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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 14 2018
Journal Name
Journal Of Engineering And Applied Sciences
DEMONSTRATE OF MAGNETIC FIELD EFFECT ON THE CAPABILITY OF ADSORPTION PROCESS IN THE REMOVAL OF AZO DYE FROM THE AQUEOUS SOLUTIONS ON CALCINED IRAQI BENTONITE CLAY MINERAL VIA COLUM
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Publication Date
Fri Nov 11 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of auditing in analyzing the relationship between the governance of investment policy and the cost of debt and its reflection on the continuity of the institution: (بحث تطبيقي في عينة من الشركات المدرجة في سوق العراق للأوراق المالية)
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The research aims to determine the effectiveness of auditing in light of the relationship between the governance of investment policy and the cost of debt in companies listed on the Iraqi Stock Exchange. The problem of the research is to raise the question about the effect of the governance of investment policy and the cost of debt on the effectiveness of auditing and auditors. During the research, the most important of them were: the existence of an impact relationship on the effectiveness of auditing through the relationship between the governance of investment policy and the cost of debt. The companies listed in the Iraqi Stock Exchange lack an effective proposed guide or framework dealing with the governance of investment policy desp

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Publication Date
Thu Apr 21 2022
Journal Name
Journal Of Petroleum Research And Studies
Smart Well Modelling for As Reservoir in AG Oil Field
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Intelligent or smart completion wells vary from conventional wells. They have downhole flow control devices like Inflow Control Devices (ICD) and Interval Control Valves (ICV) to enhance reservoir management and control, optimizing hydrocarbon output and recovery. However, to explain their adoption and increase their economic return, a high level of justification is necessary. Smart horizontal wells also necessitate optimizing the number of valves, nozzles, and compartment length. A three-dimensional geological model of the As reservoir in AG oil field was used to see the influence of these factors on cumulative oil production and NPV. After creating the dynamic model for the As reservoir using the program Petrel (2017.4), we

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Geological Journal
Radiological Effects Assessment in East Baghdad Oil Field, Southern Area
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Radiological assessment for the East Baghdad oilfield-southern part was conducted in the current study. 10 samples (scale, soil, sludge, water, and oil) from the different stages of oil production were collected. 232Th, 226Ra, and 40K in the samples were analyzed with 40% efficiency for Gamma spectrometry. system based on HPGe. The findings indicated that the examined sites exhibit comparatively lower levels of NORM contamination, in contrast to other global oilfields. Nevertheless, certain areas, particularly those within separation stages, demonstrate relatively elevated NORM concentrations exceeding the global average in soil and sludge. The maximum value of 226Ra, 232Th, was found in sludge sample the findings indicated that ove

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Publication Date
Wed Apr 01 2015
Journal Name
Al–bahith Al–a'alami
University Youth Attitudes towards Electronic Advertisements and their Relationship to the Behavior of the Consumer A Field Study of a Sample of Students of the College of Mass-Communication / University of Baghdad as a Model
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This research aims at identifying the communicative habits and content reflections on the communication process, especially the young audience which is one of the main group for whom the announcements are made. Because young people face life with passion and aspiration making them respond to each effect used by the media in the design of the advertising using all the effective techniques, attractive methods for young children like depending on drama, technical tricks, music and logos easily to be remembered and responded to the desires of the young in their entertainment. This research also aims at identifying the impact of the internet as a channel of commercial advertising on the purchasing behavior of young people at the universities

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The effectiveness of teaching the theory of TRIZ in expressive performance and the development of creative thinking among preparatory school students
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The current research aims to find out (the effectiveness of teaching TRIZ theory in the expressive performance and the development of creative thinking among preparatory school students)
To achieve this, the researcher adopted on an experimental design is located in women with partial seizure experimental designs field in order to achieve the goals of the research, has sample consisted of two divisions seminars Mentzmtin in junior high school Diyala for Boys, and divided the sample of (60) called on the two groups, the first pilot of ( 30) student, and the other officer and number (30), student, and studied researchers experimental group theory TRIZ, while he studied the officer in the traditional manner, the researcher conducted a pa

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Publication Date
Wed Feb 05 2020
Journal Name
Political Sciences Journal
The role and effectiveness of the United Nations Security Council in light of the competition of international powers: an analytical study
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Abstract As the United Nations approaches its 70th anniversary, the world is going through the most severe accumulation of serious international security failures in recent memory, challenging the UN Security Council’s ability to address them effectively. Over the past four years, crises in Libya, Syria and Ukraine have precipitated a worrisome erosion of great power relations that has complicated Security Council decision making on a number of trouble spots. Its inability to devise consensus responses to the escalating civil war in Syria has been particularly troubling, resulting in the regional spill over into Iraq and the emergence of Islamic State as a new threat to peace in the region and beyond. Meanwhile, the UN’s often under

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Publication Date
Sat Mar 30 2024
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Optimization of Separator Size and Operating Pressure for Three-phase Separators in the West Qurna1 Oil Field
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An optimization study was conducted to determine the optimal operating pressure for the oil and gas separation vessels in the West Qurna 1 oil field. The ASPEN HYSYS software was employed as an effective tool to analyze the optimal pressure for the second and third-stage separators while maintaining a constant operating pressure for the first stage. The analysis involved 10 cases for each separation stage, revealing that the operating pressure of 3.0 Kg/cm2 and 0.7 Kg/cm2 for the second and third stages, respectively, yielded the optimum oil recovery to the flow tank. These pressure set points were selected based on serval factors including API gravity, oil formation volume factor, and gas-oil ratio from the flow tank.    To impro

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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Risk-Based Inspection Due to Corrosion Consequences for Oil and Gas Flowline: A Review
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   The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli

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Publication Date
Fri Dec 25 2009
Journal Name
Wireless Personal Communications
A N-Radon Based OFDM Trasceivers Design and Performance Simulation Over Different Channel Models
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In this paper a new method is proposed to perform the N-Radon orthogonal frequency division multiplexing (OFDM), which are equivalent to 4-quadrature amplitude modulation (QAM), 16-QAM, 64-QAM, 256-QAM, ... etc. in spectral efficiency. This non conventional method is proposed in order to reduce the constellation energy and increase spectral efficiency. The proposed method gives a significant improvement in Bit Error Rate performance, and keeps bandwidth efficiency and spectrum shape as good as conventional Fast Fourier Transform based OFDM. The new structure was tested and compared with conventional OFDM for Additive White Gaussian Noise, flat, and multi-path selective fading channels. Simulation tests were generated for different channels

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