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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
Mon Jun 30 2025
Journal Name
Acta Logistica
A business continuity-based framework for risk management in smart supply chains: a fuzzy multi-criteria decision-making approach
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The aim of this study is to develop a novel framework for managing risks in smart supply chains by enhancing business continuity and resilience against potential disruptions. This research addresses the growing uncertainty in supply chain environments, driven by both natural phenomena-such as pandemics and earthquakes—and human-induced events, including wars, political upheavals, and societal transformations. Recognizing that traditional risk management approaches are insufficient in such dynamic contexts, the study proposes an adaptive framework that integrates proactive and remedial measures for effective risk mitigation. A fuzzy risk matrix is employed to assess and analyze uncertainties, facilitating the identification of disr

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
THE STUDY ON ABILITY OF ESCHERICHIA COLI ISOLATED FROM DIFFERENT CLINICAL CASES TO BIOFILM FORMATION AND DETECTION OF CSGD GENE RESPONSIBLE FOR PRODUCE CURLI (FIMBRIAE)
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A total of 165 clinical sample included Urine, Swab wounds and Burns were collected from Baghdad Governorate. Results showed that rate all isolates of E. coli was 50(30.3%) and rate of urine infection was 46(92%) and rate of swab wounds infection 4(8%). Where was diagnostic based on streaked on MacConkey agar, then single colony was transferred to Eosin Methylene Blue (EMB). Identification some of the biochemical test included: Catalase test, Oxidase test, Indole test, Methyl red, Vogues - Proskauer test and Citrate Utilization test. Then confirmed by the Vitek - 2 Compact System. The ability of E.coli isolate to biofilm formation to be studied it is considered one of the most important factors of virulence and has role in causing injury an

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Publication Date
Mon Jan 13 2020
Journal Name
Day 3 Wed, January 15, 2020
Numerical Simulation of Gas Lift Optimization Using Genetic Algorithm for a Middle East Oil Field: Feasibility Study
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<p>Gas-lift technique plays an important role in sustaining oil production, especially from a mature field when the reservoirs’ natural energy becomes insufficient. However, optimally allocation of the gas injection rate in a large field through its gas-lift network system towards maximization of oil production rate is a challenging task. The conventional gas-lift optimization problems may become inefficient and incapable of modelling the gas-lift optimization in a large network system with problems associated with multi-objective, multi-constrained, and limited gas injection rate. The key objective of this study is to assess the feasibility of utilizing the Genetic Algorithm (GA) technique to optimize t</p> ... Show More
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Publication Date
Wed May 05 2021
Journal Name
Journal Of Petroleum Research And Studies
The Role of Chemistry of the Oil-Field Water in the Distribution of Reservoir Pressures: A Case Study of Mishrif Reservoir in the Southern Oil-Fields, Iraq
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Mishrif Formation is the main reservoir in oil-fields (North Rumaila, South Rumaila, Majnoon, Zubair and West Qurna) which located at Basrah southern Iraq. The Inductively coupled plasma-Mass spectrometer (ICP-MS) was used for the water chemistry analysis and Scanning Electron Microprobe (SEM) for the purpose of mineralogy diagnosis. A weak acidic water of salinity six-time greater than seawater plays a role in generating the formation pressure and controlling the fluid flow. The potentiometric subsurface maps were modeled and the direction of super-pressure sites that are of a great importance in the oil exploration were marked to pay attention during future drilling.

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Publication Date
Sat Aug 02 2025
Journal Name
Engineering, Technology &amp; Applied Science Research
A New Method for Face-Based Recognition Using a Fuzzy Face Deep Model
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Face recognition is a crucial biometric technology used in various security and identification applications. Ensuring accuracy and reliability in facial recognition systems requires robust feature extraction and secure processing methods. This study presents an accurate facial recognition model using a feature extraction approach within a cloud environment. First, the facial images undergo preprocessing, including grayscale conversion, histogram equalization, Viola-Jones face detection, and resizing. Then, features are extracted using a hybrid approach that combines Linear Discriminant Analysis (LDA) and Gray-Level Co-occurrence Matrix (GLCM). The extracted features are encrypted using the Data Encryption Standard (DES) for security

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Publication Date
Thu Jun 06 2019
Journal Name
Indian Journal Of Public Health, Research And Development
Clinical Manifestation of Singleton Pregnancy Complicated by Diabetes Mellitus
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Publication Date
Fri May 01 2020
Journal Name
Environmental Technology & Innovation
Environmental remediation of synthetic leachate produced from sanitary landfills using low-cost composite sorbent
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Publication Date
Mon Dec 30 2013
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Permeability Prediction of Un-Cored Intervals Using FZI Method and Matrix Density Grouping Method: A Case Study of Abughirab Field/Asmari FM., Iraq
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Knowledge of permeability is critical for developing an effective reservoir description. Permeability data may be calculated from well tests, cores and logs. Normally, using well log data to derive estimates of permeability is the lowest cost method. This paper will focus on the evaluation of formation permeability in un-cored intervals for Abughirab field/Asmari reservoir in Iraq from core and well log data. Hydraulic flow unit (HFU) concept is strongly related to the flow zone indicator (FZI) which is a function of the reservoir quality index (RQI). Both measures are based on porosity and permeability of cores. It is assumed that samples with similar FZI values belong to the same HFU. A generated method is also used to calculate permea

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Publication Date
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
Education and the Challenges of Globalization during the Corona Pandemic: A Field Study from Baghdad University Professors’ Point of View: ميسم ياسين عبيد
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study aims to examine education and the challenges of globalization in light of Corona pandemic. The examination involves surveying a randomly selected sample from the University of Baghdad’s professors, particularly from the colleges of Education for Women, Arts, and Sciences. The purpose of this examination is to learn about the dimensions of globalization, its effects on the educational process, and the importance of distance education during the spread of Corona virus quarantine. To achieve this, the researcher followed a descriptive and analytical approach by applying a questionnaire to a sample of 70 teachers who were randomly selected electronically. Results have shown that 78.6% emphasized the contribution of globalization duri

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Publication Date
Sun Apr 07 2013
Journal Name
Journal Of Educational And Psychological Researches
Effectiveness of enrichment activities through using software program for second graders in Conversation article
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Today we are witnessing huge scientific and technical progress so we need more skills and methods of thinking that needs to be acquired by the teacher, as the importance of computers in education  there are  many teachers  suffering  of the difficulty in teaching for pupils . researchers tried to  find a good suitable way with the technological  interests for now which represent by  computer design software and the introduction of enrichment activities in the curriculum because it is one of a contemporary trends for the development of the Arabic language with various levels of education and knowing if this program has negative or positive impact.

So&nbsp

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