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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 Feb 25 2024
Journal Name
Baghdad Science Journal
An exploratory study of history-based test case prioritization techniques on different datasets
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In regression testing, Test case prioritization (TCP) is a technique to arrange all the available test cases. TCP techniques can improve fault detection performance which is measured by the average percentage of fault detection (APFD). History-based TCP is one of the TCP techniques that consider the history of past data to prioritize test cases. The issue of equal priority allocation to test cases is a common problem for most TCP techniques. However, this problem has not been explored in history-based TCP techniques. To solve this problem in regression testing, most of the researchers resort to random sorting of test cases. This study aims to investigate equal priority in history-based TCP techniques. The first objective is to implement

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
The Role of Gender and Culture in Dealing with the Arab Woman's Issues Embodied in Caricatures: A Cognitive Linguistic Analysis
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Gender and culture are among the factors that influence the process of understanding and interpreting different types of communication, especially images. The current study, which is a part of a master’s thesis, aims at investigating the role of gender and culture in interpreting and understanding the caricatures that deal with women’s issues in Arab societies. To this end, the researchers adopted Barthes’ (1957) concepts of denotation and connotation in his theory of mythologies in addition to Langacker’s (1987) theory of (Domains). The research concludes that the female subjects have better cognitive abilities in investing the signs within the selected caricatures. The other factor the study reached to is that the respondents

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Publication Date
Thu Sep 26 2019
Journal Name
Al-kindy College Medical Journal
Administration of I.V. lidocaine before induction of general anesthesia prolong suxamethonium action in caesarian section surgeries. clinical assessment--------
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Background: Known as suxamethonium or succinylcholine, is a medication used to cause short-term paralysis as part of general anesthesia. The duration of operation is one of the important factors accounting to the success of the operation. Simple safe available drug can change the plan of anesthesia.

Objective:  The purpose of this study was to assess adding Lidocaine three minutes intravenously before induction of general anesthesia on the duration of optimum prolongation the action of  Suxamethonium  . With other group with regular meth

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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
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
The Ameliorating Effect of Ashwagandha (Withania Somnifera) Extract on Hippocampus and Growth Plate Changes Associated With Propylthiouracil Induced Hypothyroidism in Juvenile Rats : Ashwagandha on Hippocampus and Growth Plate Changes Associated With hypothyroid rats
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Background: Hypothyroidism is a decrease in the production of the thyroid hormones and leads to gland dysfunction. Ashwagandha extract was used as an ayurvedic treatment and supposed to be as antihypothyroidism agent.

Objectives: to investigate the impact of ashwagandha (Ash) extract on propylthiouracil (PTU)-induced hypothyroidism in rats.

Subjects and Methods: The rats were divided into three groups, control group, PTU (hypothyroid) group (6mg/kg/day by oral route), PTU (6mg/kg/day by oral route) +Ash (50mg/kg/day by oral route) treated group. All treatment continued for

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES: A COMPARATIVE STUDY OF THE CONSUMERS ATTITUDE ON THE MEAT HYGIENE SLAUGHTERED IN AND OUTSIDETHE SLAUGHTER HOUSEES
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The study was conducted to assess the attitude and awareness of a sample of people regarding the indiscriminate slaughter and its effects on health and the environment compared with slaughtering  in a slaughterhouse. The sample consisted of 120 persons from six equal professional groups contacted with the butchery labour (livestock keeper, truck driver, butcher, veterinarian, shopkeeper and consumer). The age ranged 22-76 years old, mean 52±10  years, lived ≥ 5 years in the Baghdad city. The results showed that there is a preference for slaughtering inside the slaughterhouse due to the presence of veterinary examination, slaughtering and preparing meat in a healthy, easy-to-clean places, unlike the indiscriminate sla

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Factors associated with Exacerbation of Myasthenia Gravis in a Group of Iraqi Patients
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Background: Myasthenia gravis is an autoimmune disease of the neuromuscular junction that results in fluctuating muscle weakness as well as significant fatigue. Disease exacerbation is a critical condition, and the predisposing factors for it need to be identified to improve preventive measures.

Objectives:  Our study aims to determine the predisposing factors for myasthenia gravis exacerbations in a group of Iraqi patients.

Subjects and Methods: A total number of 30 myasthenia gravis patients were admitted to the hospital with an exacerbation of their symptoms, determined as the development of functional disability, dysphagia, or respiratory fai

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Geological Journal
Advanced Technique of Rock Typing Characterization of Mishrif Formation, Amara Oil Field in Southern Iraq
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Reservoir rock typing integrates geological, petrophysical, seismic, and reservoir data to identify zones with similar storage and flow capacities. Therefore, three different methods to determine the type of reservoir rocks in the Mushrif Formation of the Amara oil field. The first method represents cluster analysis, a statistical method that classifies data points based on effective porosity, clay volume, and sonic transient time from well logs or core samples. The second method is the electrical rock type, which classifies reservoir rocks based on electrical resistivity. The permeability of rock types varies due to differences in pore geometry, mineral composition, and fluid saturation. Resistivity data are usually obtained from w

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Estimation of the Petrophysical Properties of the Lower Cretaceous Yamama (YC) Formation in Siba Field
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   In southern Iraq, the Yamama Formation has been a primary carbonate resource since the Lower Cretaceous era. This study covers Siba Field, which is located in southeastern Iraq. This paper will be devoted to a YC unit of study. The most crucial step in reservoir management is petrophysical characterization. The primary goal of this research is to assess the reservoir features and lithology of the Yamama (YC) Formation in the Siba region. Accessible excellent logs include sonic, density, neutron, gamma-ray, SP, and resistivity readings. The Interactive Petrophysics (IP4.4) program examined and estimated petrophysical features such as clay volume, porosity, and water saturation. The optimum approach was the neutron density and clay vo

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of job redesign in the performance of the inspectors general offices Field research
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       Concentrated research topic in the study of variables key to the work of offices of inspectors Amyin ، a (re- design function، and performance Organisational ) and took this message to know the nature of the relationship and the impact of the dimensions of the re- design function as a variable interpretative through its dimensions، is ( the diversity of skill، selecting the task ، the importance of task، autonomy، feedback )، and performance Organisational variable responsive through two dimensions are ( effectiveness ، efficiency )، and in order to test the research hypotheses were absorbed variables in the form of a questionnaire and were questionnaire primary means of gatheri

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