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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
Sat Aug 25 2012
Journal Name
Wireless Personal Communications
Multi-Objective Evolutionary Algorithm Based on Decomposition for Energy Efficient Coverage in Wireless Sensor Networks
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Publication Date
Sun May 27 2018
Journal Name
Journal Of Advanced Transportation
Accident Management System Based on Vehicular Network for an Intelligent Transportation System in Urban Environments
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As cities across the world grow and the mobility of populations increases, there has also been a corresponding increase in the number of vehicles on roads. The result of this has been a proliferation of challenges for authorities with regard to road traffic management. A consequence of this has been congestion of traffic, more accidents, and pollution. Accidents are a still major cause of death, despite the development of sophisticated systems for traffic management and other technologies linked with vehicles. Hence, it is necessary that a common system for accident management is developed. For instance, traffic congestion in most urban areas can be alleviated by the real-time planning of routes. However, the designing of an efficie

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Estimate the Parallel System Reliability in Stress-Strength Model Based on Exponentiated Inverted Weibull Distribution
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Abstract<p>In this paper, we employ the maximum likelihood estimator in addition to the shrinkage estimation procedure to estimate the system reliability (<italic>R<sub>k</sub> </italic>) contain <italic>K<sup>th</sup> </italic> parallel components in the stress-strength model, when the stress and strength are independent and non-identically random variables and they follow two parameters Exponentiated Inverted Weibull Distribution (EIWD). Comparisons among the proposed estimators were presented depend on simulation established on mean squared error (MSE) criteria.</p>
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Publication Date
Tue Jan 01 2019
Journal Name
Reviews In Medical Microbiology
Virulence factors genotyping of Klebsiella pneumoniae clinical isolates from Baghdad
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Seventy of Klebsiella pneumoniae isolates had been collected from some Hospitals in Baghdad city from October to December 2017. The 70 isolates were taken from diverse clinical specimens. All K. pneumoniae isolates were identified based on API 20 E and Vitek2 compact system. Antibiotics sensitivity test was carried out toward 10 antibiotics using discs diffusion method. The level of antibiotics resistance was 81.42% for Ceftriaxone, whereas the low level of antibiotics resistance was 37.14% for Piperacillin. K. pneumoniae isolates were typed genotypically by using two different methods of amplification, multiplex-PCR and enterobacterial repetitive intergenic consensus (ERIC)-PCR typing methods. Results showed that out of 70 isolates, there

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Publication Date
Thu Dec 16 2021
Journal Name
Kufa Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer Lens Implantation for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Aim: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: Sixty eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design) in the Eye Specialty Private Hospital, Baghdad, Iraq were studied. The mean spherical refraction was -11.32±3.17 diopter (D) with a range of -6.00 to -18.00 D and a mean cylinder of -2.61±1.16 with range of -1.00 to -5.50 D. The outcome measures that evaluat

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer lens Implantat for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber.

Objective: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. in  Eye Specialty Private Hospital, Baghdad, Iraq.

Type of the Study: a prospective non randomize intervention study.

Methods: 60 eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design).Mean spherical refraction was ₋11.32 diopter

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Ecological Engineering
Optimization of Response Surface Methodology for Removal of Cadmium Ions from Wastewater using Low Cost Materials
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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
Sun Jul 01 1990
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
CHALCIDOID (HYMENOPTERA.) PARASITES OF THE BRUCHID BEETLES IN IRAQ WITH A DESCRIPTION OF A NEW SPECIES)
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The present work deals with five species of parasitic Hymenoptera belonging to Pteromalidae, Eupelmidae and Eurytornidae which have been reared from brachid beetles. A new species, Eurytoma irakensis is described and the species, Bruchocida orientalis Crawford is recorded for the first time from Iraq.

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Publication Date
Fri Jun 02 2023
Journal Name
East European Journal Of Physics
Electroexcitation Form Factors and Deformation of 20,22Ne Isotopes Based on the Shell Model and Hartree-Fock plus BCS Calculations
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Nuclear structure of 20,22Ne isotopes has been studied via the shell model with Skyrme-Hartree-Fock calculations. In particular, the transitions to the low-lying positive and negative parity excited states have been investigated within three shell model spaces; sd for positive parity states, spsdpf large-basis (no-core), and zbme model spaces for negative parity states. Excitation energies, reduced transition probabilities, and elastic and inelastic form factors were estimated and compared to the available experimental data. Skyrme interaction was used to generate a one-body potential in the Hartree-Fock calculations for each selected excited states, which is then used to calculate the single-particle matrix elements. Skyrme interac

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