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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
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Cardiac Rehabilitation Instructional Program on Health-related Quality of Life for Patients Undergone Coronary Artery Bypass Graft Surgery
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Objective(s): evaluation of effectiveness of cardiac rehabilitation instructional program on health-related quality of life and to find out the relationship between health-related quality of life and patient’s socio-demographic and clinical characteristics.  Methodology: A descriptive study design was carried out from 8th August, 2022 to 10th January, 2023. A non-probability purposive sample of (50) patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases using pre-experimental design. The data were collected by direct interview with sample using questionnaire composed of three parts: part (1) Socio-demographic and clinical characteristics which included 11 items. Part (2) Knowledge r

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Cardiac Rehabilitation Instructional Program on Health-related Quality of Life for Patients Undergone Coronary Artery Bypass Graft Surgery
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Objective(s): evaluation of effectiveness of cardiac rehabilitation instructional program on health-related quality of life and to find out the relationship between health-related quality of life and patient’s socio-demographic and clinical characteristics. 

Methodology: A descriptive study design was carried out from 8th August, 2022 to 10th January, 2023.

A non-probability purposive sample of (50) patients undergone coronary artery bypass graft surgery at Iraqi center for heart diseases using pre-experimental design. The data were collected by direct interview with sample using questionnaire composed of three parts: part (1) Socio-demographic and clinical ch

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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
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Proposing an Analysis System to Monitoring Weightlifting Based on Training (Snatch and Clean and Jerk)
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Analysis system of sports players is very important for individuals in weightlifting. Assessment of player and strength is important for the performance of weightlifting. This paper proposes an analytical method for weightlifters with check-by-frame video. This analysis system can compute the major steps of seven positions in both snatch and clean and jerk methods in frame-video weightlifting monitoring of movements. Each user can compute the major steps of the seven positions of Hu moments among two frames in the video during training, and the Euclidian distance can be computed for the Hu moment values and lifting moment values in the snatch and clean and jerk methods during training. The outcome of the proposed system shows on efficien

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Publication Date
Wed Aug 31 2022
Journal Name
Ieee Access
SHE Networks: Security, Health, and Emergency Networks Traffic Priority Management Based on ML and SDN
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Recently, the increasing demand to transfer data through the Internet has pushed the Internet infrastructure to the nal edge of the ability of these networks. This high demand causes a deciency of rapid response to emergencies and disasters to control or reduce the devastating effects of these disasters. As one of the main cornerstones to address the data trafc forwarding issue, the Internet networks need to impose the highest priority on the special networks: Security, Health, and Emergency (SHE) data trafc. These networks work in closed and private domains to serve a group of users for specic tasks. Our novel proposed network ow priority management based on ML and SDN fullls high control to give the required ow priority to SHE dat

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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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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
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
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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