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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 30 2012
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Estimation of the Rock Mechanical Properties Using Conventional Log Data in North Rumaila Field
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Hydrocarbon production might cause changes in dynamic reservoir properties. Thus the consideration of the mechanical stability of a formation under different conditions of drilling or production is a very important issue, and basic mechanical properties of the formation should be determined.
There is considerable evidence, gathered from laboratory measurements in the field of Rock Mechanics, showing a good correlation between intrinsic rock strength and the dynamic elastic constant determined from sonic-velocity and density measurements.
The values of the mechanical properties determined from log data, such as the dynamic elastic constants derived from the measurement of the elastic wave velocities in the material, should be more a

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Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Engineering
The Economic Evaluation of Various Production Scenarios for Zubair Reservoir in the Kifl Field
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This work evaluates the economic feasibility of various production scenarios for the Zubair reservoir in the Kifl oil field using cash flow and net present value (NPV) calculations. The Kifl field is an exploratory field that has not yet been developed or assessed economically. The first well was drilled in 1960, and three other wells were later drilled to assess the oil accumulation, so in this research, Different production scenarios were evaluated economically. These scenarios were proposed based on the reservoir model of the Zubair formation in the field. The research methodology used QUE$TOR software to estimate capital expenditures (CapEx) and operating expenditures (OpEx) based on field-level data, production prof

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Publication Date
Fri Jan 01 2010
Journal Name
International Journal Of Communication Networks And Distributed Systems
A novel Radon-based multi-carrier direct sequence code division multiple access transceiver design and simulation
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Multi-carrier direct sequence code division multiple access (MC-DS-CDMA) has emerged recently as a promising candidate for the next generation broadband mobile networks. Multipath fading channels have a severe effect on the performance of wireless communication systems even those systems that exhibit efficient bandwidth, like orthogonal frequency division multiplexing (OFDM) and MC-DS-CDMA; there is always a need for developments in the realisation of these systems as well as efficient channel estimation and equalisation methods to enable these systems to reach their maximum performance. A novel MC-DS-CDMA transceiver based on the Radon-based OFDM, which was recently proposed as a new technique in the realisation of OFDM systems, will be us

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Engineering
Valuation of Construction Projects Based on of Quantity Scale by using Expert System
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The subject of an valuation of quality of construction projects is one of the topics which it becomes necessary of the absence of the quantity standards in measuring the control works and the quality valuation standards in constructional projects. In the time being it depends on the experience of the workers which leads to an apparent differences in the valuation.

The idea of this research came to put the standards to evaluate the quality of the projects in a special system depending on quantity scale nor quality specifying in order to prepare an expert system “ Crystal “ to apply this special system to able the engineers to valuate the quality of their projects easily and in more accurate ways.

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Publication Date
Fri Jan 19 2024
Journal Name
Research Journal Of Pharmacy And Technology
Serum Levels of Fetuin-A, Ischemia-modified Albumin (IMA), and Ferritin in Hospitalized patients with severe COVID-19. A Case-control Study
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Objective: To measure the serum levels of Fetuin-A, ischemia-modified albumin (IMA), and ferritin in hospitalized patients with severe COVID-19in Baghdad, Iraq. Moreover, to determine these biomarkers' cut-off valuesthat differentiate between severely ill patients and control subjects. Methods: This case-control study was done from 15 September to the end of December 2021 and involved a review of the files and collectionof blood samples from patients (n=45, group1) hospitalized in COVID-19 treatment centersbecause of severe symptoms compared tohealthy subjects as controls (n=44, group2). Results: Fetuin-A serum levels were not statistically different between patients and controls. In contrast, IMA and ferritin levels were significan

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Publication Date
Mon Dec 20 2021
Journal Name
Baghdad Science Journal
IoT System on Dynamic Fish Feeder Based on Fish Existence for Agriculture Aquaponic Breeders
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Maintaining and breeding fish in a pond are a crucial task for a large fish breeder. The main issues for fish breeders are pond management such as the production of food for fishes and to maintain the pond water quality. The dynamic or technological system for breeders has been invented and becomes important to get maximum profit return for aquaponic breeders in maintaining fishes. This research presents a developed prototype of a dynamic fish feeder based on fish existence. The dynamic fish feeder is programmed to feed where sensors detected the fish's existence. A microcontroller board NodeMCU ESP8266 is programmed for the developed h

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
independence of the central banks with a focus on measuring the independence of the central bank of Jordan
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The main topic of this study is central around the independence of Jordanian central bank and the extent of the effectiveness at the bank in leading the monetary policy without interferences or pressures from side of the government.  the degree of independence of Jordanian central bank was  based on the following based hypothesis following ,there is relationship between the independence of the central bank and the legislative and economical indices. the most important recommendations are degree of independence of the Jordan central bank 43.5% is a good one, but it possible to reach a higher degree than this one by to making some modification on the Jordanian central bank law and by the central bank should be more rigid

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Publication Date
Fri May 31 2019
Journal Name
Journal Of Engineering
A Comparative Study of Various Intelligent Algorithms based Path Planning for Mobile Robots
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In general, path-planning problem is one of most important task in the field of robotics. This paper describes the path-planning problem of mobile robot based on various metaheuristic algorithms. The suitable collision free path of a robot must satisfies certain optimization criteria such as feasibility, minimum path length, safety and smoothness and so on. In this research, various three approaches namely, PSO, Firefly and proposed hybrid FFCPSO are applied in static, known environment to solve the global path-planning problem in three cases. The first case used single mobile robot, the second case used three independent mobile robots and the third case applied three follow up mobile robot.  Simulation results, whi

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Publication Date
Tue Feb 24 2015
Journal Name
Robotica
Multi-level control of zero-moment point-based humanoid biped robots: a review
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SUMMARY<p>Researchers dream of developing autonomous humanoid robots which behave/walk like a human being. Biped robots, although complex, have the greatest potential for use in human-centred environments such as the home or office. Studying biped robots is also important for understanding human locomotion and improving control strategies for prosthetic and orthotic limbs. Control systems of humans walking in cluttered environments are complex, however, and may involve multiple local controllers and commands from the cerebellum. Although biped robots have been of interest over the last four decades, no unified stability/balance criterion adopted for stabilization of miscellaneous walking/running modes of biped </p> ... Show More
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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
A Digital-Based Optimal AVR Design of Synchronous Generator Exciter Using LQR Technique
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In this paper a new structure for the AVR of the power system exciter is proposed and designed using digital-based LQR. With two weighting matrices R and Q,  this method produces an optimal regulator that is used to generate the feedback control law. These matrices are called state and control weighting matrices and are used to balance between the relative importance of the input and the states in the cost function that is being optimized. A sample power system composed of single machine connected to an infinite- bus bar (SMIB) with both a conventional and a proposed Digital AVR (DAVR) is simulated. Evaluation results show that the DAVR damps well the oscillations of the terminal voltage and presents a faster respo

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