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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 Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Physiotherapy on the Motor Recovery and Improvement in Patients with Facial Palsy
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Objectives: The study aims to investigate the efficiency of physiotherapy methods to improve the
degree of the clinical recovery of the peripheral facial palsy.
Methodology: This study is carried out at the Rehabilitation Center-Baghdad from November 2009 till
March 2010. This study includes (40) patient, their ages are from (13) to (55) years old; (24) male and
(16) female with unilateral facial palsy of undetermined cause. House-Brackmann facial recovery
scores have been used before and after the physiotherapy treatment.
Results: The results show that the physiotherapy sessions obtained the best effect of the electrical
stimulation, exercises and massage in the treatment of facial palsy. Highly respondents in femal

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Publication Date
Tue Aug 27 2024
Journal Name
Algorithms
Multithreading-Based Algorithm for High-Performance Tchebichef Polynomials with Higher Orders
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Tchebichef polynomials (TPs) play a crucial role in various fields of mathematics and applied sciences, including numerical analysis, image and signal processing, and computer vision. This is due to the unique properties of the TPs and their remarkable performance. Nowadays, the demand for high-quality images (2D signals) is increasing and is expected to continue growing. The processing of these signals requires the generation of accurate and fast polynomials. The existing algorithms generate the TPs sequentially, and this is considered as computationally costly for high-order and larger-sized polynomials. To this end, we present a new efficient solution to overcome the limitation of sequential algorithms. The presented algorithm us

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
King Khalid University towards Strategies Compatible with Brain-Based Learning (BBL)
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The study aimed to reveal the level of knowledge and tendencies of high- study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with brain-based learning (BBL). And Then, putting a proposed concept to develop knowledge and tendencies of high-study students specializing in curriculum and teaching methods at King Khalid University towards harmonious strategies with Brain-based learning (BBL). For achieving this goal, a cognitive test and a scale of tendency were prepared to apply harmonious strategies with brain-based learning. The descriptive approach was used because it suits the goals of the study. The study sample consisted of (70) male and female students of postgraduate

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Publication Date
Mon Feb 18 2019
Journal Name
Iraqi Journal Of Physics
Anomaly in the earth magnetic field at north provinces of Najaf city
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This paper investigated in the numerical simulation model to calculate the Earth magnetic field components at north provinces of Najaf city (Longitude 44.316 o -44.3592o E and Latitude 32.0508o - 32.0256o N). The components of the Earth magnetic field (total intensity (F), horizontal intensity (H), declination (D), inclination (I), the north component(X), the east component(Y), and Down component(Z)) were found by using spherical harmonic world magnetic model (WMM2010). A great deal of anomaly has been discovered in all components of the Earth magnetic field at the selected region (Long. 44.345o-44.335o E, Lat.32.042o-32.032o N) using Kriging method.

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Publication Date
Thu Jul 16 2020
Journal Name
Diyala Agricultural Sciences Journal
FIELD EMERGENCE IN PRIMED SEED OF SORGHUM CULTIVARS TO TOLERATE DROUGHT STRESS
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An experiment was carried out in pots under open field conditions in the fall seasons of 2017 and 2018 at the College of Agricultural Engineering Sciences, University of Baghdad, for improving field emergence and drought stress tolerance in sorghum. Three factors were studied. 1st factor was three cultivars (Inqath, Rabeh and Buhoth70). 2nd factor was primed and unprimed seed. 3rd factor was represented by the irrigation intervals every 2, 4 and 6 days. Randomized complete block design with four replicates was used. The results showed that Buhoth 70 cultivar had a significant superiority compared to others in traits of the first and final count of emergence, emergence energy and emergence rate index (54.2%, 26.7%, 1.747 and 70.7 % d

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Petrophysical Properties of Khasib Formation in East Baghdad Oil Field Southern Area
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Petrophysical properties evaluation from well log analysis has always been crucial for the identification and assessment of hydrocarbon bearing zones. East Baghdad field is located 10 km east of Baghdad city, where the southern area includes the two southern portions of the field, Khasib formation is the main reservoir of East Baghdad oil field.

In this paper, well log data of nine wells have been environmentally corrected, where the corrected data used to determine lithology, shale volume, porosity, and water saturation. Lithology identified by two methods; neutron-density and M-N matrix plots, while the shale volume estimated by single shale indicator and dual shale indicator, The porosity is calculated from the three common po

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Publication Date
Tue Feb 28 2023
Journal Name
Iraqi Geological Journal
Estimation of Petrophysical Properties for Zubair Reservoir in Abu-Amood Oil Field
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The petrophysical analysis is significant to determine the parameters controlling the production wells and the reservoir quality. In this study, Using Interactive petrophysics software to analyze the petrophysical parameters of five wells penetrated the Zubair reservoir in the Abu-Amood field to evaluate a reservoir and search for hydrocarbon zones. The available logs data such as density, sonic, gamma ray, SP, neutron, and resistivity logs for wells AAm-1, AAm-2, AAm-3, AAm-4, and AAm-5 were used to determine the reservoir properties in Zubair reservoir. The density-neutron and neutron-sonic cross plots, which appear as lines with porosity scale ticks, are used to distinguish between the three main lithologies of sandstone, limesto

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Publication Date
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Re-evaluation of Petro physical Properties in Yammama Formation at Nasiriya Field
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Nasiriya field is located about 38 Km to the north – west of Nasiriya city. Yammama, a giant lower cretaceous reservoir in Nasiriya field which is lithologically formed from limestone. Yammama mainly was divided into three main reservoir units YA, YB1, YB2 and YB3 and it is separated by impermeable layers of variable thickness. An accurate petro physical evolution of the reservoir is of great importance perform an excellent geological model so that four petro physical properties which are shale volume, porosity, water saturation and permeability was re-evaluated. The volume of shale was calculated using the density and neutron logs (VSH-DN) rather than using gamma ray log because of presence a uranium content in the formation that make

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Publication Date
Sun Dec 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Prevention of Scale Formation in Heat Exchanger Pipes by Using Magnetic Field
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The possibility of using the magnetic field technique in prevention of forming scales in heat exchangers pipes using
hard water in heat transfer processes, also the studying the effective and controllable parameters on the mechanism of
scale formation.
The new designed heat exchanger experimental system was used after carrying out the basic process designs of the
system. This system was used to study the effect of the temperature (40-90 °C) and water flow rate (0.6-1.2 L/min) on
the total hardness with time as a function of precipitation of hardness salts from water and scale formation.
Different magnetic field designs in the heat exchanger experimental system were used to study the effect of magnetic
field design a

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Publication Date
Thu Aug 28 2025
Journal Name
Sciences Journal Of Physical Education
Automated empowerment and its effectiveness to developing skill performance for dribbling and passing accuracy of football
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Among the many modern skill-enhancing work practices, machine learning is among the mostskill-enhancing practices in the workplace, as it helps students remember more of what they havelearned, hone the technical talents and skills of football players, and make better use of theirmotor skills. The use of machine learning and its practical applications in football could havesignificant benefits by improving talent development and making better use of scientifictechniques. The primary objective of this study was to determine the effectiveness of machinelearning in improving soccer dribbling and passing accuracy in children aged 10-12 years. Thestudy authors hypothesized that soccer players in the Al-Zohour Neighborhood Youth Forumwould greatly

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