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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 Nov 01 2017
Journal Name
Journal Of Engineering
Performance evaluation of Sequencing Batch Reactor and Conventional Wastewater Treatment Plant based on Reliability assessment
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Baghdad city has been faced numerous issues related to freshwater environment deteriorations due to many reasons, mainly was the discharge of wastewater without adequate treatment. Al- Rustamiya Wastewater Treatment Plant (WWTP) have been constructed among many plants in Baghdad city to reduce the amount of wastewater discharged into natural environment and its subsequent adverse effects. This study was conducted to evaluate the performance of the plant which consist of a conventional activated sludge (CAS) and sequencing batch reactors (SBR) systems as secondary treatment units and its ability to meet Iraqi specifications. A reliability level determination and analysis also were conducted to find the plant's stability and its capabi

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Publication Date
Tue Dec 10 2024
Journal Name
Mesopotamian Journal Of Cybersecurity
Development of Robust and Efficient Symmetric Random Keys Model based on the Latin Square Matrix
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Symmetric cryptography forms the backbone of secure data communication and storage by relying on the strength and randomness of cryptographic keys. This increases complexity, enhances cryptographic systems' overall robustness, and is immune to various attacks. The present work proposes a hybrid model based on the Latin square matrix (LSM) and subtractive random number generator (SRNG) algorithms for producing random keys. The hybrid model enhances the security of the cipher key against different attacks and increases the degree of diffusion. Different key lengths can also be generated based on the algorithm without compromising security. It comprises two phases. The first phase generates a seed value that depends on producing a rand

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Publication Date
Thu Mar 29 2018
Journal Name
Construction Research Congress 2018
Consideration of Worker Safety in the Design Process: A Statistical-Based Approach Using Analysis of Variance (ANOVA)
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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
Thu Jan 20 2022
Journal Name
Webology
Hybrid Intrusion Detection System based on DNA Encoding, Teiresias Algorithm and Clustering Method
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Until recently, researchers have utilized and applied various techniques for intrusion detection system (IDS), including DNA encoding and clustering that are widely used for this purpose. In addition to the other two major techniques for detection are anomaly and misuse detection, where anomaly detection is done based on user behavior, while misuse detection is done based on known attacks signatures. However, both techniques have some drawbacks, such as a high false alarm rate. Therefore, hybrid IDS takes advantage of combining the strength of both techniques to overcome their limitations. In this paper, a hybrid IDS is proposed based on the DNA encoding and clustering method. The proposed DNA encoding is done based on the UNSW-NB15

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Publication Date
Mon Dec 03 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Condition assessment and rehabilitation for trunk sewer deterioration based on Semi-Markov model
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An accurate assessment of the pipes’ conditions is required for effective management of the trunk sewers. In this paper the semi-Markov model was developed and tested using the sewer dataset from the Zublin trunk sewer in Baghdad, Iraq, in order to evaluate the future performance of the sewer. For the development of this model the cumulative waiting time distribution of sewers was used in each condition that was derived directly from the sewer condition class and age data. Results showed that the semi-Markov model was inconsistent with the data by adopting ( 2 test) and also, showed that the error in prediction is due to lack of data on the sewer waiting times at each condition state which can be solved by using successive conditi

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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
Coronavirus Disease Diagnosis, Care and Prevention (COVID-19) Based on Decision Support System
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              Automated clinical decision support system (CDSS) acts as new paradigm in medical services today. CDSSs are utilized to increment specialists (doctors) in their perplexing decision-making. Along these lines, a reasonable decision support system is built up dependent on doctors' knowledge and data mining derivation framework so as to help with the interest the board in the medical care gracefully to control the Corona Virus Disease (COVID-19) virus pandemic and, generally, to determine the class of infection and to provide a suitable protocol treatment depending on the symptoms of patient. Firstly, it needs to determine the three early symptoms of COVID-19 pandemic criteria (fever, tiredness, dry cough and breat

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Publication Date
Mon Jan 01 2024
Journal Name
Fifth International Conference On Applied Sciences: Icas2023
Facial deepfake performance evaluation based on three detection tools: MTCNN, Dlib, and MediaPipe
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Publication Date
Fri May 04 2018
Journal Name
Wireless Personal Communications
IFRS: An Indexed Face Recognition System Based on Face Recognition and RFID Technologies
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