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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
Sun Jan 01 2017
Journal Name
International Journal Of Recent Trends In Engineering & Research
Password Authentication Based On Modify Bidirectional Associative Memory (MBAM)
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Password authentication is popular approach to the system security and it is also very important system security procedure to gain access to resources of the user. This paper description password authentication method by using Modify Bidirectional Associative Memory (MBAM) algorithm for both graphical and textual password for more efficient in speed and accuracy. Among 100 test the accuracy result is 100% for graphical and textual password to authenticate a user.

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Publication Date
Mon Jul 01 2019
Journal Name
Arpn Journal Of Engineering And Applied Sciences
PSEUDO RANDOM NUMBER GENERATOR BASED ON NEURO-FUZZY MODELS
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Producing pseudo-random numbers (PRN) with high performance is one of the important issues that attract many researchers today. This paper suggests pseudo-random number generator models that integrate Hopfield Neural Network (HNN) with fuzzy logic system to improve the randomness of the Hopfield Pseudo-random generator. The fuzzy logic system has been introduced to control the update of HNN parameters. The proposed model is compared with three state-ofthe-art baselines the results analysis using National Institute of Standards and Technology (NIST) statistical test and ENT test shows that the projected model is statistically significant in comparison to the baselines and this demonstrates the competency of neuro-fuzzy based model to produce

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Publication Date
Tue Nov 01 2016
Journal Name
2016 International Conference On Advances In Electrical, Electronic And Systems Engineering (icaees)
Efficient routing algorithm for VANETs based on distance factor
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There has been a great deal of research into the considerable challenge of managing of traffic at road junctions; its application to vehicular ad hoc network (VANET) has proved to be of great interest in the developed world. Dynamic topology is one of the vital challenges facing VANET; as a result, routing of packets to their destination successfully and efficiently is a non-simplistic undertaking. This paper presents a MDORA, an efficient and uncomplicated algorithm enabling intelligent wireless vehicular communications. MDORA is a robust routing algorithm that facilitates reliable routing through communication between vehicles. As a position-based routing technique, the MDORA algorithm, vehicles' precise locations are used to establish th

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University: The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University
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Abstract

     The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha.  The SPSS program processed

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Proposition Framework to Application Kaizen Cost Technique of to realization Target Pricing: Practical Study in the Al-Muthanna Cement Company
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The study the problem emerged in the inability of local companies to enter the field of active competition with other companies operating in the same economic sector due to the high cost of their products, hence, the companies that want to apply this technique can effectively compete in order to achieve those objectives.

  So this study focused on the goal of reducing the cost of products by reducing the cost product to a minimum , as the study was based in its hypothesis on the ability of companies to application this technique which in turn leads to increased profits under conditions of normal working and the power available and their potential in improving the quality of its products, as well as the need for full coordina

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Publication Date
Thu Nov 22 2018
Journal Name
International Journal Of Applied Pharmaceutics
PREPARATION AND IN VITRO EVALUATION OF CYCLODEXTRIN BASED EFFERVESCENT AND DISPERSIBLE GRANULES OF CARBAMAZEPINE
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Objective: Carbamazepine is typically used for the treatment of seizure disorders and neuropathic pain. One of the major problems with this drug is its low solubility in water; therefore the objective of this study was to enhance the solubility of carbamazepine by complexation with cyclodextrin to be formulated as effervescent and dispersible granules.Methods: Solvent evaporation method was used to prepare, binary (Carbamazepine/β-cyclodextrin) complex and ternary (Carbamazepine/β-cyclodextrin/hydroxypropyl methyl cellulose (HPMC E5). The more soluble complex will be further formulated as unit dose effervescent and dispersible granules. The complexes were evaluated for their solubility, drug content, percentage practical yield and

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Publication Date
Fri Jan 01 2021
Journal Name
Fme Transactions
FAT-based adaptive backstepping control of an electromechanical system with an unknown input coefficient
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This paper is focused on orthogonal function approximation technique FAT-based adaptive backstepping control of a geared DC motor coupled with a rotational mechanical component. It is assumed that all parameters of the actuator are unknown including the torque-current constant (i.e., unknown input coefficient) and hence a control system with three motor control modes is proposed: 1) motor torque control mode, 2) motor current control mode, and 3) motor voltage control mode. The proposed control algorithm is a powerful tool to control a dynamic system with an unknown input coefficient. Each uncertain parameter/term is represented by a linear combination of weighting and orthogonal basis function vectors. Chebyshev polynomial is used

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Laminar Free Convection In Horizontal Annulus Filled With Glass Beads And With Annular Fins On The Inner Cylinder
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An experimental and numerical study has been carried out to investigate the heat transfer by natural convection and radiation in a two dimensional annulus enclosure filled with porous media (glass beads) between two horizontal concentric cylinders. The outer cylinders are of (100, 82 and70mm) outside diameters and the inner cylinder of 27 mm outside diameter with (or without) annular fins attached to it. Under steady state condition; the inner cylinder surface is maintained at a high temperature by applying a uniform heat flux and the outer cylinder surface at a low temperature inside a freezer. The experiments were carried out for an annulus filled with
glass beads at a range of modified Rayleigh number (4.9 ≤ Ra≤ 69), radiation

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of enabling the effectiveness of the work of the audit committees in private commercial banks (A survey study of the views of a sample of the objective of the inspection bodies represented by the Central Bank and the Securities Commission and e
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The aim of this study is to identify the effect of enabling the effectiveness of the work of the audit committees in private commercial banks and to identify the extent of awareness of the importance of empowerment in the work of these committees, especially as it is known that these committees, especially the inspection committees that go to private banks and from various sources including committees of the Central Bank of Iraq Committees of the Securities Commission and finally committees of the external audit offices, through an analysis of the determinants of empowerment in the performance of the most important work of the audit committees, namely: supervising the process of preparing reports, supervising the system of intern

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Computational Design And Engineering
CFD analysis of phase-change material-based heat storage with dimple-shaped fins: evaluation of fin configuration and distribution pattern
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Abstract<p>Phase-change materials (PCMs) have a remarkable potential for use as efficient energy storage means. However, their poor response rates during energy storage and retrieval modes require the use of heat transfer enhancers to combat these limitations. This research marks the first attempt to explore the potential of dimple-shaped fins for the enhancement of PCM thermal response in a shell-and-tube casing. Fin arrays with different dimensions and diverse distribution patterns were designed and studied to assess the effect of modifying the fin geometric parameters and distribution patterns in various spatial zones of the physical domain. The results indicate that increasing the number of </p> ... Show More
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