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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 Jul 01 2018
Journal Name
Materials Letters
Temperature stable electric field-induced strain in Er-doped BNT-BT-BKT ceramics
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Publication Date
Sun Aug 31 2025
Journal Name
The Iraqi Geological Journal
Late Campanian-Maastrichtian Planktonic Foraminiferal Biostratigraphy in Ain Zalah Oil Field, Northwestern Iraq
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An analysis of three selected wells in the Ain Zala oil field (AZ-16, AZ-17, and AZ-24) in the northwestern part of Mosul Governorate. In terms of biostratigraphy, it consists of planktonic and suspended foraminifera, which comprise 37 species belonging to 17 genera. Based on the recorded planktonic foraminifera, three main biozones were identified: Globotruncana aegyptiaca Partial Zone, which refers to the age of the Late Campanian, Gansserina gansseri Partial Range Zone, which indicates the age of the Early Maastrichtian, and Abathomphalus mayaroensis Interval Zone, which indicates the age of the Late Maastrichtian. The Abathomphalus mayaroensis Interval Zone is divided into four subzones: Racemiguembelina fructicosa Partial Range

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Publication Date
Sat Sep 03 2022
Journal Name
International Journal Of Health Sciences
3D geological modeling for Yamama reservoir in Al-Nasiriyah oil field Southern Iraq
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The geological modeling of an oil-bearing reservoir, which specifies the lithology and analyzes the petrophysical parameters of complex reservoir, its being created using Petrel software to construct reservoir models that describe and estimate porosity and water saturation distributions. 3D modeling of carbonate reservoirs has proven to be a highly effective technique for evaluate the economic benefit of the reservoir by estimating the formation petrophysical properties and calculating the oil reserves. The study aims constructed on evaluated Yamama formation in Four drilling wells (Nasiriyah-1, Nasiriyah-3, Nasiriyah-4, and Nasiriyah-5) entering the Yamama Formation of the Al-Nasiriyah field. In Al-Nasiriyah Oil field, and within t

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Wormholes Models for the Optimum Matrix Acidizing in Mi4 Unit-Ahdeb Oil Field
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Innovative laboratory research and fluid breakthroughs have improved carbonate matrix stimulation technology in the recent decade. Since oil and gas wells are stimulated often to increase output and maximum recovery, this has resulted in matrix acidizing is a less costly alternative to hydraulic fracturing; therefore, it is widely employed because of its low cost and the fact that it may restore damaged wells to their previous productivity and give extra production capacity. Limestone acidizing in the Mishrif reservoir has never been investigated; hence research revealed fresh insights into this process. Many reports have stated that the Ahdeb oil field's Mishrif reservoir has been unable to be stimulated due to high inj

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using the Google Classroom Educational Platform in Teaching Mathematics Curricula from the Teachers' Point of View
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The study aims to find out the effectiveness of using the Google classroom educational platform in teaching mathematics curricula from the viewpoint of teachers in the Governorate of Al Dhahirah, Sultanate of Oman. The researcher adopted the descriptive-analytical approach. To collect the needed data, a questionnaire of two dimensions was used. It includes (13) items to measure the effectiveness of using the Google classroom in teaching mathematics curricula from the teacher's point of view and includes (10) items to measure the difficulties of using the Google classroom in teaching mathematics curricula from the teachers' point of view. These tools were applied to (32) male and (31) female as the study sample. They represent mathematics

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Engineering
Mixed Convection in a Square Cavity Filled with Porous Medium with Bottom Wall Periodic Boundary Condition
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Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure head , , , , and ), sinusoidal amplitude range of

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Mixed Convection in a Square Cavity Filled with Porous Medium with Bottom Wall Periodic Boundary Condition
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Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic  pressure sinusoidal  amplitude  range and

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Publication Date
Fri Jun 30 2023
Journal Name
College Of Islamic Sciences
Belief in the Last Day and its impact on building a Muslim's personality
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Research Summary

        The doctrine of belief in the Last Day is one of the pillars of faith, and the doctrine of resurrection and reckoning are part of this day.

 Belief in the Last Day puts a person in constant control over himself, as this control creates in this person happiness and a decent life, and he renounces the world and turns away from all vices and adorns all virtues.

        On the other hand, we find that the person who does not believe in this day does not stand before his eyes anything that prevents him from doing injustices and corruption in the land. The doctrine of belief in the Last Day alone is

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Publication Date
Sun Oct 01 2023
Journal Name
Fuel
Matrix acidizing in carbonate rocks and the impact on geomechanical properties: A review
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Acid treatment is a widely used stimulation technique in the petroleum industry. Matrix acidizing is regarded as an effective and efficient acidizing technique for carbonate formations that leads to increase the fracture propagation, repair formation damage, and increase the permeability of carbonate rocks. Generally, the injected acid dissolves into the rock minerals and generates wormholes that modify the rock structure and enhance hydrocarbon production. However, one of the key issues is the associated degradation in the mechanical properties of carbonate rocks caused by the generated wormholes, which may significantly reduce the elastic properties and hardness of rocks. There have been several experimental and simulation studies regardi

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Publication Date
Mon Dec 05 2022
Journal Name
Baghdad Science Journal
A Security and Privacy Aware Computing Approach on Data Sharing in Cloud Environment
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Today, the role of cloud computing in our day-to-day lives is very prominent. The cloud computing paradigm makes it possible to provide demand-based resources. Cloud computing has changed the way that organizations manage resources due to their robustness, low cost, and pervasive nature. Data security is usually realized using different methods such as encryption. However, the privacy of data is another important challenge that should be considered when transporting, storing, and analyzing data in the public cloud. In this paper, a new method is proposed to track malicious users who use their private key to decrypt data in a system, share it with others and cause system information leakage. Security policies are also considered to be int

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