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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
Wed Jun 30 2021
Journal Name
College Of Islamic Sciences
What Imam Ibn al-Subki disagreed with Imam al-Amadi in Tashnif al-Masma’, the chapter on analogy as a model
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Takbiratul Ehram "The First Takbeer to Start Prayer" means: the words that the worshiper says to start his prayers, and refrain from anything invalidates it. the findings revealed that the four school jurists agreed that the prayer is not valid without Takbiratul Ehram "The First Takbeer to Start Prayer", and they disagreed on its description, so the majority of jurists said that it is a pillar, and some of them called it an obligatory, but Hanafi made it a condition. Likewise, the four jurists agreed that the one who articulates Takbiratul Ehram "The First Takbeer to Start Prayer" with the word: “Allahu Akbar,”; his Takbeer is correct, and they disagreed about the one who adds a word, or replaced it with another, where the m

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Publication Date
Thu Jul 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Processing Eruca sativa leaves in the nanoscale and study its effectiveness for removing Cibacron red dye from their aqueous solutions
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    The discharge of dyes into the water is a significant source of pollution, which is especially concerning given that textile mills are the primary contributor. Nanomaterial-based solutions to this issue have required extensive research and investigation due to their complex nature. In this research, novel nanoparticle were successfully synthesized using the leaves of the Eruca sativa plant. The nano was analyzed using scanning and transmission electron microscopy (SEM and TEM) measurements, and their crystal structure was determined using the X-ray diffraction technique (XRD). The incorporation of NPs resulted in an increase in the uptake of the Cibacron red dye. At a contact time of 30 minutes, observed a faster adsorption o

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Publication Date
Tue Jun 30 2026
Journal Name
Journal Of Engineering
Parametric Study Of Laminar Free Convection In Horizontal Annulus With And Without Fins On The Inner Cylinder
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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
Effect of Metformin Therapy on Reducing Leptin Resistance and Enhancing Ovulation in Women with Polycystic Ovary Syndrome
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Background: The relation between insulin resistance ,leptin levels and other hormones in women with polycystic ovary syndrome(PCOS) is still controversial.Metformin therapy is proved effective in reducing insulin resistance and also in some studies it was seen to be effective in reducing leptin levels.
Al- Kindy Col Med J 2012 ; Vol .8 No. (2) p: 65
Objective: to study the effect of metformin on reducing leptin levels and enhancing ovulation in PCOS women.
Methods:metformin 500mg 3 times daily for 3 months was was given to 36 women
with proved PCOS, in addition to that, other parameters were included.
Results:28 women out of 36(77.78%) showed an evidence of ovulation ovulation after 3 months of metformin therapy(p<0.01)

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Publication Date
Tue May 28 2019
Journal Name
Al-khwarizmi Engineering Journal
Heuristic D* Algorithm Based on Particle Swarm Optimization for Path Planning of Two-Link Robot Arm in Dynamic Environment
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 Finding a path solution in a dynamic environment represents a challenge for the robotics researchers, furthermore, it is the main issue for autonomous robots and manipulators since nowadays the world is looking forward to this challenge. The collision free path for robot in an environment with moving obstacles such as different objects, humans, animals or other robots is considered as an actual problem that needs to be solved.  In addition, the local minima and sharp edges are the most common problems in all path planning algorithms. The main objective of this work is to overcome these problems by demonstrating the robot path planning and obstacle avoidance using D star (D*) algorithm based on Particle Swarm Optimization (PSO)

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Publication Date
Thu Feb 01 2024
Journal Name
Baghdad Science Journal
Estimating concentration of toxic ions Arsenic in water by using Photonic Crystal Fiber based on Surface Plasmon Resonance (SPR)
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In this work, an enhanced Photonic Crystal Fiber (PCF) based on Surface Plasmon Resonance (SPR) sensor using a sided polished structure for the detection of toxic ions Arsenic in water was designed and implemented. The SPR curve can be obtained by polishing the side of the PCF after coating the Au film on the side of the polished area, the SPR curve can be obtained. The proposed sensor has a clear SPR effect, according to the findings of the experiments. The estimated signal to Noise Ratio (SNR), sensitivity (S), resolution (R), and Figures of merit (FOM) are approaching; the SNR is 0.0125, S is 11.11 μm/RIU, the resolution is 1.8x〖10〗^(-4), and the FOM is 13.88 for Single-mode Fiber- Photonic Crystal Fiber- single mode Fiber (SMF-P

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Publication Date
Wed Sep 01 2021
Journal Name
Applications And Applied Mathematics: An International Journal (aam)
Stability and Bifurcation of a Cholera Epidemic Model with Saturated Recovery Rate
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In this paper, a Cholera epidemic model is proposed and studied analytically as well as numerically. It is assumed that the disease is transmitted by contact with Vibrio cholerae and infected person according to dose-response function. However, the saturated treatment function is used to describe the recovery process. Moreover, the vaccine against the disease is assumed to be utterly ineffective. The existence, uniqueness and boundedness of the solution of the proposed model are discussed. All possible equilibrium points and the basic reproduction number are determined. The local stability and persistence conditions are established. Lyapunov method and the second additive compound matrix are used to study the global stability of the system.

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Publication Date
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
The dynamics of a delayed ecological model with predator refuge and cannibalism
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This study has contributed to understanding a delayed prey-predator system involving cannibalism. The system is assumed to use the Holling type II functional response to describe the consuming process and incorporates the predator’s refuge against the cannibalism process. The characteristics of the solution are discussed. All potential equilibrium points have been identified. All equilibrium points’ local stability analyses for all time delay values are investigated. The system exhibits a Hopf bifurcation at the coexistence equilibrium, which is further demonstrated. The center manifold and normal form theorems for functional differential equations are then used to establish the direction of Hopf bifurcation and the stability of the per

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Publication Date
Mon Jan 15 2018
Journal Name
International Journal Of Science And Research (ijsr)
Production a Digital Map with the Aid of Total Station and (GIS)
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Geographic information system (GIS) is utilized in a variety of tasks such as, resource management, urban planning, emergency planning in case of accident, and rapid response etc. The aim of this study is to produce a digital map with the aid of GIS and a survey data. A survey data is conducted with Total Station technique on sanitary planning positions. The campus of Baghdad University is chosen to test the execution and accuracy of the results for sewer manholes locations. During the field survey, Total Station (Nikon Nivo) is used to identify the 3-D coordinates for each location. Finally, Geographical Information System (GIS) are utilized to present the digital map of the network sewer pipe line to the end users. Although Geographic Inf

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Angiolymphoid Hyperplasia with Eosinophilia : a Case Report and Review of the Literature
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A case of angiolymphoid hyperplasia with eosinophilia (ALH) is reported in a 42-year-old woman who developed multiple nodules behind the ear. Angiolymphoid hyperplasia with eosinophilia usually occurs on the head and neck of young adults and is more common in women than in men. Characteristic histologic features of ALH present in this case included proliferation of thick-walled blood vessels lined by prominent endothelial cells, infiltration of the interstitium by chronic inflammatory cells (mainly eosinophils), and presence of lymphoid follicles with germinal centers. The patient referred for surgeon for complete excision. in this context , cases previously described in the literature, and the differential diagnosis of ALH are discussed

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