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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 Jun 09 2020
Journal Name
Article In Journal Of Engineering Science And Technology
English Numbers Recognition Based on Sign Language Using Line-Slope Features and PSO-DBN Optimization Method
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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Physics: Conference Series
EEG Motor-Imagery BCI System Based on Maximum Overlap Discrete Wavelet Transform (MODWT) and cubic SVM
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Abstract<p>Communication of the human brain with the surroundings became reality by using Brain- Computer Interface (BCI) based mechanism. Electroencephalography (EEG) being the non-invasive method has become popular for interaction with the brain. Traditionally, the devices were used for clinical applications to detect various brain diseases but with the advancement in technologies, companies like Emotiv, NeuoSky are coming up with low cost, easily portable EEG based consumer graded devices that can be used in various application domains like gaming, education etc as these devices are comfortable to wear also. This paper reviews the fields where the EEG has shown its impact and the way it has p</p> ... Show More
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Publication Date
Mon Mar 11 2019
Journal Name
Baghdad Science Journal
Developing Load Balancing for IoT - Cloud Computing Based on Advanced Firefly and Weighted Round Robin Algorithms
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The evolution of the Internet of things (IoT) led to connect billions of heterogeneous physical devices together to improve the quality of human life by collecting data from their environment. However, there is a need to store huge data in big storage and high computational capabilities.   Cloud computing can be used to store big data.  The data of IoT devices is transferred using two types of protocols: Message Queuing Telemetry Transport (MQTT) and Hypertext Transfer Protocol (HTTP). This paper aims to make a high performance and more reliable system through efficient use of resources. Thus, load balancing in cloud computing is used to dynamically distribute the workload across nodes to avoid overloading any individual r

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Publication Date
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Flexible handover solution for vehicular ad-hoc networks based on software defined networking and fog computing
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<p>Vehicular ad-hoc networks (VANET) suffer from dynamic network environment and topological instability that caused by high mobility feature and varying vehicles density. Emerging 5G mobile technologies offer new opportunities to design improved VANET architecture for future intelligent transportation system. However, current software defined networking (SDN) based handover schemes face poor handover performance in VANET environment with notable issues in connection establishment and ongoing communication sessions. These poor connectivity and inflexibility challenges appear at high vehicles speed and high data rate services. Therefore, this paper proposes a flexible handover solution for VANET networks by integrating SDN and

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Publication Date
Tue Dec 01 2020
Journal Name
Systematic Reviews In Pharmacy
A Study On The Effects Of Risk Factors On The Pathology And The Development Of Breast Cancer In Iraqi Women
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Breast cancer is one of the most important malignant diseases all over the world. The incidence of breast cancer is increasing around the world and it is still the leading cause of cancer mortality An Approximately 1.3 million new cases were diagnosed worldwide last year. With areas rising increasing, risk factors for breast cancer including obesity, early menarche, alcohol and smoking, environmental contamination and reduced or late birth rates become more prevalent. In Iraq, breast cancer ranks first among types of cancers diagnosed in women. This study was conducted on one hundred twenty women with breast cancer that was evaluated and investigated for the possible role of the risk factors on the development of breast cancer in females. T

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Publication Date
Fri May 12 2023
Journal Name
Bulletin Of The Chemical Society Of Ethiopia
SYNTHESIS, CHARACTERIZATION, ANTIMICROBIAL STUDIES, AND MOLECULAR DOCKING STUDIES OF TRANSITION METAL COMPLEXES FORMED FROM A BENZOTHIAZOLE-BASED AZO LIGAND
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The azo ligand obtained from the diazotization reaction of 2-aminobenzothiazole and 4- nitroaniline yielded a novel series of complexes with Co(II), Ni(II), Cu(II), and Zn(II) ions. The complexes were investigated using spectral techniques such as UV-Vis, FT-IR, 1H and 13C NMR spectroscopic analyses, LC-MS and atomic absorption spectrometry, electrical conductivity, and magnetic susceptibility. The molar ratio of the synthesized compounds was determined using the ligand exchange ratio, which revealed the metal-ligand ratios in the isolated complexes were 1:2. The synthesized complexes were tested for antimicrobial activity against S. aureus, E. coli, C. albicans, and C. tropicalis bacterial species. Additionally, their binding affinities we

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
THE role of Organizational flexibility and its impact in responding to achieve higher performance requirements; Field research in the General Directorate of Municipalities.
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Municipalities.

Abstract

The purpose of this research is to measure the impact of regulatory flexibility dimensions (formal and authoritarian procedures) to achieve response to the requirements of high performance dimensions (the effective recruitment, intensive training, motivate employees, participation of workers) in the general municipal Directorate as one of the directorates of the Ministry of Municipalities and Public Works. For the purpose of this measure it has been selected sample composed of 88 individuals from the research community represents the levels of assistant general manager of department heads and managers of people and some of the staff to answer the questionnaire prepared for the purpose Hama

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Publication Date
Mon Apr 04 2016
Journal Name
European Journal Of Oral Sciences
Experimental polyethylene-hydroxyapatite carrier-based endodontic system: an in vitro study on dynamic thermomechanical properties, sealing ability, and measurements of micro-computed tomography voids
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The dynamic thermomechanical properties, sealing ability, and voids formation of an experimental obturation hydroxyapatite-reinforced polyethylene (HA/PE) composite/carrier system were investigated and compared with those of a commercial system [GuttaCore (GC)]. The HA/PE system was specifically designed using a melt-extrusion process. The viscoelastic properties of HA/PE were determined using a dynamic thermomechanical analyser. Human single-rooted teeth were endodontically instrumented and obturated using HA/PE or GC systems, and then sealing ability was assessed using a fluid filtration system. In addition, micro-computed tomography (μCT) was used to quantify apparent voids within the root-canal space. The data were statistically analys

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Publication Date
Sat Apr 29 2023
Journal Name
International Journal Of Biomaterials
The Influence of the Hyaluronic Acid Gel on the Postoperative Sequelae following Surgical Removal of the Impacted Mandibular Third Molar in Comparison with the A-PRF: A Randomized Controlled Trial
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One of the most common procedures in oral surgery is the removal of impacted mandibular third molars, often followed by pain, swelling, alveolitis, and trismus. Purpose. To compare the outcomes of the intrasocket application of 1% hyaluronic acid oral gel (HA) and advanced platelet-rich fibrin (A-PRF) on the expected postoperative complications, pain, swelling, and trismus follow the surgical extraction of the impacted mandibular third molar. Material and Methods. A randomized controlled trial was conducted at the Oral and Maxillofacial Surgery Unit, Dental Teaching Hospital. Healthy patients who required surgical removal of the impacted mandibular third molar were divided randomly into three groups. The extraction site of the group

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Publication Date
Sun Dec 02 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 accurate t

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