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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 Jan 29 2024
Journal Name
Advances In Systems Analysis, Software Engineering, And High Performance Computing
Evaluating Antivirus Effectiveness Against Malware in Ascending Order for Increasing Blockchain Endpoint Protection
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Blockchain represents a new promising technology with a huge economic impact resulting from its uses in various fields such as digital currency and banking; malware represents a serious threat to users, and there are many differences in the effectiveness of antivirus software used to deal with the problem of malware. This chapter has developed a coefficient for measuring the effectiveness of antivirus software. This chapter evaluates the effectiveness of antivirus software by conducting tests on a group of protection programs using a folder containing an amount of data. These programs are applied to combat viruses contained in this folder. The study revealed that the effectiveness of antivirus software is as follows: AVG scored 0%,

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Diagnostic and Predictive Values of IL-6 in a Group of Iraqi Patients with Rheumatoid Arthritis
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الخلفية: التهاب المفاصل الرَثَيَانِي أو الداء الرثياني أو الالتهاب المفصلي الروماتويدي هو مرض مزمن، من الأمراض الانضدادية التي تؤدي بالجهاز المناعي لمهاجمة المفاصل، مسببة التهابات وتدميرًا لها. ومن الممكن أيضًا أن يدمر جهاز المناعة أعضاء أخرى في الجسم مثل الرئتين والجلد. وفي بعض الحالات، يسبب المرض الإعاقة، مؤدية إلى فقدان القدرة على الحركة والإنتاجية. ويتم تشخيص المرض بواسطة تحاليل دم مخبرية مثل تحلي

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Publication Date
Sun Mar 08 2026
Journal Name
Statistics, Optimization And Information Computing
Adult Dengue Fever in Bangladesh: A One-Sample Rank-Based Test of Hematologic Location Against Healthy References
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Dengue fever is a mosquito-borne viral infection that produces characteristic abnormalities in routine blood tests, yet these hematologic changes are typically analysed separately for each parameter rather than as a combined multivariate profile. This study investigated whether the joint hematologic profile of adult dengue patients in Bangladesh is systematically displaced from healthy adult reference values. We analysed a cohort of laboratory-confirmed adult dengue cases from a Bangladeshi hospital and focused on four core hematologic indices: haemoglobin, white blood cell count, platelet count, and platelet distribution width (PDW). External adult reference means were used to define a healthy location vector, and robust multivariate infer

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Comparison between Open Mini-incision Thyroidectomy and Conventional Thyroidectomy: Clinical Experience and Literatures Review
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Background: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Engineering
Pilot Based Channel Estimation and Synchronization in OFDM System
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Channel estimation and synchronization are considered the most challenging issues in Orthogonal Frequency Division Multiplexing (OFDM) system. OFDM is highly affected by synchronization errors that cause reduction in subcarriers orthogonality, leading to significant performance degradation. The synchronization errors cause two issues: Symbol Time Offset (STO), which produces inter symbol interference (ISI) and Carrier Frequency Offset (CFO), which results in inter carrier interference (ICI). The aim of the research is to simulate Comb type pilot based channel estimation for OFDM system showing the effect of pilot numbers on the channel estimation performance and propose a modified estimation method for STO with less numb

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Global Pharma Technology
Molecular Investigation of Curli Fimbriae Genes in Enterobacter cloacae Isolated from Various Clinical Sources in Baghdad, Iraq
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Thirteen isolates were collected from various clinical sources during the periodfrom 22/10/2017 to 22/12/2017. All the isolates were diagnosed based on the microscopic and biochemical propertiesby Vitek-2 Compact system. All isolates formed biofilm 100%, with 30% of isolatesbiofilm produced strongly and 70% on medium. The results of the present study have shown the presence of Curli fimbriae genes in E. cloacae bacteria from cases of urinary tract infections, infected patient with blood bacteremia and inflammation of wounds. Curli fimbriae is considered to be an important factor in the virulence of E.cloacae bacteria, which plays an important role in adhering and combining cells on solid surfaces to form the biofilmand helps in the adhesion

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Unicornuate Uterus with a Non-Communicating Rudimentary Horn in a Palestinian Patient with Familial Mediterranean Fever: Case Report
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Rudimentary non-communicating functional uterine horn with unicornuate uterus, originating from anomalous embryological development of one Mullerian duct, is prone to different complications either at the gynecological or obstetrical level such as chronic pelvic pain, hematometra, subfertility and decreased quality of life. This unique case report presents a 14-year-old female with a history of severe chronic pelvic pain. She was diagnosed with Familial Mediterranean Fever (FMF) and had an appendectomy for suspected appendicitis within the symptoms’ interval. Ultrasound showed a right 5*6 cm right complex cystic mass assuming ovarian in place. She underwent a suspected endometrioma cystectomy operation and was diagnosed with left unico

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Publication Date
Mon Nov 01 2021
Journal Name
Applied Thermal Engineering
Investigation on the combustion and performance characteristics of a DI free piston linear generator engine fuelled with CNG-CO2 blend
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Publication Date
Tue Oct 07 2003
Journal Name
University Of Baghdad
A STUDY ON SOLVENT EXTRACTION OF HOLMIUM (III) WITH SUDAN BLACK B REAGENT (M.Sc. Thesis)
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Publication Date
Mon Jul 10 2023
Journal Name
Journal Of Engineering
Bearing Capacity of a Strip Model Footing on Loose Sand Reinforced With Pomegranate Sticks Mat
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A series of laboratory model tests has been carried out to investigate the using of pomegranate sticks mat as reinforcement to increase the bearing capacity of footing on loose sand. The influence of depth and length of pomegranate sticks layer was examined. In the present research single layer of pomegranate sticks reinforcement was used to strengthen the loose sand stratum beneath the strip footing. The dimensions of the used foundation were 4*20 cm. The reinforcement layer has been embedded at depth 2, 4 and 8 cm under surcharge stresses . Reinforcing layer with length of 8 and 16 cm were used. The final model test results indicated that the inclusion of pomegranate sticks reinforcement is very effective in improvement the loading cap

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