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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 Oct 25 2023
Journal Name
Journal Of Optics
Integrated gallium phosphide-waveguide polarization rotator based on rotating a horizontal slot by 45 degree for 700 nm wavelength
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Abstract<p>Polarization manipulation elements operating at visible wavelengths represent a critical component of quantum communication sub-systems, equivalent to their telecom wavelength counterparts. The method proposed involves rotating the optic axis of the polarized input light by an angle of 45 degree, thereby converting the fundamental transverse electric (TE<sub>0</sub>) mode to the fundamental transverse magnetic (TM<sub>0</sub>) mode. This paper outlines an integrated gallium phosphide-waveguide polarization rotator, which relies on the rotation of a horizontal slot by 45 degree at a wavelength of 700 nm. This will ultimately lead to the conception of a mode hybridization phenomeno</p> ... Show More
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Publication Date
Wed Oct 25 2023
Journal Name
Journal Of Optics
Integrated gallium phosphide-waveguide polarization rotator based on rotating a horizontal slot by 45 degree for 700 nm wavelength
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Polarization manipulation elements operating at visible wavelengths represent a critical component of quantum communication sub-systems, equivalent to their telecom wavelength counterparts. The method proposed involves rotating the optic axis of the polarized input light by an angle of 45 degree, thereby converting the fundamental transverse electric (TE0) mode to the fundamental transverse magnetic (TM0) mode. This paper outlines an integrated gallium phosphide-waveguide polarization rotator, which relies on the rotation of a horizontal slot by 45 degree at a wavelength of 700 nm. This will ultimately lead to the conception of a mode hybridization phenomenon in the waveguide. The simulation results demonstrate a polarization co

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Publication Date
Wed Sep 01 2010
Journal Name
The International Journal Of Biochemistry &amp; Cell Biology
A plate-based assay system for analyses and screening of the Leishmania major inositol phosphorylceramide synthase
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Sphingolipids are key components of eukaryotic membranes, particularly the plasma membrane. The biosynthetic pathway for the formation of these lipid species is largely conserved. However, in contrast to mammals, which produce sphingomyelin, organisms such as the pathogenic fungi and protozoa synthesize inositol phosphorylceramide (IPC) as the primary phosphosphingolipid. The key step involves the reaction of ceramide and phosphatidylinositol catalysed by IPC synthase, an essential enzyme with no mammalian equivalent encoded by the AUR1 gene in yeast and recently identified functional orthologues in the pathogenic kinetoplastid protozoa. As such this enzyme represents a promising target for novel anti-fungal and anti-protozoal drugs. Given

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Publication Date
Mon Jan 01 2024
Journal Name
Lecture Notes In Electrical Engineering
A Method Combining Compressive Sensing-Based Method of Moment and LU Decomposition for Solving Monostatic RCS
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Publication Date
Mon Jan 01 2024
Journal Name
Optical Materials
Design and analysis of a high sensitivity open microchannel PCF-based surface plasmon resonance refractometric sensor
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Publication Date
Thu May 17 2012
Journal Name
Eurasip Journal On Wireless Communications And Networking
A cluster-based proxy mobile IPv6 for IP-WSNs
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Publication Date
Wed Jul 06 2022
Journal Name
Journal Of Al-qadisiyah For Computer Science And Mathematics
Pixel Based Techniques for Gray Image Compression: A review
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Currently, with the huge increase in modern communication and network applications, the speed of transformation and storing data in compact forms are pressing issues. Daily an enormous amount of images are stored and shared among people every moment, especially in the social media realm, but unfortunately, even with these marvelous applications, the limited size of sent data is still the main restriction's, where essentially all these applications utilized the well-known Joint Photographic Experts Group (JPEG) standard techniques, in the same way, the need for construction of universally accepted standard compression systems urgently required to play a key role in the immense revolution. This review is concerned with Different

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Publication Date
Sun Nov 01 2020
Journal Name
Journal Of Engineering
A Signal Amplification-based Transceiver for Visible Light Communication
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Visible light communication (VLC) is an upcoming wireless technology for next-generation communication for high-speed data transmission. It has the potential for capacity enhancement due to its characteristic large bandwidth. Concerning signal processing and suitable transceiver design for the VLC application, an amplification-based optical transceiver is proposed in this article. The transmitter consists of a driver and laser diode as the light source, while the receiver contains a photodiode and signal amplifying circuit. The design model is proposed for its simplicity in replacing the trans-impedance and transconductance circuits of the conventional modules by a simple amplification circuit and interface converter. Th

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Publication Date
Fri Feb 08 2013
Journal Name
Advances In Life Science And Technology
An Analytical and Clinical Study for Measure the Bioavailabilityof Zinc in Serum Using Flame Atomic Absorption Technique
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An analytical and clinical study has been applied for measure the bioavailability of Zinc in serum of twenty adults healthy volunteers, using flame atomic absorption spectrophotometer (FAAS) at 213.9 nm. The calibration graph is linear in the ranges of 0.25-1.5 μg.mL-1 with correlation coefficient (R) 0.09996)μg.mL1-and molar absorpitivites 22957.76(L.mol1-cm-1.The concentration of Zinc determined in serum of all volunteers before and after administered orally a tablet of 50 mg zinc sulphate, produced by Samara drugs company (SDI). All data were subjected to statistical analysis by calculating accuracy, precision in addition to other parameters. The results indicate that the average maximum concentration (C-max ± SD) of blood zinc was 0.

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Publication Date
Sat Aug 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using BIM for Optimizing the Upgrading Cost to Convert the Traditional Buildings to Sustainable Buildings in Iraq
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Abstract<p>A high percentage of existing buildings in Iraq are traditional buildings, yet there is approximately no such green building in Baghdad or other governorates. Most of these buildings require urgent upgrading to increase their performance (operationally, economically, and environmentally), also the building owners looking for identifying and implementing many of the green building measures to reduce the operational and maintenance costs of their buildings. The decision-makers need to support the possibility of achieving sustainable measures of existing building rating systems such as LEED or BREEAM, and that would require an optimization model. The goal of this study is to maximize the</p> ... Show More
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