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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 Jul 01 2023
Journal Name
Journal Of Engineering
Material Selection for Unmanned Aerial Vehicles (UAVs) Wings Using Ashby Indices Integrated with Grey Relation Analysis Approach Based on Weighted Entropy for Ranking
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The designer must find the optimum match between the object's technical and economic needs and the performance and production requirements of the various material options when choosing material for an engineering application. This study proposes an integrated (hybrid) strategy for selecting the optimal material for an engineering design depending on design requirements. The primary objective is to determine the best candidate material for the drone wings based on Ashby's performance indices and then rank the result using a grey relational technique with the entropy weight method. Aluminum alloys, titanium alloys, composites, and wood have been suggested as suitable materials for manufacturing drone wings. The requirement

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Publication Date
Tue Oct 18 2022
Journal Name
University Of Baghdad
Experimental Study and Analysis of Matrix Acidizing for Mishrif Formation-Ahdeb Oil Field
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Carbonate matrix stimulation technology has progressed tremendously in the last decade through creative laboratory research and novel fluid advancements. Still, existing methods for optimizing the stimulation of wells in vast carbonate reservoirs are inadequate. Consequently, oil and gas wells are stimulated routinely to expand production and maximize recovery. Matrix acidizing is extensively used because of its low cost and ability to restore the original productivity of damaged wells and provide additional production capacity. The Ahdeb oil field lacks studies in matrix acidizing; therefore, this work provided new information on limestone acidizing in the Mishrif reservoir. Moreover, several reports have been issued on the difficulties en

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Publication Date
Sun Nov 15 2020
Journal Name
Journal Of Petroleum Research And Studies
Reservoir Model and Production Strategy of Mishrif Reservoir-Nasryia Oil Field Southern Iraq
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Nasryia oil field is located about 38 Km to the north-west of Nasryia city. The field was discovered in 1975 after doing seismic by Iraqi national oil company. Mishrif formation is a carbonate rock (Limestone and Dolomite) and its thickness reach to 170m. The main reservoir is the lower Mishrif (MB) layer which has medium permeability (3.5-100) md and good porosity (10-25) %. Form well logging interpretation, it has been confirmed the rock type of Mishrif formation as carbonate rock. A ten meter shale layer is separating the MA from MB layer. Environmental corrections had been applied on well logs to use the corrected one in the analysis. The combination of Neutron-Density porosity has been chosen for interpretation as it is c

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Publication Date
Sat Jan 01 2022
Journal Name
Structural Durability &amp; Health Monitoring
Seismic Analysis of Reinforced Concrete Silos under Far-Field and Near-Fault Earthquakes
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Publication Date
Fri Oct 09 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Thickness of Buccal Bone at Various Sites of the Mandible and Its Clinical Significance in MonocorticalScrews Placement Using Multi-Slice Computed Tomography
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Background:Open reduction and internal fixation (ORIF) of using miniplates and screws is the treatment of choice of mandibular fractures. It is important to know both: the region where the bone providesafirm anchorage, andthe topography of the dental apices and inferior alveolar nerve to avoiddamaging them when inserting the screw. The aim of this study is to determine the thickness of buccal cortical plate and that of buccal bone at the parasymphysis and mandibular body, thereby determining the area that provide afirm anchorage and the maximum length of mono-cortical screws that can be safely placed in these regions without injuring the tooth roots or mandibular nerve. Materials and Methods:The sample of the present study was 110 Iraqi sub

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Publication Date
Tue Oct 14 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Illness Perceptions and Response to Treatment with Romiplostim in Iraqi Patients with Refractory Immune Thrombocytopenia Purpura: A Cross-Sectional Study
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Background: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4

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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
Sun May 15 2022
Journal Name
Revistabionatura
Synthesis and characterization of azo liquid crystal compounds based on 5H-Thiazolo [3,4-b][1,3,4] thiadiazole unit
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A calamitic symmetric liquid crystalline consisting of an azo group containing 5H-Thiazolo[3,4-b][1,3,4]thiadiazole moiety compound[III] was synthesized via sequence reactions starting from reaction terephthaldehyde with mercaptoacetic acid and thiosemicarbazide in the presence of concentrated sulfuric acid to synthesized 5,5'-(1,4-phenylene)bis(5Hthiazolo[4,3-b][1,3,4]thiadiazol-2-amine)[I] then the azo compound [II] synthesized by coupling between diazonium salt of the compound [I] with phenol at (0-4) ̊C., after that the compound [III] was synthesized by the reaction of the compound [II] with methyl bromide in alkaline media. The compounds are characterized by melting points, FTIR and 1HNMR spectroscopy. The mesomorphic behavior was stu

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Publication Date
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering
Intrusion detection method for internet of things based on the spiking neural network and decision tree method
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The prevalence of using the applications for the internet of things (IoT) in many human life fields such as economy, social life, and healthcare made IoT devices targets for many cyber-attacks. Besides, the resource limitation of IoT devices such as tiny battery power, small storage capacity, and low calculation speed made its security a big challenge for the researchers. Therefore, in this study, a new technique is proposed called intrusion detection system based on spike neural network and decision tree (IDS-SNNDT). In this method, the DT is used to select the optimal samples that will be hired as input to the SNN, while SNN utilized the non-leaky integrate neurons fire (NLIF) model in order to reduce latency and minimize devices

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Publication Date
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Intrusion detection method for internet of things based on the spiking neural network and decision tree method
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The prevalence of using the applications for the internet of things (IoT) in many human life fields such as economy, social life, and healthcare made IoT devices targets for many cyber-attacks. Besides, the resource limitation of IoT devices such as tiny battery power, small storage capacity, and low calculation speed made its security a big challenge for the researchers. Therefore, in this study, a new technique is proposed called intrusion detection system based on spike neural network and decision tree (IDS-SNNDT). In this method, the DT is used to select the optimal samples that will be hired as input to the SNN, while SNN utilized the non-leaky integrate neurons fire (NLIF) model in order to reduce latency and minimize devices

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