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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 Mar 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
An efficient multistage CBIR based on Squared Krawtchouk-Tchebichef polynomials
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Abstract<p>Image databases are increasing exponentially because of rapid developments in social networking and digital technologies. To search these databases, an efficient search technique is required. CBIR is considered one of these techniques. This paper presents a multistage CBIR to address the computational cost issues while reasonably preserving accuracy. In the presented work, the first stage acts as a filter that passes images to the next stage based on SKTP, which is the first time used in the CBIR domain. While in the second stage, LBP and Canny edge detectors are employed for extracting texture and shape features from the query image and images in the newly constructed database. The p</p> ... Show More
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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
An Application Domain Based on General Object Oriented Software Models
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Any software application can be divided into four distinct interconnected domains namely, problem domain, usage domain, development domain and system domain. A methodology for assistive technology software development is presented here that seeks to provide a framework for requirements elicitation studies together with their subsequent mapping implementing use-case driven object-oriented analysis for component based software architectures. Early feedback on user interface components effectiveness is adopted through process usability evaluation. A model is suggested that consists of the three environments; problem, conceptual, and representational environments or worlds. This model aims to emphasize on the relationship between the objects

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Online Sumarians Cuneiform Detection Based on Symbol Structural Vector Algorithm
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The cuneiform images need many processes in order to know their contents
and by using image enhancement to clarify the objects (symbols) founded in the
image. The Vector used for classifying the symbol called symbol structural vector
(SSV) it which is build from the information wedges in the symbol.
The experimental tests show insome numbersand various relevancy including
various drawings in online method. The results are high accuracy in this research,
and methods and algorithms programmed using a visual basic 6.0. In this research
more than one method was applied to extract information from the digital images
of cuneiform tablets, in order to identify most of signs of Sumerian cuneiform.

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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
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
Short Text Semantic Similarity Measurement Approach Based on Semantic Network
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Estimating the semantic similarity between short texts plays an increasingly prominent role in many fields related to text mining and natural language processing applications, especially with the large increase in the volume of textual data that is produced daily. Traditional approaches for calculating the degree of similarity between two texts, based on the words they share, do not perform well with short texts because two similar texts may be written in different terms by employing synonyms. As a result, short texts should be semantically compared. In this paper, a semantic similarity measurement method between texts is presented which combines knowledge-based and corpus-based semantic information to build a semantic network that repre

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Publication Date
Fri Jul 01 2011
Journal Name
Engineering And Technology Journal
Off-Line Arabic Signature Recognition Based on Invariant Moments Properties
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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
Sun Nov 01 2020
Journal Name
Iop Conference Series
Modified PRESENT Encryption algorithm based on new 5D Chaotic system
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Cryptography is a major concern in communication systems. IoE technology is a new trend of smart systems based on various constrained devices. Lightweight cryptographic algorithms are mainly solved the most security concern of constrained devices and IoE systems. On the other hand, most lightweight algorithms are suffering from the trade-off between complexity and performance. Moreover, the strength of the cryptosystems, including the speed of the algorithm and the complexity of the system against the cryptanalysis. A chaotic system is based on nonlinear dynamic equations that are sensitive to initial conditions and produce high randomness which is a good choice for cryptosystems. In this work, we proposed a new five-dimensional of a chaoti

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