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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
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Optimization of Gas Lifting Design in Mishrif Formation of Halfaya Oil Field
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The optimization of artificial gas lift techniques plays a crucial role in the advancement of oil field development. This study focuses on investigating the impact of gas lift design and optimization on production outcomes within the Mishrif formation of the Halfaya oil field. A comprehensive production network nodal analysis model was formulated using a PIPESIM Optimizer-based Genetic Algorithm and meticulously calibrated utilizing field-collected data from a network comprising seven wells. This well group encompasses three directional wells currently employing gas lift and four naturally producing vertical wells. To augment productivity and optimize network performance, a novel gas lift design strategy was proposed. The optimization of

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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
Calculation of Pressure Loss of Two Drilling Muds in Noor Oil Field
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In this work, calculation of pressure losses in circulating system for two drilling muds is evaluated in Noor oil field. Two types of drilling muds that were used for drilling section 12 1/4" and 8 3/4" which are Salt saturated mud and Ferro Chrome Lignosulfonate-Chrome Lignite mud. These calculations are based on field data that were gathered from the drilling site of well Noor-15, which are included, rheological data, flow data and specification of drill string. Based on the obtained results, the best rheological model that fit their data is the Herschel-Bulkley model according to correlation coefficient value for their two drilling mud. Also, the difference between the calculated pressure lo

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Analysis of the performance of a fiber optic sensor used to measure the intensity of the electric field
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In this research was conducted to provide a product to analyze the performance sensor fiber optic used to measure and feel the intensity of the electric field results showed obtained that use sensor long gives reactive high electric field strength and a high value for allergic sensor, but that is at the expense of reducing the intensity of the electric field that is detected

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Publication Date
Wed Oct 18 2023
Journal Name
Ieee Access
A New Imputation Technique Based a Multi-Spike Neural Network to Handle Missing Data in the Internet of Things Network (IoT)
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Publication Date
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Correlation Study of Retinol Binding Protein4, Vitamin A with Liver Function Enzymes in Iraqi Fracture Patients with and without DM2
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A fracture is a damage to bone tissue that causes damage to the tissue surrounding the bone and may penetrate the skin. Subjects and methods: the present study included (80) fractured Iraqi patients (and 40) patients with DM2 and (40) without DM2 and compared them with (40) healthy control. Patients and control are matched in age. This study showed a significant increase in retinol-binding protein 4 (RBP4) and a considerable decrease in Vit .A GPT and GOT in fracture patients with and without DM2. In addition, there was a significant negative correlation between RBP4 with (GPT and GOT) in fracture patients with DM2 and a significant positive correlation between RBP4 with (GPT and GOT) in fracture patients without DM2.       

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Publication Date
Tue Nov 01 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Correlation Study of Retinol Binding Protein4, Vitamin A with Liver Function Enzymes in Iraqi Fracture Patients with and without DM2
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Background: Recent research indicates that persistent inflammatory responses may contribute to the rise of diabetic nephropathy (DN) and diabetic cardiovascular disease (DCVD) in type 2 diabetes mellitus patients (DM2). Numerous molecules associated with inflammation and angiogenesis have been implicated in the development and progression of DN and DCVD, respectively. Methods: The subjects were separated into five groups: healthy controls (n= 25), type 2 diabetes mellitus patients (n= 30), type 2 diabetes mellitus patients with nephropathy DN (n= 30), and type 2 diabetes mellitus patients with cardiovascular disease DCVD (n= 30). The blood levels of irisin, IL-8, HbA1C, urea, and creatinine were determined. Results: In current study there w

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Publication Date
Thu Dec 15 2022
Journal Name
Arab World English Journal
Genre-Based Analysis of Selected Political Debates: A Discourse Analysis Study
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The researchers of the present study have conducted a genre analysis of two political debates between American presidential nominees in the 2016 and 2020 elections. The current study seeks to analyze the cognitive construction of political debates to evaluate the typical moves and strategies politicians use to express their communicative intentions and to reveal the language manifestations of those moves and strategies. To achieve the study’s aims, the researchers adopt Bhatia’s (1993) framework of cognitive construction supported by van Emeren’s (2010) pragma-dialectic framework. The study demonstrates that both presidents adhere to this genre structuring to further their political agendas. For a positive and promising image

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Publication Date
Mon Feb 13 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the Cooperative Inquiry Strategy in the Achievement and Development of Mathematical Communication Skills of Elementary School Students
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Abstract

This study aims at investigating the effectiveness of the cooperative inquiry strategy in developing the achievement and development of mathematical communication skills of elementary school students. To achieve this aim, the experimental method was utilized. The study sample consisted of an experimental group (n = 34) and a control group (n = 31), which were randomly selected from primary schools. A Teacher's Guide for teaching a unit entitled "Statistics and Graphic Representations" for the sixth elementary graders in the first semester were devised. A (30) multiple-choice item achievement test distributed at the levels of (recall, comprehension, and application), as well as an (18) item mathematical c

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Publication Date
Thu Mar 23 2023
Journal Name
Journal Of Kerbala For Agricultural Sciences
Evaluation of the effectiveness of spore suspension and fungal filtrate of Metarhizium anisopliae fungus in controlling Tribolium castaneum (Coleoptera: Tenebrionidae)
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This study evaluated the effect of spore suspension and fungal filtrate against different developmental stages of Tribolium castaneum third and fifth larval instars and adults. Two isolates of entomopathogenic fungus Metarhizium anisopliae were used (commercially (Met 52 EC), and domesticly). For the two isolates, the effectiveness of various conidial concentrations were (1 × 104 ; 1 × 106 ; 1 × 108  conidia/ ml) and various concentrations of fungal filtrate (100,75,50%) were evaluated. It is observed that the fungal filtrate at a concentration of 75% and the conidial concentration of 1 x 108 conidia /ml for both isolates were the most effective in causing the highest mortality rates to the third and fifth instar larva and adult

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Publication Date
Wed Dec 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A Vision to development the Islamic banks that operating under the financial system based on interest: (Iraq Case Study)
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This paper aims to build a modern vision for Islamic banks to ensure sustainability and growth, as well it aims to highlight the positive Iraqi steps in the Islamic banking sector. In order to build this vision, several scientific research approaches were adopted (quantitative, descriptive analytical, descriptive). As for the research community, it was for all the Iraqi private commercial banks, including Islamic banks. The research samples varied according to a diversity of the methods and the data availability. A questionnaire was constructed and conducted, measuring internal and external honesty. 50 questionnaires were distributed to Iraqi academic specialized in Islamic banking. All distributed forms were subject to a thorough analys

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