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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 Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Senserless Speed and Position of Direct Field Orientation Control Induction Motor Drive
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Direct field-orientation Control (DFOC) of induction motor drives without mechanical speed sensors at the motor shaft has the attractions of low cost and high reliability. To replace the sensor, information on the rotor speed and position are extracted from measured stator currents and from voltages at motor terminals. In this paper presents direct field-orientation control (DFOC) with two type of kalman filter (complete order and reduced order extended kalman filter) to estimate flux, speed, torque and position. Simulated results show how good performance for reduced order extended kalman filter over that of complete  order extended kalman filter in tracking performance and reduced time of state estimation.

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Publication Date
Thu Jul 01 2021
Journal Name
Energy
Experimental investigations of the performance of a flat-plate solar collector using carbon and metal oxides based nanofluids
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Publication Date
Fri Apr 25 2014
Journal Name
Journal Of Pharmaceutical &amp; Scientific Innovation
EFFECT OF CARROT AND GINGER EXTRACTS (ALONE AND IN COMBINATION WITH CIPROFLOXACIN) ON MULTIDRUG RESISTANT PSEUDOMONAS AERUGINOSA
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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Dorsal plication during penile orthoplasty with and without neurovascular bundle mobilizationA comparative clinical trial conducted At Ghazy Al-Hariri teaching hospital for surgical specialties (2013 –2015)
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Background: Dorsal plication on each side of the penis at the 2 and 10-o’clock positions had been a mainstay for correction of ventral penile curvature. However, because only the 12-o’clock position proved to be a nerve-free zone, dorsal plication at the 12-o’clock position can be advocated.

Objectives: To evaluate tunica albuginea plication with and without neurovascular bundle mobilization in patients with ventral penile curvature. Type of the study: A prospective study.

Methods: A 34 patients with a mean age of (4.8 ± 0.54) years, Who still

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Publication Date
Thu Jan 30 2020
Journal Name
Neuroquantology
Studying Effect of Temperature on Electron Transport Parameter and Coefficients in CF3I Mixture with N2O
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Publication Date
Sat Dec 01 2018
Journal Name
2018 Third Scientific Conference Of Electrical Engineering (scee)
A UWB Monopole Antenna Design based RF Energy Harvesting Technology
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Recently, wireless charging based RF harvesting has interfered our lives [1] significantly through the different applications including biomedical, military, IoT, RF energy harvesting, IT-care, and RFID technologies. Wirelessly powered low energy devices become significantly essential for a wide spectrum of sensing applications [1]. Such devices require for low energy resources from sunlight, mechanical vibration, thermal gradients, convection flows or other forms of harvestable energy [2]. One of the emerging power extraction resources based on passive devices is harvesting radio frequency (RF) signals powers [3]–[5]. Such applications need devices that can be organized in very large numbers, so, making separate node battery impractical.

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Publication Date
Fri Apr 01 2011
Journal Name
Al-mustansiriyah Journal Of Science
A Genetic Algorithm Based Approach For Generating Unit Maintenance Scheduling
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Publication Date
Wed Oct 01 2008
Journal Name
2008 First International Conference On Distributed Framework And Applications
A strategy for Grid based t-way test data generation
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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Enhancement Ear-based Biometric System Using a Modified AdaBoost Method
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          The primary objective of this paper is to improve a biometric authentication and classification model using the ear as a distinct part of the face since it is unchanged with time and unaffected by facial expressions. The proposed model is a new scenario for enhancing ear recognition accuracy via modifying the AdaBoost algorithm to optimize adaptive learning. To overcome the limitation of image illumination, occlusion, and problems of image registration, the Scale-invariant feature transform technique was used to extract features. Various consecutive phases were used to improve classification accuracy. These phases are image acquisition, preprocessing, filtering, smoothing, and feature extraction. To assess the proposed

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Effectiveness of Quantitative Instruments in Controlling Money Supply: An Applied Research in the Central Bank of Iraq
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This research deals with the role of quantitative (indirect) tools of monetary policy that used by the Central Bank of Iraq in order to control and manage the size of the money supply that intermediate goal through which monetary policy is able to achieve its final goals, foremost among which is to reduce inflation and raise the value of the local currency in front of foreign currency rates. The research is based on a major hypothesis stating that quantitative tools have a direct and strong influence on the money supply, especially under the circumstances of the shift towards a market economy. There has been a branching relationship with this statistically significant relationship between the money supply and the quantitative tools used

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