matrix Composite
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Abstract

     In this investigation, Al2O3 nano material of 50nm particles size were added to the 6061 Al aluminium alloy by using the stir casting technique to fabricate the nanocomposite of 10wt% Al2O3. The experimental results observed that the addition of 10wt% Al2O3 improved the fatigue life and strength of constant and cumulative fatigue. Comparison between the S-N curves behaviour of metal matrix (AA6061) and the nanocomposite 10wt% Al2O3 has been made. The comparison revealed that 12.8% enhancement in fatigue strength at 107cycles due to 10wt% nano reinforcement. Also cumulative fatigue l

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Publication Date
Fri Jul 01 2016
Journal Name
Colloids And Surfaces A: Physicochemical And Engineering Aspects
Stability and thermophysical properties of water-based nanofluids containing triethanolamine-treated graphene nanoplatelets with different specific surface areas
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tA novel synthesis procedure is presented for preparing triethanolamine-treated graphene nanoplatelets(TEA-GNPs) with different specific areas (SSAs). Using ultrasonication, the covalently functionalizedTEA-GNPs with different weight concentrations and SSAs were dispersed in distilled water to prepareTEA-GNPs nanofluids. A simple direct coupling of GNPs with TEA molecules is implemented to synthesizestable water-based nanofluids. The effectiveness of the functionalization procedure was validated by thecharacterization and morphology tests, i.e., FTIR, Raman spectroscopy, EDS, and TEM. Thermal conduc-tivity, dispersion stability, and rheological properties were investigated. Using UV–vis spectrometer, ahighest dispersion stability of 0.876

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Publication Date
Sun Dec 01 2024
Journal Name
Energy Storage
Comprehensive Study of <scp>PAN</scp>‐<scp>NaBF<sub>4</sub></scp> Solid Polymer Electrolytes: Insights Into Optical, Structural, Thermal, Electrical, and Electrochemical Properties for Sodium‐Ion Batteries
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ABSTRACT<p>This research explores the use of solid polymer electrolytes (SPEs) as a conductive medium for sodium ions in sodium‐ion batteries, presenting a possible alternative to traditional lithium‐ion battery technology. The researchers prepare SPEs with varying molecular weight ratios of polyacrylonitrile (PAN) and sodium tetrafluoroborate (NaBF<sub>4</sub>) using a solution casting method with dimethyl formamide as the solvent. Through optical absorbance measurements, we identified the PAN:NaBF<sub>4</sub> (80:20) SPE composition as having the lowest energy band gap value (4.48 eV). This composition also exhibits high thermal stability based on thermogravimetric analysis results. </p> ... Show More
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Publication Date
Thu Nov 27 2025
Journal Name
Frontiers In Robotics And Ai
Design of modified fractional-order PID controller for lower limb rehabilitation exoskeleton robot based on an improved elk herd hybridized with grey wolf and multi-verse optimization algorithms
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Rehabilitation robots are widely recognized as vital for restoring motor function in patients with lower-limb impairments. A Modified Fractional-Order Proportional-Integral-Derivative (MFOPID) controller is proposed to improve trajectory tracking of a 2-DoF Lower Limb Rehabilitation Exoskeleton Robot (LLRER). The classical FOPID is augmented with a modified control formulation by which steady-state error is reduced and the transient response is sharpened. Controller gains and fractional orders were tuned offline using a hybrid metaheuristic Improved Elk Herd Optimization hybridized with Grey Wolf and Multi-Verse Optimization algorithms (IElk-GM) so that exploration and exploitation are balanced. Superiority over the classical FOPID

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Publication Date
Sat Mar 26 2022
Journal Name
Indian Journal Of Ecology
Assessment of Antimicrobial Resistance to Klebsiella pneumonia Isolated from Various Clinical Samples in Baghdad
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Klebsiella pneumoniae is a severe opportunistic strain of enteric bacteria that is a major cause of urinary tract infection and pneumonia. This study was conducted in Baghdad City during September 2020-November 2020 on 50 clinical samples of urine, vaginal, sputum, wound swabs, ear swabs, and burn swabs. strains were identified using the VITEK-2 compact system and tested in K. pneumoniae terms of susceptibility to various antimicrobial drugs by Kirby-Bauer test. The isolates were more predominant in the females (56%) compared to males (44%). The antibiotic resistance rate of varied among different isolated clinical sample sources. K. pneumoniae K. pneumoniae isolated from different clinical specimens differed with respect

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Publication Date
Thu Sep 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
12- months color stability of direct resin composite veneers in anterior teeth: Clinical trial
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Background: This clinical trial aims to evaluate the color changes of direct resin composite veneer (DCV) restorations based on spectrophotometric analysis of 4 different types of resin composites between the baseline immediately after polishing and after one year of follow-up. Materials and methods: 28 patients were assessed for eligibility for participation, aged between 18 and 38 years old, who indicated for DCV restorations in anterior maxillary teeth were considered for participation in this study. In total, 25 patients who met the inclusion criteria were selected (6 males and 19 females, mean age: 20.9 at the time of restoration placement), and 3 patients were excluded. Partic

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
On The Dynamical Behavior of a Prey-Predator Model With The Effect of Periodic Forcing
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The dynamical behavior of a two-dimensional continuous time dynamical system describing by a prey predator model is investigated. By means of constructing suitable Lyapunov functional, sufficient condition is derived for the global asymptotic stability of the positive equilibrium of the system. The Hopf bifurcation analysis is carried out. The numerical simulations are used to study the effect of periodic forcing in two different parameters. The results of simulations show that the model under the effects of periodic forcing in two different parameters, with or without phase difference, could exhibit chaotic dynamics for realistic and biologically feasible parametric values.

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