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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
Thu Jan 30 2020
Journal Name
Journal Of Engineering
  Positional Accuracy Assessment for Updating Authoritative Geospatial Datasets Based on Open Source Data and Remotely Sensed Images
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OpenStreetMap (OSM) represents the most common example of online volunteered mapping applications. Most of these platforms are open source spatial data collected by non-experts volunteers using different data collection methods. OSM project aims to provide a free digital map for all the world. The heterogeneity in data collection methods made OSM project databases accuracy is unreliable and must be dealt with caution for any engineering application. This study aims to assess the horizontal positional accuracy of three spatial data sources are OSM road network database, high-resolution Satellite Image (SI), and high-resolution Aerial Photo (AP) of Baghdad city with respect to an analogue formal road network dataset obtain

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Publication Date
Wed Mar 01 2023
Journal Name
Iaes International Journal Of Artificial Intelligence (ij-ai)
Design and implementation monitoring robotic system based on you only look once model using deep learning technique
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<span lang="EN-US">The need for robotics systems has become an urgent necessity in various fields, especially in video surveillance and live broadcasting systems. The main goal of this work is to design and implement a rover robotic monitoring system based on raspberry pi 4 model B to control this overall system and display a live video by using a webcam (USB camera) as well as using you only look once algorithm-version five (YOLOv5) to detect, recognize and display objects in real-time. This deep learning algorithm is highly accurate and fast and is implemented by Python, OpenCV, PyTorch codes and the Context Object Detection Task (COCO) 2020 dataset. This robot can move in all directions and in different places especially in

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Publication Date
Wed Jun 14 2023
Journal Name
Al-academy
The effectiveness of the harvesting strategy in the collection of environmental art by the Institute of Fine Arts students
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 The current research aims to: (know the effectiveness of the harvesting strategy in the achievement of the students of the Institute of Fine Arts in environmental art.
- In order to know this effectiveness, the researcher put a main zero hypothesis and derived six sub-hypotheses from it. the usual way; As the research community reached (120) male and female students of the Fine Arts Institutes for the morning study in Baghdad. As for the research sample, it was chosen by the simple random method, and the number was (75) male and female students for the year 2021-2022 AD. The researcher applied a pre-knowledge test for the four groups of research to find out the level of previous experiences of students in the subject of environmen

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Engineering
Effectiveness of Nanomaterial in the Roof of the Building to Achieve Energy Conservation for Indoor Environment of the Building
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The construction sector consumes large amounts of energy during the lifetime of a building. This consumption starts with manufacturing and transferring building materials to the sites and demolishing this building after a long time of occupying it. The topic of energy conservation and finding the solution inside the building spaces become an important and urgent necessity. It is known that the roof is exposed to a high amount of thermal loads compared to other elements in a building envelope, so this needs some solutions and treatments to control the flow of the heat through them. These solutions and treatments may be achieved by using nanomaterials. Recently, nanomaterials have high properties, so that this made them go

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Publication Date
Sat Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Anti-Inflammatory Activity of Gingko Biloba Extract in Cotton Pellet-Induced Granuloma in Rats: A comparative Study with Prednisolone and Dexamethasone
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The current study was designed to evaluate the anti-inflammatory effect of GKB in the rat model of granulomatous inflammation. Thirty rats were distributed into five groups:  The first group served as negative control group that received distilled water (DW) only without inducting inflammation, positive control group; treated with DW with the induction of inflammation and they were assigned to cotton pellet-induced granuloma, ginkgo biloba (GKB) treated group (200mg/kg/day), dexamethasone-treated group (1mg/kg), and Prednisolone treated group (5mg/kg). All the treatments were given orally for seven consecutive days.  On day eight, the rats were anesthetized and the pellets together with granulation tissue were carefully removed

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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 Oct 28 2024
Journal Name
Anggaran : Jurnal Publikasi Ekonomi Dan Akuntansi
The Role Of Emotional Intelligence in The Board Of Directors and Its Impact On The Performance and Value Of Institutions and Conservative Practices In Light Of Crises (Applied Research On a Sample Of Banks Listed On ISX)
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This research aims to underscore the significance of women's emotional intelligence in enhancing the effectiveness of the Board of Directors, a crucial component of internal governance, particularly during crises. Despite strides made in recent decades in appointing women to senior roles in government, business, and education, challenges persist in improving women's leadership opportunities, especially in developing countries. The study utilizes statistical methods, including Pearson's correlation, to analyze the relationships between variables within a sample of banks listed on the Iraqi securities market, comparing periods before and during the COVID-19 pandemic (2019 and 2020). The goal is to measure the impact of female emotiona

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Publication Date
Sat May 08 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
Sequencing of IL-10 Gene Promoter for -592 (A/C) and -1082 (A/G) Positions in Iraqi Children Patients with Type 1 Diabetes Mellitus
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We studied the relationship between DNA sequencing of interleukin-10 (IL-10) gene promoter for -1082 (A/G) and -592 (A/C) positions with the concentration of IL-10 in blood serum of Iraqi children with type 1 diabetes mellitus (T1D). Fifty blood serum samples collected from children with age ranged between 7-12 years. Thirty-five blood samples collected from patient children with T1D, and compared with 15 healthy children age matched as control sample. The results revealed decreasing in anti-inflammatory IL-10 concentration in T1D patient’s blood serum (0.068 Pg/ml) as compared with the control sample (0.111 Pg/ml). No significant differences were found in interleukin concentration between the studied samples when they analyzed with the M

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Publication Date
Thu Aug 10 2023
Journal Name
Migration Letters
The Effectiveness of E-Training in Developing the Skills of Designing E-Courses for Teachers of Arabic in the Colleges of Education in Iraq
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This study aimed to examine the effects of electronic training to improve the skills of designing electronic courses for teachers of Arabic language in the colleges of education in Iraq. The descriptive approach is applied and the sample included 145 teachers of Arabic who were selected randomly from the colleges of education in Iraq. Moreover, the results reflected that e-training is effective in improving the skills related to designing online educational courses for teachers of Arabic in the colleges of education in Iraq. Besides, there was no difference between the mean of the respondents' responses to the total score of the tool on the role of electronic training to develop the skills related to electronic courses designing for teacher

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Al-rafidain University College For Sciences ( Print Issn: 1681-6870 ,online Issn: 2790-2293 )
The Use of Logistic Regression Model in Estimating the Probability of Being Affected By Breast Cancer Based On the Levels of Interleukins and Cancer Marker CA15-3
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Breast cancer has got much attention in the recent years as it is a one of the complex diseases that can threaten people lives. It can be determined from the levels of secreted proteins in the blood. In this project, we developed a method of finding a threshold to classify the probability of being affected by it in a population based on the levels of the related proteins in relatively small case-control samples. We applied our method to simulated and real data. The results showed that the method we used was accurate in estimating the probability of being diseased in both simulation and real data. Moreover, we were able to calculate the sensitivity and specificity under the null hypothesis of our research question of being diseased o

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