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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
Tue May 01 2018
Journal Name
Journal Of Physics: Conference Series
Hiding Techniques for Dynamic Encryption Text based on Corner Point
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Hiding technique for dynamic encryption text using encoding table and symmetric encryption method (AES algorithm) is presented in this paper. The encoding table is generated dynamically from MSB of the cover image points that used as the first phase of encryption. The Harris corner point algorithm is applied on cover image to generate the corner points which are used to generate dynamic AES key to second phase of text encryption. The embedded process in the LSB for the image pixels except the Harris corner points for more robust. Experimental results have demonstrated that the proposed scheme have embedding quality, error-free text recovery, and high value in PSNR.

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Publication Date
Sat Jul 09 2022
Journal Name
Wireless Communications And Mobile Computing
An Optimized Approach for Industrial IoT Based on Edge Computing
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The Internet of Things (IoT) is an information network that connects gadgets and sensors to allow new autonomous tasks. The Industrial Internet of Things (IIoT) refers to the integration of IoT with industrial applications. Some vital infrastructures, such as water delivery networks, use IIoT. The scattered topology of IIoT and resource limits of edge computing provide new difficulties to traditional data storage, transport, and security protection with the rapid expansion of the IIoT. In this paper, a recovery mechanism to recover the edge network failure is proposed by considering repair cost and computational demands. The NP-hard problem was divided into interdependent major and minor problems that could be solved in polynomial t

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Image Steganography using Dynamic Threshold based on Discrete Cosine Transform
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The art of preventing the detection of hidden information messages is the way that steganography work. Several algorithms have been proposed for steganographic techniques. A major portion of these algorithms is specified for image steganography because the image has a high level of redundancy. This paper proposed an image steganography technique using a dynamic threshold produced by the discrete cosine coefficient. After dividing the green and blue channel of the cover image into 1*3-pixel blocks, check if any bits of green channel block less or equal to threshold then start to store the secret bits in blue channel block, and to increase the security not all bits in the chosen block used to store the secret bits. Firstly, store in the cente

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Publication Date
Sun Apr 01 2018
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Information Hiding using LSB Technique based on Developed PSO Algorithm
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<p>Generally, The sending process of secret information via the transmission channel or any carrier medium is not secured. For this reason, the techniques of information hiding are needed. Therefore, steganography must take place before transmission. To embed a secret message at optimal positions of the cover image under spatial domain, using the developed particle swarm optimization algorithm (Dev.-PSO) to do that purpose in this paper based on Least Significant Bits (LSB) using LSB substitution. The main aim of (Dev. -PSO) algorithm is determining an optimal paths to reach a required goals in the specified search space based on disposal of them, using (Dev.-PSO) algorithm produces the paths of a required goals with most effi

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Publication Date
Tue Jun 14 2022
Journal Name
Chemical Papers
Nile red based dye D–π–A as a promising material for solar cell applications
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A recently reported Nile red (NR) dye conjugated with benzothiadiazole species paves the way for the development of novel organic-based sensitizers used in solar cells whose structures are susceptible to modifications. Thus, six novel NR structures were derived from two previously developed structures in laboratories. In this study, density functional theory (DFT) calculations and time-dependent DFT (TD-DFT) were used to determine the optoelectronic properties of the NR-derived moieties such as absorption spectra. Various linkers were investigated in an attempt to understand the impact of π-linkers on the optoelectronic properties. According to the findings, the presence of furan species led to the planarity of the molecule and a reduction

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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
Political Sciences Journal
A study in Tunisian - Iraqi Relations and its role in determining strategies for dealing with conflict and peace situations
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If the State attaches great importance to its foreign relations and intends to strengthen them in order to ensure the achievement of the highest national goals and interests. External relations between countries are one of the most prominent features of foreign policy, which depends on a combination of internal and external factors, the modern relations between Tunisia and Tunisia, which goes back to the pre-independence of Tunisia, when Iraq was a supporter of Tunisia's independence from France in the 1940s, Although these relations did not cause any disturbance by the two countries, but they remained weak relations did not develop in all areas except the sports and cultural field, which we will determine the reasons and the pos

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Publication Date
Tue May 24 2022
Journal Name
Analytical Science& Technology
A Review: Synthesis and characterization of metals complexes with paracetamol drug
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In this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial

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Publication Date
Sat Jul 01 2023
Journal Name
Analytical Science & Technology
A Review: Synthesis and characterization of metals complexes with paracetamol drug
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In this review, previous studies on the synthesis and characterization of the metal Complexes with paracetamol by elemental analysis, thermal analysis, (IR, NMR and UV-Vis (spectroscopy and conductivity. In reviewing these studies, the authors found that paracetamol can be coordinated through the pair of electrons on the hydroxyl O-atom, carbonyl O-atom, and N-atom of the amide group. If the paracetamol was a monodentate ligand, it will be coordinated by one of the following atoms O-hydroxyl, O-carbonyl or N-amide. But if the paracetamol was bidentate, it is coordinated by atoms (O-carbonyl and N-amide), (O-hydroxyl and N-amide) or (O-carbonyl and O-hydroxyl). The authors also found that free paracetamol and its complexes have antimicrobial

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Population Therapeutics And Clinical Pharmacology
Evaluation of the Expression of RCC and KIM-1 Biomarkers in Nephrotoxicity of Rabbits Treated with Ochratoxins A
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