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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
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 Oct 13 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 May 18 2025
Journal Name
Discover Food
Analysis of the effectiveness of natural treatments for preserving apricots and the YOLOv7 application for early damage detection
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Maintaining the quality of apricot fruits during storage is not an easy task due to the changes in their physical and chemical properties, so it is necessary to use less expensive, easy to apply, environmentally friendly, and safer preservatives to maintain the nutritional value of apricot. The damage to some fruits during storage can be a source of infection, which leads to the damage of healthy fruits more quickly, which requires building an intelligent model to detect damaged fruits. The aim of the research is to study the effect of immersing apricots in lemon juice once and sugar-water solution again on the quality properties of apricots, including sweetness, color, hardness, and water content. On the other hand, the YOLOv7 algorithm wa

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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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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
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Calibrating the Reservoir Model of the Garraf Oil Field
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   History matching is a significant stage in reservoir modeling for evaluating past reservoir performance and predicting future behavior. This paper is primarily focused on the calibration of the dynamic reservoir model for the Meshrif formation, which is the main reservoir in the Garraf oilfield. A full-field reservoir model with 110 producing wells is constructed using a comprehensive dataset that includes geological, pressure-volume-temperature (PVT), and rock property information. The resulting 3D geologic model provides detailed information on water saturation, permeability, porosity, and net thickness to gross thickness for each grid cell, and forms the basis for constructing the dynamic reservoir model. The dynamic reservoir mo

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Publication Date
Mon Dec 13 2021
Journal Name
International Journal Of Reproductive Biomedicine (ijrm)
Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study
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Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and thi

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Application Effect of the Conflict Management Strategies On Increasing Workers Productivity at the Electricity Company (IGEC) (Field Study Irbid Governorate)
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Research aimed to explore the Application Effect of the Conflict Management Strategies by the managements to solve conflict between and inside the conflicted parties within (IGEC) to increase the productivity of the workers. To collect data, 110 questioners had been distributed among managers and heads of departments of all managerial levels, 102 answered questioners regained, 5 of them were disqualify for statistical analytic, only 97 were taking in consideration   for statistical analysis presenting 93% of the retained number.

SPSS Program supported with a group of statistical tools, had been used for analysis purposes such as Kronbach Alpha test to assure the validity & stability of the t

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Publication Date
Sat Jun 26 2021
Journal Name
Journal Of The College Of Education For Women
The Geographical Analysis of Health's Field for Families in Al-Adhamiyah and Rusafa Districts in 2016: سمر حسين عكله, و صلاح محسن جاسم
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This research aims to analyze the indicators of spatial variation in the guide of health field in both Al-Adhamiyah and Rusafa districts according to the environmental and administrative units in 2016. The analysis was done by groups of health guide indicators. The objectives of the study were to identify the spatial variation of health services and assess the health situation for families following the environmental and administrative units of the studied area. Such objectives can be done by specifying the extent of the families’ consent to the type of services, measuring the cases of deprivation, and identifying the most deprived areas. The study has finally concluded that there is a clear spatial variation between the indicators and

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