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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
Tue Feb 01 2022
Journal Name
Baghdad Science Journal
Association of Endothelin-I and A symmetric Dimethylarginine Levels with Insulin Resistance in Type-2 Diabetes Mellitus Patients
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Endothelin-I (ET-I) is one of the potent vasoconstrictors secreted from endothelial cells when needed. Many studies revealed the elevation of serum ET-I with human diabetes and microangiopathies. Since insulin resistance is a case of mixed diabetic and pre-diabetic cases, many risk factors beyond obesity and inflammation are proposed. The current study aims to demonstrate the association between serum ET-I and asymmetric dimethylarginine (ADMA) and insulin resistance in type 2 diabetes mellitus (T2DM). Sera of 73 subjects were enrolled currently (control= 35 subjects, and 38 with T2DM for more than 7 years), aged (40-60) years old, with distinct body mass index (BMI) ≤ 25 for control volunteers and (BMI) ≥ 25 for obesity and diabetes

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Publication Date
Thu Sep 29 2022
Journal Name
World Journal Of Clinical Infectious Diseases
Five-year retrospective hospital-based study on epidemiological data regarding human leishmaniasis in West Kordofan state, Sudan
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Publication Date
Mon Apr 27 2026
Journal Name
Applied Fruit Science
Predicting Bitter Orange (Citrus aurantium L.) Maturity by Machine Learning Based on Picking Force in Smart Picker
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Manual fruit picking is labor-intensive and can damage fruit. Fully mechanized picking is efficient, but it also risks fruit damage. Therefore, semi-automated tools are needed to improve bitter orange picking. This paper presents a smart manual picker designed to facilitate picking while predicting fruit maturity based on picking force as well as various chemical and physical parameters using machine learning (ML). The study methodology consists of five stages: (1) manufacturing the smart picker, (2) picking 50 bitter orange samples, (3) measuring the characteristics of the bitter oranges in the laboratory, (4) training different ML models, and (5) identifying the most accurate model for predicting fruit maturity. The results indicate that

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Publication Date
Sun Dec 01 2024
Journal Name
Journal Of Industrial And Engineering Chemistry
Highly efficient oil-in-water emulsion separation based on innovative stannic oxide/polyvinylchloride (SnO2/PVC) microfiltration membranes
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Publication Date
Mon Nov 01 2021
Journal Name
Integration
Power density aware application mapping in mesh-based network-on-chip architecture: An evolutionary multi-objective approach
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Publication Date
Mon Apr 29 2024
Journal Name
Journal Of The College Of Basic Education
Detection Of Biofilm Formation By Beta- Lactam Resistance Klebsiella Pneumoniae Isolated From Clinical Specimens And Aquatic Samples
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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
Antibiotic Resistance of Staphylococcus Sp. Isolated from Air, Surface, Food and Clinical samples Collected from Baghdad Hospital
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Staphylococcus Sp.is the most common type of bacteria found in contamination place, we design this
study to compare the contamination accident between two hospitals in Baghdad.One of them isthe Burns
Specialist Hospital in the Medical CityinRusafa and another one is Al-Karama Hospital in Karkh. The
samples were collected fromOperativeWard No1 (OW1), Operative Ward No2 (OW2), Consulting Pharmacy
(CP), Emergency Room (ER), Reception Room (RR), Women's Ward (WW) and Men's Ward (MW).The
samples were taken from inside each clinical unit, surfaces, food, and air. The results showed that the
number of samples containing Staphylococcus sp. bacteria is 81, including 45 belonging to Al-Karama Burns
Ward Ho

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Publication Date
Tue Feb 02 2016
Journal Name
International Journal Of Modern Physics B
Preparation of iron oxide nanoparticles by laser ablation in DMF under effect of external magnetic field
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We have studied the effect of applying an external magnetic field on the characteristics of iron oxide (IO) nanoparticles (NPs) synthesized by pulsed laser ablation in dimethylformamide (DMF). The NPs synthesized with and without applying of magnetic field were characterized by Fourier transformation infrared spectroscopy (FT-IR), UV–Vis absorption, scanning electron microscope (SEM), atomic force microscope (AFM), and X-ray diffraction (XRD). SEM results confirmed that the particle size was decreased after applying magnetic field.

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Publication Date
Thu Mar 31 2022
Journal Name
Iraqi Geological Journal
Development of Artificial Intelligence Models for Estimating Rate of Penetration in East Baghdad Field, Middle Iraq
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It is well known that the rate of penetration is a key function for drilling engineers since it is directly related to the final well cost, thus reducing the non-productive time is a target of interest for all oil companies by optimizing the drilling processes or drilling parameters. These drilling parameters include mechanical (RPM, WOB, flow rate, SPP, torque and hook load) and travel transit time. The big challenge prediction is the complex interconnection between the drilling parameters so artificial intelligence techniques have been conducted in this study to predict ROP using operational drilling parameters and formation characteristics. In the current study, three AI techniques have been used which are neural network, fuzzy i

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Publication Date
Thu Jan 01 2026
Journal Name
Journal Of Engineering
The 2D Seismic Evaluation of Petrophysical Characters of Yamama Reservoir in Nasiriyah Oil Field, Southern Iraq
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Since seismic reflection data produce comprehensive subsurface images that reveal geological structures likely to contain minerals, oil, and gas, they are essential for resource exploitation. When paired with well logs, these data enable seismic and petrophysical assessments that lower drilling risks and boost efficiency. Wireline logs from five wells and seismic coverage of the Nasiriyah oil field (Dhi-Qar Governorate), processed with Schlumberger software, were used to characterize the Yamama reservoir. Synthetic seismograms connected reservoir tops to seismic data; however, resistivity and gamma logs helped with correlation and sequence delineation. Wells' correlation described the migration routes of hydrocarbons and reservoir c

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