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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 Jun 11 2021
Journal Name
Egyptian Journal Of Chemistry
Visfatin as a biomarker of obesity in iraqi adolescences with metabolic syndrome
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The present study aims to study the correlation between visfatin levels and metabolic syndrome in Iraqi obese adolescence (with and without metabolic syndrome) and its relation with other studied biochemical parameters. Sixty obese adolescences were depended in this study (with and without metabolic syndrome), compared with (30) non-obese children as control group. This study was done in the period from April 2020 until the end of December 2020, in the National Diabetes Centre/Mustansiriya University, Baghdad/Iraq. There were no significant differences in age, height, waist circumferences (WC), and diastolic blood pressure (DBP) in the patients' groups. In contrast, a significant increase differs (p<0.05) was recorded in the values of

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Publication Date
Sun Jun 01 2025
Journal Name
Al-khwarizmi Engineering Journal
Improving Barcode Vision Scanning Process using a Drone-based Tracking PID Controller for Warehouse in Industry 4.0
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Drones play a vital role in the fundamental aspects of Industry 4.0 by converting conventional warehouses into intelligent ones, particularly in the realm of barcode scanning. Various potential issues frequently arise during barcode scanning by drones, specifically when the drone camera has difficulty obtaining distinct images due to certain factors, such as distance, capturing the image whilst flying, noise in the environment and different barcode dimensions. In addressing these challenges, this study proposes an approach that combines a proportional–integral–derivative (PID) controller with image processing techniques. The PID controller is responsible for continuously monitoring the camera’s input, detecting the difference

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn: 1683 - 3597 , E-issn : 2521 - 3512)
Assessment of the Clinical Pharmacists' Role by Physicians at Baghdad Hospitals
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In Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals.  To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view. The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire  The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in Baghdad h

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessment of the Clinical Pharmacists' Role by Physicians at Baghdad Hospitals
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In Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals.

 To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view.

The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire 

The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in

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Publication Date
Wed Jun 11 2008
Journal Name
Journal Of Al-nahrain University
ANALYSIS OF A MOLECULAR DYNAMICS SIMULATION OF THE ACETYLCHOLINESTERASE ENZYME AND ITS COMPLEX WITH (AXILLARIDINE-A) INHIBITOR
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Molecular dynamics (MD) simulations were carried out in order to investigate the binding mode of axillaridine-A at the active site of human acetylcholinesterase (AChE) enzyme. 2.0 nanosecond of MD simulations was made for the protein and the complex to dynamically explore the active site and the behavior of the ligand at the peripheral AChE binding site. These calculations for the enzyme alone showed that the active site of AChE is located at the bottom of a deep and narrow cavity whose surface is lined with rings of aromatic residues and Tyr72 is almost perpendicular to the Trp286 ring and forms a stable - interaction. The size of the active site of the complex decreases with time due to increase the interaction. Axillaridine-A forms

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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
Fri Dec 01 2023
Journal Name
Case Studies In Chemical And Environmental Engineering
Removal of copper from a simulated wastewater by electromembrane extraction technique using a novel electrolytic cell provided with a flat polypropylene membrane infused with 1-octanol and DEHP as a carrier
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Publication Date
Fri Dec 01 2023
Journal Name
Case Studies In Chemical And Environmental Engineering
Removal of copper from a simulated wastewater by electromembrane extraction technique using a novel electrolytic cell provided with a flat polypropylene membrane infused with 1-octanol and DEHP as a carrier
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Publication Date
Wed Jul 24 2024
Journal Name
An International Journal Of Optimization And Control: Theories &amp; Applications (ijocta)
The effect of a psychological scare on the dynamics of the tumor-immune interaction with optimal control strategy
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Contracting cancer typically induces a state of terror among the individuals who are affected. Exploring how chemotherapy and anxiety work together to affect the speed at which cancer cells multiply and the immune system’s response model is necessary to come up with ways to stop the spread of cancer. This paper proposes a mathematical model to investigate the impact of psychological scare and chemotherapy on the interaction of cancer and immunity. The proposed model is accurately described. The focus of the model’s dynamic analysis is to identify the potential equilibrium locations. According to the analysis, it is possible to establish three equilibrium positions. The stability analysis reveals that all equilibrium points consi

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Publication Date
Tue Mar 12 2024
Journal Name
Semiconductor Physics, Quantum Electronics And Optoelectronics
Numerical study of single-layer and interlayer grating polarizers based on metasurface structures for quantum key distribution systems
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Polarization is an important property of light, which refers to the direction of electric field oscillations. Polarization modulation plays an essential role for polarization encoding quantum key distribution (QKD). Polarization is used to encode photons in the QKD systems. In this work, visible-range polarizers with optimal dimensions based on resonance grating waveguides have been numerically designed and investigated using the COMSOL Multiphysics Software. Two structures have been designed, namely a singlelayer metasurface grating (SLMG) polarizer and an interlayer metasurface grating (ILMG) polarizer. Both structures have demonstrated high extinction ratios, ~1.8·103 and 8.68·104 , and the bandwidths equal to 45 and 55 nm for th

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