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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
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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Publication Date
Sun Mar 29 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Using Different Methods to Predict Oil in Place in Mishrif Formation / Amara Oil Field
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The reserve estimation process is continuous during the life of the field due to risk and inaccuracy that are considered an endemic problem thereby must be studied. Furthermore, the truth and properly defined hydrocarbon content can be identified just only at the field depletion. As a result, reserve estimation challenge is a function of time and available data. Reserve estimation can be divided into five types: analogy, volumetric, decline curve analysis, material balance and reservoir simulation, each of them differs from another to the kind of data required. The choice of the suitable and appropriate method relies on reservoir maturity, heterogeneity in the reservoir and data acquisition required. In this research, three types of rese

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Role Of Quality Management In Enhancing The Efficiency And Effectiveness Of Settling Accounts Tax(Empirical Study You Jordan Income &Sales Tax Department
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This research aims to investigate the role of quality management in enhancing the efficiency and effectiveness of settling accounts tax in terms of achieving satisfaction in charge of the hand and the increase of tax revenue on the other hand, by testing the main hypothesis of the study and the sub-hypotheses in the Income and Sales Tax Department in Jordan for the period 2000-20

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Publication Date
Sat Nov 04 2023
Journal Name
Russian Journal Of General Chemistry
Synthesis and Characterization of Metals Complexes with Uracil and Uracil Derivatives (A Review)
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Previous studies on the synthesis and characterization of metal chelates with uracil by elemental analysis, conductivity, IR, UV-Vis, NMR spectroscopy, and thermal analysis were covered in this review article. Reviewing these studies, we found that uracil can be coordinated through the electron pair on the N1, N3, O2, or O4 atoms. If the uracil was a mono-dentate ligand, it will be coordinated by one of the following atoms: N1, N3 or O2. But if the uracil was bi-dentate ligand, it will be coordinated by atoms N1 and O2, N3 and O2 or N3 and O4. However, when uracil forms complexes in the form of polymers, coordination occurs through the following atoms: N1 and N3 or N1 and O4.

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Publication Date
Sat Apr 01 2023
Journal Name
Russian Journal Of General Chemistry
Synthesis and Characterization of Metals Complexes with Uracil and Uracil Derivatives (A Review)
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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
SYNTHESIS OF THE NEW NAPROXEN SELECTIVE ELECTRODE BASED ON IMPRINTED POLYMER USING DIFFERENT MONOMERS AND ITS DETERMINATION AT PHARMACEUTICAL PREPARATION: SYNTHESIS OF THE NEW NAPROXEN SELECTIVE ELECTRODE BASED ON IMPRINTED POLYMER USING DIFFERENT MONOMERS AND ITS DETERMINATION AT PHARMACEUTICAL PREPARATION
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ABSTRACT

Naproxen(NPX) imprinted liquid electrodes of polymers are built using polymerization precipitation. The molecularly imprinted (MIP) and non imprinted (NIP) polymers were synthesized using NPX as a template. In the polymerization precipitation involved, styrene(STY) was used as monomer, N,N-methylenediacrylamide (N,N-MDAM) as a cross-linker and benzoyl peroxide (BPO) as an initiator. The molecularly imprinted membranes and the non-imprinted membranes were prepared using acetophenone(AOPH) and di octylphathalate(DOP)as plasticizers in PVC matrix. The slopes and detection limits of the liquid electrodes ranged from)-18.1,-17.72 (mV/decade and )4.0 x 10-

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Publication Date
Mon Aug 01 2016
Journal Name
2016 38th Annual International Conference Of The Ieee Engineering In Medicine And Biology Society (embc)
Selecting the optimal movement subset with different pattern recognition based EMG control algorithms
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Publication Date
Wed Mar 24 2021
Journal Name
Ieee Access
Smart IoT Network Based Convolutional Recurrent Neural Network With Element-Wise Prediction System
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An Intelligent Internet of Things network based on an Artificial Intelligent System, can substantially control and reduce the congestion effects in the network. In this paper, an artificial intelligent system is proposed for eliminating the congestion effects in traffic load in an Intelligent Internet of Things network based on a deep learning Convolutional Recurrent Neural Network with a modified Element-wise Attention Gate. The invisible layer of the modified Element-wise Attention Gate structure has self-feedback to increase its long short-term memory. The artificial intelligent system is implemented for next step ahead traffic estimation and clustering the network. In the proposed architecture, each sensing node is adaptive and able to

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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
Wed Sep 01 2021
Journal Name
Journal Of Engineering
Water Treatment With Conventional and Alternative Coagulants: A Review
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There is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i

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