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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
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Immunoglobulins assessment (IgE,G,A,M) in some Iraqi patients with acute and chronic urticaria
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60 patients diagnosed as having urticaria were included in the study ; 30 patients were effected with acute urticaria and 30 patients were affected with chronic urticaria. In addition, 30 healthy adult volunteers were selected as control group .The patients and control groups sera were examined with enzyme linked immunosorbent assay ( ELISA) to detect total level IgE and radial immunodiffusion (RID) to detect levels of IgG , IgA and IgM . The total level of IgE in acute urticaria ( 1.45±0.13) IU/mL and chronic urticaria (2.12 ± 0.10) IU/mL patients were significantly higher than the control groups ( 0.85 ± 0.10)IU/mL (p<0.05). The level of IgG in acute urticaria ( 12.5± 0.42) g/L and chronic (13.16±0.40) g/L patients , IgA in acute (2.

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Simultanous Electricity Production and Wastewater Ttreatment in a Microbial Fuel Cell Inoculeted with Anaerobic Sludge
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In order to reduce the environmental pollution associated with the conventional energy sources and to achieve the increased global energy demand, alterative and renewable sustainable energy sources need to be developed. Microbial fuel cells (MFCs) represent a bio-electrochemical innovative technology for pollution control and a simultaneous sustainable energy production from biodegradable, reduced compounds. This study mainly considers the performance of continuous up flow dual-chambers MFC
fueled with actual domestic wastewater and bio-catalyzed with anaerobic aged sludge obtained from an aged septic tank. The performance of MFCs was mainly evaluated in terms of COD reductions and electrical power output. Results revealed that the C

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Publication Date
Mon Dec 31 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Dyslipidemia and CA15-3 serum level in Iraqi Women with Breast Tumor: A Comparative Study
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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Study on Nψβ and Nβψ - Closed sets in Neutrosophic Topological spaces
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The aim of this paper is to introduce the concept of N  and Nβ -closed sets in terms of neutrosophic topological spaces. Some of its properties are also discussed.

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Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
A Review Study on Forgery and Tamper Detection Techniques in Digital Images
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Digital tampering identification, which detects picture modification, is a significant area of image analysis studies. This area has grown with time with exceptional precision employing machine learning and deep learning-based strategies during the last five years. Synthesis and reinforcement-based learning techniques must now evolve to keep with the research. However, before doing any experimentation, a scientist must first comprehend the current state of the art in that domain. Diverse paths, associated outcomes, and analysis lay the groundwork for successful experimentation and superior results. Before starting with experiments, universal image forensics approaches must be thoroughly researched. As a result, this review of variou

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Publication Date
Wed Oct 25 2023
Journal Name
Urban Planning And Construction
A Review on Urban Planning and Its Role in Managing Flood Risks
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This review delves deep into the intricate relationship between urban planning and flood risk management, tracing its historical trajectory and the evolution of methodologies over time. Traditionally, urban centers prioritized defensive measures, like dikes and levees, with an emphasis on immediate solutions over long-term resilience. These practices, though effective in the short term, often overlooked broader environmental implications and the necessity for holistic planning. However, as urban areas burgeoned and climate change introduced new challenges, there has been a marked shift in approach. Modern urban planning now emphasizes integrated blue-green infrastructure, aiming to harmonize human habitation with water cycles. Resil

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Publication Date
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Development of an Optimized Botnet Detection Framework based on Filters of Features and Machine Learning Classifiers using CICIDS2017 Dataset
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Abstract<p>Botnet is a malicious activity that tries to disrupt traffic of service in a server or network and causes great harm to the network. In modern years, Botnets became one of the threads that constantly evolving. IDS (intrusion detection system) is one type of solutions used to detect anomalies of networks and played an increasing role in the computer security and information systems. It follows different events in computer to decide to occur an intrusion or not, and it used to build a strategic decision for security purposes. The current paper <italic>suggests</italic> a hybrid detection Botnet model using machine learning approach, performed and analyzed to detect Botnet atta</p> ... Show More
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Publication Date
Wed May 15 2024
Journal Name
Ieee Sensors Journal
Surface Crack Size Estimation Based on Quantification and Decoupling of Magnetic Flux Leakage (MFL) Signals of Circular Array Sensors
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Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Engineering
Knowledge-Based Urban Development The Impact of Knowledge- Based Urban Development in the Growth of Contemporary Cities
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Urban Development refers to many topics such as: increased population density, city size, and individual’s production, distribution of technology and the growth of commercial, industrial and service professions. Such development is linked to the coordination of social and cultural trends in order to achieve social progress and economical prosperity. Knowledge as a topic now is known as intellectual capital wich led to upgrae the concept of urban development to be extended into many fields of knowledge, for example, cultural, social and human development to move the level of community culture into a new better standard.

The research adopted the urban transformation based on knowledge as an important factor in gr

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Publication Date
Fri Dec 01 2017
Journal Name
Al-nahrain Journal For Engineering Sciences (njes)
Investigation of the thermodynamic, kinetic and equilibrium parameters of batch biosorption of Pb (II), Cu (II), and Ni (II) from aqueous phase using low cost biosorbent
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In this study, low cost biosorbent ̶inactive biomass (IB) granules (dp=0.433mm) taken from drying beds of Al-Rustomia Wastewater Treatment Plant, Baghdad-Iraq were used for investigating the optimum conditions of Pb(II), Cu(II), and Ni(II) biosorption from aqueous solutions. Various physico-chemical parameters such as initial metal ion concentration (50 to 200 mg/l), equilibrium time (0-180 min), pH (2-9), agitation speed (50-200 rpm), particles size (0.433 mm), and adsorbent dosage (0.05-1 g/100 ml) were studied. Six mathematical models describing the biosorption equilibrium and isotherm constants were tested to find the maximum uptake capacities: Langmuir, Freundlich, Redlich–Peterson, Sips, Khan, and Toth models. The best fit to the P

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