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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
Mon Sep 14 2015
Journal Name
Spe North Africa Technical Conference And Exhibition
Feasibility of Gas Lift to Increase Oil Production in an Iraqi Giant Oil Field
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Abstract<p>Gas lift is one of the artificial lift techniques which it is frequently implemented to raise oil production. Conventionally, the oil wells produce depending on the energy of reservoir pressure and solution gas which declines due to continuous production. Therefore, many oil wells after a certain production time become unable to lift oil to the surface. Thus, the continuity of production requires implementation of gas lift which works to decrease the average fluid density in the tubing by injection gas through the annulus into the tubing. This paper aims to get maximum oil production of an Iraqi giant oil field at optimum injected gas rate. The field is located in south of Iraq and in</p> ... Show More
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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
Wed Mar 01 2023
Journal Name
Journal Of Molecular Structure
Synthesis, structural investigations, XRD, DFT, anticancer and molecular docking study of a series of thiazole based Schiff base metal complexes
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A novel Schiff base (SB) ligand, abbreviated as HDMPM, resulted from the condensation of 2-amino-4-phenyl-5-methyl thiazole and 4-(diethylamino)salicyaldehyde, and its metal complexes with [Co(II), Cu(II), Ni(II), and Zn(II)] ions in high yield were formed. The physico-chemical techniques such as elemental analysis, molar conductance, IR, 1H and 13C NMR, mass spectroscopy, and electronic absorption studies were utilized to characterize the synthesized compounds. The studied compounds were examined for their possible anticancer activity against a number of human cancerous cell lines, including A549 lung carcinoma, HepG2 liver cancer, HCT116 colorectal cancer, and MCF-7 breast cancer cell lines, with doxorubicin serving as the standard. The s

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Publication Date
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Alendronate Treatment on Salivary Levels of Osteoprotegrin and TNF-α in Postmenopausal Woman with Osteoporosis and Periodontal Diseases
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Background: All diseases concerning bone destruction such as osteoporosis and periodontal diseases share common pattern in which the osteoclast cells are absolutely responsible for bone resorption that occurred when osteoclast activity exceeds osteoblast activity. Osteoprotegrin (OPG) considered as novel soluble decoy receptor known as “bone protector” since it prevents extreme bone resorption through inhibition of differentiation and activity of osteoclast by competing for binding site. It binds to receptor activator of nuclear factor kappa-B ligand (RANKL) and prevent its interaction with receptor activator of nuclear factor kappa-B (RANK), thus inhibits osteoclast formation. TNF-α is a pro-inflammatory cytokines having

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Publication Date
Tue Jan 01 2019
Journal Name
Indian Journal Of Ecology
Effectiveness of oxidation enzymes in the ratio of gluten to wheat bread via different treatments of weeds control
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Publication Date
Fri Dec 15 2023
Journal Name
Iraqi Journal Of Laser
The Reliability of Two Different Laser Wavelengths in Inducing Bone Healing Around Dental Implants: Comparative Clinical Trial
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Background/purpose: Dental implantology involves different treatments that have been used in conjunction with dental implant surgery to increase implant stability and bone regeneration process. Photobiomodulation( PBM) can be one of these techniques. The objective of this study was to evaluate the bone density around implants. Materials and methods: in this study, 10 individuals had 20 implants inserted in the posterior of their mandibles. each patient received two implants the left side served as the control whereas the right side served as the study group with a diode laser (same patients). measurements were made for each implant. Measurements were obtained using cone-

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Publication Date
Tue Oct 25 2016
Journal Name
Iosr Journal Of Pharmacy And Biological Sciences
Molecular study of blaVEB-1 gene in Proteus mirabilis isolated from clinical Samples from Baghdad City’s hospitals
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From different hospitals in Baghdad city, 25 clinical isolates of Proteus spp. were collected from different clinical samples, all isolates were identified as Proteus mirabilis by using bacteriological and biochemical assays in addition to Vitek-2 identification system. 15 (60%) isolates were identifying as Proteus mirabilis. The susceptibility of P. mirabilis isolates towards cefotaxime and ceftazidime was (66.6 %), (20%) consecutively; while extended spectrum β-lactamases producing P. mirabilis percentage was (30.7 %). Because blaVEB-1 was documented as an important indicator for increasing risk of extended spectrum beta ßlactamases producing P. mirabilis isolates that began to spread from many geographic area to Far east which inc

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Biochemical and Kinetic Studies on Alkaline Phosphatase and other Biochemical Features in Sera of Patients with type 2 Diabetes
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Background :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Robotics And Control (jrc)
Artificial Intelligence Based Deep Bayesian Neural Network (DBNN) Toward Personalized Treatment of Leukemia with Stem Cells
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The dynamic development of computer and software technology in recent years was accompanied by the expansion and widespread implementation of artificial intelligence (AI) based methods in many aspects of human life. A prominent field where rapid progress was observed are high‐throughput methods in biology that generate big amounts of data that need to be processed and analyzed. Therefore, AI methods are more and more applied in the biomedical field, among others for RNA‐protein binding sites prediction, DNA sequence function prediction, protein‐protein interaction prediction, or biomedical image classification. Stem cells are widely used in biomedical research, e.g., leukemia or other disease studies. Our proposed approach of

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