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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 2018
Journal Name
Journal Of Engineering
Knowledge-Based Urban Development The Impact of Knowledge- Based Urban Development in the Growth of Contemporary Cities
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Urban Development refers to many topics such as: increased population density, city size, and individual’s production, distribution of technology and the growth of commercial, industrial and service professions. Such development is linked to the coordination of social and cultural trends in order to achieve social progress and economical prosperity. Knowledge as a topic now is known as intellectual capital wich led to upgrae the concept of urban development to be extended into many fields of knowledge, for example, cultural, social and human development to move the level of community culture into a new better standard.

The research adopted the urban transformation based on knowledge as an important factor in gr

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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
Fri May 15 2015
Journal Name
Euphrates Journal Of Agricultural Science
Performance Evaluation of field and genetic for genotype selection from Tomato Lycopersicon esculeuntum Mill.
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The study was conducted at the fields of the Department of Horticulture and Landscape Gardening,College of Agriculture, University of Baghdad during the growing seasons of 2013- 2014 .forPerformance of Evaluation Vegetative growth and yield traits and estimate some important geneticparameter on seven selected breed of tomato which (S1-S7 ) Pure line. the results found significantdifferences between breeds in all study trails except clusters flowering number .S1 significantly plantlength which reached 227.3 .Also S1,S2 and S4 were significantly increased the number fruit for plant,Fruit weight Increased in S3 ,S6 and plant yield. Increased in S1, S4 ,S5. Genetic variation valueswere low in Floral clusters , TSS and fruit firmest and medium i

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Publication Date
Thu Jul 01 2021
Journal Name
Diyala Journal For Pure Science
Survey of Air Quality and Health Risk Assessment Around East Baghdad Oil Field, Iraq
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Air pollution evaluation of the operational processes in the East Baghdad oil field was carried out. The analysis was carried out by ICP-MS technique. Total Suspended Particles (TSP) air load was higher than Iraqi Standards and world international allowable limits of World Health Organization. The mean concentrations of gases carbon monoxide, carbon dioxide, sulfur dioxide, in the air were within national and world standards, while the mean concentration of nitrogen dioxide was higher than standard limits. The air of the study area is considered a good quality for CO, CO2 and NO2 with no health effect, while it is hazardous for TSP that have serious risk for people with respiratory disease. The mean concentrations of Cd, Cr, Cu and

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Publication Date
Wed Jan 11 2023
Journal Name
Healthcare
Short-Term (4 Day) Effects of Oral Rinsing with Miswak and Green Tea on Gingival Crevicular Fluid Flow and IL-1β Levels: A Pilot Study
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Despite the antiplaque effect of mouth-rinsing with a combination composed of miswak (Salvadora persica L.) and green tea (Camellia sinensis var. assamica) extracts, no data are available regarding its effect on gingival tissue at the molecular level. This pilot study aimed to assess the effect of oral rinsing with this combination on gingival crevicular fluid (GCF) flow and IL-1β levels. Ten subjects rinsed with either the combination, 0.12% chlorhexidine gluconate (CHX) or distilled water without toothbrushing for 4 days after receiving baseline polishing. GCF IL-1β concentration, influx, resting volume and plaque quantity were measured at baseline and after 4 days for each intervention. No significant differences in GCF flow or

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Publication Date
Sun Nov 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Development of an Optimized Botnet Detection Framework based on Filters of Features and Machine Learning Classifiers using CICIDS2017 Dataset
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Abstract<p>Botnet is a malicious activity that tries to disrupt traffic of service in a server or network and causes great harm to the network. In modern years, Botnets became one of the threads that constantly evolving. IDS (intrusion detection system) is one type of solutions used to detect anomalies of networks and played an increasing role in the computer security and information systems. It follows different events in computer to decide to occur an intrusion or not, and it used to build a strategic decision for security purposes. The current paper <italic>suggests</italic> a hybrid detection Botnet model using machine learning approach, performed and analyzed to detect Botnet atta</p> ... Show More
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Publication Date
Wed May 15 2024
Journal Name
Ieee Sensors Journal
Surface Crack Size Estimation Based on Quantification and Decoupling of Magnetic Flux Leakage (MFL) Signals of Circular Array Sensors
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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
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
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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