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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
Thu Jul 31 2025
Journal Name
Computers, Materials &amp; Continua
A Secure Audio Encryption Method Using Tent-Controlled Permutation and Logistic Map-Based Key Generation
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The exponential growth of audio data shared over the internet and communication channels has raised significant concerns about the security and privacy of transmitted information. Due to high processing requirements, traditional encryption algorithms demand considerable computational effort for real-time audio encryption. To address these challenges, this paper presents a permutation for secure audio encryption using a combination of Tent and 1D logistic maps. The audio data is first shuffled using Tent map for the random permutation. The high random secret key with a length equal to the size of the audio data is then generated using a 1D logistic map. Finally, the Exclusive OR (XOR) operation is applied between the generated key and the sh

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Cold Cracking Technology for Crude Oil Upgrading in Qaiyarah Heavy Oil Field; Technical and Economical Evaluation
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Heavy oil is classified as unconventional oil resource because of its difficulty to recover in its natural state, difficulties in transport and difficulties in marketing it. Upgrading solution to the heavy oil has positive impact technically and economically specially when it will be a competitive with conventional oils from the marketing prospective. Developing Qaiyarah heavy oil field was neglected in the last five decades, the main reason was due to the low quality of the crude oil resulted in the high viscosity and density of the crude oil in the field which was and still a major challenge putting them on the major stream line of production in Iraq. The low quality of the crude properties led to lower oil prices in the global markets

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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
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
Mon Jan 01 2024
Journal Name
Journal Of The College Of Languages (jcl)
Negation marker in Standard Persian : a typological analysis based on Givon’s functional model: عامل نفی در زبان فارسی معیار: بررسی رده‌شناختی براساس مدل نقش‌ گرایی گیون
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 Abstract:

Typological analysis about  the negation marker  in different languages is one of the fields of research that has attracted much attention.  In Persian language, this constituent has been analysed from different aspects. This study aimed to analyse  different aspects of negation marker  in  the adjectives,  the noun phrases and  the verb phrases based on typological analysis.  Many studies have been revealed that  the negation in adjectives has shown lexically and morphologically. In the noun phrases, /hich/  has used as a negative marker necessarily marking the verb phrase as negative too. In the verb phrases, negation occurs morphologically by the addition of the prefix /n

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Deductive Group Pattern in Developing the Creative Thinking of Second Intermediate Grade Pupils in History Discipline
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The present study aims to identify the effectiveness of deductive group patterns in developing the creative thinking of second-intermediate-grade pupils in history discipline. The current null hypothesis has been investigated: There are no statistically significant differences at (0.05) between the scores mean of the experimental group pupils who were taught according to the deductive group pattern and the scores mean of the control group pupils who were taught according to traditional method in creative thinking testing. the study sample was divided into two groups: an experimental group of (30) female students and a control group of (31) female students. The two groups are equalized based on the variables of age, the scores of the firs

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Publication Date
Sat Dec 01 2018
Journal Name
Indian Journal Of Ecology
Classification of al-hammar marshes satellite images in Iraq using artificial neural network based on coding representation
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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
The Vertical variations of Atmospheric Methane (CH4) concentrations over selected cities in Iraq based on AIRS data
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The Atmospheric Infrared Sounder (AIRS) on EOS/Aqua satellite provides diverse measurements of Methane (CH4) distribution at different pressure levels in the Earth's atmosphere. The focus of this research is to analyze the vertical variations of (CH4) volume mixing ratio (VMR) time-series data at four Standard pressure levels SPL (925, 850, 600, and 300 hPa) in the troposphere above six cities in Iraq from January 2003 to September 2016. The analysis results of monthly average CH4VMR time-series data show a significant increase between 2003 and 2016, especially from 2009 to 2016; the minimum values of CH4 were in 2003 while the maximum values were in 2016. The vertical distribution of CH4<

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Publication Date
Mon Jul 01 2019
Journal Name
Biocatalysis And Agricultural Biotechnology
Determination of Diazinon in fruit samples using electrochemical sensor based on carbon nanotubes modified carbon paste electrode
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Publication Date
Wed Jun 13 2012
Journal Name
South African Journal Of Animal Science
Effect of in ovo injection with L-arginine on productive and physiological traits of Japanese quail
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This study evaluated the influence of administering different levels of L-arginine into eggs of 0-day-old Japanese quail embryos. On day 0 of incubation, 480 eggs (120 for each treatment group) were injected with 0% arginine (C group), 1% arginine (T1), 2% arginine (T2) or 3% arginine (T3). After hatching, 336 quail chicks (84 chicks produced from each in ovo injection treatment) were placed in an experimental quail house and allocated to four treatment groups of three replicates, with 16 quail chicks for each replicate. Traits involved in this study were hatchability rate, initial body weight (7 days of age), final body weight (42 days old), feed intake, weight gain, feed conversion ratio and blood serum glucose, protein, cholesterol, tota

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