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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
Sat May 24 2025
Journal Name
Iraqi Journal For Computer Science And Mathematics
Intrusion Detection System for IoT Based on Modified Random Forest Algorithm
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An intrusion detection system (IDS) is key to having a comprehensive cybersecurity solution against any attack, and artificial intelligence techniques have been combined with all the features of the IoT to improve security. In response to this, in this research, an IDS technique driven by a modified random forest algorithm has been formulated to improve the system for IoT. To this end, the target is made as one-hot encoding, bootstrapping with less redundancy, adding a hybrid features selection method into the random forest algorithm, and modifying the ranking stage in the random forest algorithm. Furthermore, three datasets have been used in this research, IoTID20, UNSW-NB15, and IoT-23. The results are compared with the three datasets men

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Publication Date
Wed Jul 12 2023
Journal Name
Energies
Finite Time Disturbance Observer Based on Air Conditioning System Control Scheme
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A novel robust finite time disturbance observer (RFTDO) based on an independent output-finite time composite control (FTCC) scheme is proposed for an air conditioning-system temperature and humidity regulation. The variable air volume (VAV) of the system is represented by two first-order mathematical models for the temperature and humidity dynamics. In the temperature loop dynamics, a RFTDO temperature (RFTDO-T) and an FTCC temperature (FTCC-T) are designed to estimate and reject the lumped disturbances of the temperature subsystem. In the humidity loop, a robust output of the FTCC humidity (FTCC-H) and RFTDO humidity (RFTDO-H) are also designed to estimate and reject the lumped disturbances of the humidity subsystem. Based on Lyapunov theo

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Publication Date
Wed Oct 14 2026
Journal Name
Iraqi Journal Of Biotechnology
STUDY ON TOTAL PEROXIDASE ENZYMES ACTIVITIES AND SOME TRACE ELEMENTS IN PATIENTS WITH BREAST TUMORS
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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
A Pragmatic Analysis of Illocutionary Act in a Selected Presidential Speech on COVID-19
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     This paper aims at studying the illocutionary speech acts: direct and indirect to show the most dominant ones in a presidential speech delivered by the USA president. The speech is about the most critical health issue in the world, COVID-19 outbreak.  A descriptive qualitative study was conducted by observing the first speech delivered by president Trump concerning coronavirus outbreak and surveying the illocutionary acts: directive, declarative, commissive, expressive, and representative. Searle's (1985) classification of illocutionary speech acts is adopted in the analysis.

     What are the main types of the illocutionary speech acts performed by Trump in his speech?; Why does

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Publication Date
Wed Oct 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of serum and salivary oxidant and total antioxidant status of patients with recurrent aphthous stomatitis in a sample of Basrah city
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Background: Recurrent Aphthous Stomatitis (RAS) is the most common painful oral mucosal disease, affecting approximately 20% of the population. RAS presents with a wide spectrum of severity ranging from a minor nuisance to complete debility. Many of factors thought to have been involved in its etiology; that might have at the same time a direct or indirect impact upon oxidant/antioxidant system and trigger free radicals production. The aim of this study was to determine the possible association of oxidant/total antioxidant status and recurrent aphthous stomatitis (RAS). Subjects, materials and methods: The study consisted of thirty patients with recurrent aphthous stomatitis and thirty healthy controls from which saliva and blood samples we

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the (PEOE) Model in Teaching Science to Develop the Skills of Generating and Evaluating Information and the Scientific Sense among Intermediate First Grade Students
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The research aimed mainly to discover the effectiveness of the (PEOE) model in teaching science to develop the skills of generating and evaluating information and the emotional side of the scientific sense of the intermediate first grade students. An experimental approach with a quasi-experimental design called pre-test and post-test control design was used. The research sample consisted of (60) students, who were selected in a random cluster method, (30) students in the experimental group studied the unit "The Nature of Material" using the (PEOE) model, and (30) students in the control group studied according to the prevailing method of teaching. The research materials and tools were represented in: a teacher's guide for teaching the un

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Publication Date
Sun Oct 01 2017
Journal Name
Ieee Transactions On Neural Systems And Rehabilitation Engineering
A Framework of Temporal-Spatial Descriptors-Based Feature Extraction for Improved Myoelectric Pattern Recognition
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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Mothers Knowledge and Practices with Hemophilic Children type A at Azadi Teaching Hospital in Kirkuk City
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Objective: The study aims to assess the knowledge and practices of mothers with hemophilia children type - A - ,
socio-economic status and association between mother demographic information with their knowledge and practices
toward their children in Azadi Teaching Hospital in Kirkuk.
Methodology: Descriptive study no probability (purposive) sample. Selected Fifty-five of mothers having hemophilia
children, started from November 2012 to May 2013. Study was carried out in the Azadi teaching hospital in
Kirkuk. By using questionnaire which consists from five parts include demographic characteristics for mother and
children, socio-economic, Knowledge and practices data gathered, by direct interview with the mothers in the

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of Mixed Convection in an Enclosure with a Cold Movable Top Wall and Hot Bottom Wall
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Mixed convection heat transfer to air inside an enclosure is investigated experimentally. The bottom wall of the enclosure is maintained at higher temperature than that of the top wall which keeps in oscillation motion, whereas the left and right walls are well insulated. The differential temperature of the bottom and top walls changed several times in order to accurately characterize the temperature distribution over a considerable range of Richardson number. Adjustable aspect ratio box was built as a test rig to determine the effects of Richardson number and aspect ratio on the flow behavior of the air inside the enclosure. The flow fields and the average Nusselt number profiles were presented in this wo

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Comparative study of anterior knee pain after patelloplasty with and without circumferential denervation in a total knee arthroplasty
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Background: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery.

Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient.

Type of the study:Cross- sectional study.

Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this pros

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