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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 Apr 01 2019
Journal Name
Journal Of Engineering
Investigation of Optimum Heat Flux Profile Based on the Boiling Safety Factor
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An experimental study is conducted to investigate the effect of heat flux distribution on the boiling safety factor of its cooling channel. The water is allowed to flow in a horizontal circular pipe whose outlet surface is subjected to different heat flux profiles. Four types of heat flux distribution profiles are used during experiments: (constant distribution profile, type a, triangle distribution profile with its maximum in channel center, type b, triangle distribution profile with its maximum in the channel inlet, type c, and triangle distribution profile with its maximum in the channel outlet, type d). The study is conducted using heat sources of (1000 and 2665W), water flow rates of (5, 7 and 9 lit/min). The water

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Publication Date
Mon Jan 28 2013
Journal Name
Spie Proceedings
Enhancement of security for free space optics based on reconfigurable chaotic technique
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Free Space Optical (FSO) technology offers highly directional, high bandwidth communication channels. This technology can provide fiber-like data rate over short distances. In order to improve security associated with data transmission in FSO networks, a secure communication method based on chaotic technique is presented. In this paper, we have turned our focus on a specific class of piece wise linear one-dimensional chaotic maps. Simulation results indicate that this approach has the advantage of possessing excellent correlation property. In this paper we examine the security vulnerabilities of single FSO links and propose a solution to this problem by implementing the chaotic signal generator “reconfigurable tent map”. As synchronizat

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Publication Date
Thu Dec 18 2025
Journal Name
Journal Of Optical Communications
Enhancing of underwater wireless optical communication system based on single photon detector
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Abstract<p>This work investigates a simulation model of an underwater optical wireless communication (UOWC) system. Several water scenarios are considered: Harbor I (HA-I), Harbor II (HA-II), Coastal Ocean (CO), Clear Ocean (CL), and Pure Sea (PU). A laser diode (LD) with modulation schemes (NRZ-OOK) transmits data at various speeds of 2.5 Gbps, 5 Gbps, and 10 Gbps. To identify the optical signal, a single-photon detection (SPD), APD and PIN photodiodes are utilized. The analytical evaluation of the performance is executed using Q-factor, received power and bit error rate (BER). According to the results, the PU achieved an underwater distance of 35.5 m, 35 m, 34.5 m, for data tran</p> ... Show More
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Publication Date
Sat Mar 31 2018
Journal Name
Journal Of Engineering
Estimation of Minimum Miscibility Pressure for 〖CO〗_2 Flood Based on EOS
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CO2 Gas is considered one of the unfavorable gases and it causes great air pollution. It’s possible to decrease this pollution by injecting  gas in the oil reservoirs to provide a good miscibility and to increase the oil recovery factor. MMP was estimated by Peng Robinson equation of state (PR-EOS). South Rumila-63 (SULIAY) is involved for which the miscible displacement by  is achievable based on the standard criteria for success EOR processes. A PVT report was available for the reservoir under study. It contains deferential liberation (DL) and constant composition expansion (CCE) tests.  PVTi software is one of the (Eclipse V.2010) software’s packages, it has been used to achieve the goal.

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Engineering
Dual Stages of Speech Enhancement Algorithm Based on Super Gaussian Speech Models
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Various speech enhancement Algorithms (SEA) have been developed in the last few decades. Each algorithm has its advantages and disadvantages because the speech signal is affected by environmental situations. Distortion of speech results in the loss of important features that make this signal challenging to understand. SEA aims to improve the intelligibility and quality of speech that different types of noise have degraded. In most applications, quality improvement is highly desirable as it can reduce listener fatigue, especially when the listener is exposed to high noise levels for extended periods (e.g., manufacturing). SEA reduces or suppresses the background noise to some degree, sometimes called noise suppression alg

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Publication Date
Wed Sep 30 2020
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Estimation of Minimum Miscibility Pressure for Hydrocarbon Gas Injection Based on EOS
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The important parameter used for determining the probable application of miscible displacement is the MMP (minimum miscibility pressure). In enhanced oil recovery, the injection of hydrocarbon gases can be a highly efficient method to improve the productivity of the well especially if miscibility developed through the displacement process. There are a lot of experiments for measuring the value of the miscibility pressure, but they are expensive and take a lot of time, so it's better to use the mathematical equations because of it inexpensive and fast. This study focused on calculating MMP required to inject hydrocarbon gases into two reservoirs namely Sadi and Tanomaa/ East Baghdad field. Modified Peng Robenson Equation of State was

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Publication Date
Thu Dec 01 2022
Journal Name
Al-khwarizmi Engineering Journal
BER Performance Improvement of Dual Chaotic Maps Based on STBC Communication System
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Sensitive information of any multimedia must be encrypted before transmission. The dual chaotic algorithm is a good option to encrypt sensitive information by using different parameters and different initial conditions for two chaotic maps. A dual chaotic framework creates a complex chaotic trajectory to prevent the illegal use of information from eavesdroppers. Limited precisions of a single chaotic map cause a degradation in the dynamical behavior of the communication system. To overcome this degradation issue in, a novel form of dual chaos map algorithm is analyzed. To maintain the stability of the dynamical system, the Lyapunov Exponent (LE) is determined for the single and dual maps. In this paper, the LE of the single and dual maps

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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
A Comparative Study on the Double Prior for Reliability Kumaraswamy Distribution with Numerical Solution
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This work, deals with Kumaraswamy distribution. Kumaraswamy (1976, 1978) showed well known probability distribution functions such as the normal, beta and log-normal but in (1980) Kumaraswamy developed a more general probability density function for double bounded random processes, which is known as Kumaraswamy’s distribution. Classical maximum likelihood and Bayes methods estimator are used to estimate the unknown shape parameter (b). Reliability function are obtained using symmetric loss functions by using three types of informative priors two single priors and one double prior. In addition, a comparison is made for the performance of these estimators with respect to the numerical solution which are found using expansion method. The

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Energy Storage
A hybrid solidification enhancement in a latent-heat storage system with nanoparticles, porous foam, and fin-aided foam strips
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Publication Date
Mon Jan 01 2018
Journal Name
African Journal Of Hospitality, Tourism And Leisure
An analytical study of the strategic flexibility variation as a function of the dynamic capabilities based on supply chain management (Case study: The General Petroleum Products Distribution Company in Baghdad)
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