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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
Mon Apr 26 2021
Journal Name
Journal Of Electrical Engineering &amp; Technology
ANFIS Based Reinforcement Learning Strategy for Control A Nonlinear Coupled Tanks System
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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
A Modified Strength Pareto Evolutionary Algorithm 2 based Environmental /Economic Power Dispatch
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A Strength Pareto Evolutionary Algorithm 2 (SPEA 2) approach for solving the multi-objective Environmental / Economic Power Dispatch (EEPD) problem is presented in this paper. In the past fuel cost consumption minimization was the aim (a single objective function) of economic power dispatch problem. Since the clean air act amendments have been applied to reduce SO2 and NOX emissions from power plants, the utilities change their strategies in order to reduce pollution and atmospheric emission as well, adding emission minimization as other objective function made economic power dispatch (EPD) a multi-objective problem having conflicting objectives. SPEA2 is the improved version of SPEA with better fitness assignment, density estimation, an

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Publication Date
Sun Jul 01 2012
Journal Name
Applied Soft Computing
A new evolutionary based routing protocol for clustered heterogeneous wireless sensor networks
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Publication Date
Mon Aug 01 2022
Journal Name
مجلة الرافدين للعلوم الرياضية
Fartlek exercises and their effect on molecular biology (vascular endothelial growth factor-basic fibroblast growth factor) and some physical variables for players 800m arena and field for youth
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The study aimed to : - To determine whether there are significant differences between Fartlek training and the increase in the molecular biology (VEGF - basal fibroblast growth factor) for arena and field players in an (800m) youth event. - Determine whether there are statistically significant differences between Fartlek training and the increase in molecular biology and some physical variables for the players (800m) in the arena and field for youth. - Determine whether the Fartlek training method is the most appropriate to achieve statistically significant differences in the research variables for the players (800m) in the arena and field for youth. The researchers used the experimental method for its suitability and the nature of the rese

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Publication Date
Tue Oct 01 2019
Journal Name
Karbala Journal Of Physical Education Sciences
Effect of use a designed device to develop some biochemical variables for rear vault dismount with one-half twist on parallel bars in gymnastics
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The research included five sections containing the first section on the introduction o research and its importance and was addressed to the importance of the game of gymnastic and skilled parallel bars effectiveness and the importance of biochemical variables, either the research problem that there is a difference in learning this skill and difficulty in learning may be one of the most important reasons are falling and injury Has a negative impact on the performance and lack of sense of movement of is one of the obstacles in the completion of the skill and the goal of research to design a device that helps in the development of biochemical changes to skill of rear vault dismount with one-half twist on parallel bars in gymnastics . And the n

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Asphaltene Precipitation Investigation Using a Screening Techniques for Crude Oil Sample from the Nahr-Umr Formation/Halfaya Oil Field
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Many oil and gas processes, including oil recovery, oil transportation, and petroleum processing, are negatively impacted by the precipitation and deposition of asphaltene. Screening methods for determining the stability of asphaltenes in crude oil have been developed due to the high cost of remediating asphaltene deposition in crude oil production and processing. The colloidal instability index, the Asphaltene-resin ratio, the De Boer plot, and the modified colloidal instability index were used to predict the stability of asphaltene in crude oil in this study. The screening approaches were investigated in detail, as done for the experimental results obtained from them. The factors regulating the asphaltene precipitation are different fr

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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
Fri Jan 24 2020
Journal Name
Iraqi Journal Of Agricultural Sciences
RESPONSE OF ABELMOSCHUS ESCULENTUS L. FORINOCULATION WITH MYCORRHIZAE AND FOLAIR APPLICATION WITH BIO-STIMULATORS AND EFFECT ON VEGETATIVE GROWTH CHARACTERS
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The current study  was carried out at the Fields belongs of Horticulture  Department, Collage of Agricultural Engineering Science, University of  Baghdad, Al-Jadiriyah for the spring season 2016 -2017 to study the effect for  inoculation mycorrhizae and  folair application  with bio stimulators and their interaction in the growth characters of  (local okra  ptera). A factorial experiment  (2  in randomized complete block design (RCBD), the experiment included (12) treatment  Distributed  in three  replicates. The three factors used in this experiment included . The inoculation with control (C) Mycorrhizae  ( M ) , Biozyme  (B ) ( B1 2cm3.L-1), ( B2 4cm1-.L-1) , Phosphalas (P) (P 2cm3.L-1),  ( M + B1), ( M + B2), (P +

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Publication Date
Thu Oct 12 2023
Journal Name
Egyptian Journal Of Biological Pest Control
Evaluation of the effectiveness of some mycorrhizal fungi isolates against charcoal rot disease
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Abstract<sec> <title>Background

The sunflower plants are attacked by serious seed and soil-borne pathogens including charcoal rot disease that caused by Macrophomina phaseolina. This disease has serious damages to sunflower crop. This study aimed to assess the efficacy of Arbuscular mycorrhizal fungus against charcoal rot disease as fungicide alternative.

Results

Morphological and molecular identification was done, using universal primers for molecular identification. Finally, a greenhouse experiment was conducted, and

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Publication Date
Sat Dec 01 2018
Journal Name
Indian Journal Of Natural Sciences
Geology and Structure Analysis of Shaqlawa – Merawa Area, Northern Iraq Using Remote Sensing, GIS and Field Observations
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This study appears GIS techniqueand remote sensing data are matching with the field observation to identify the structural features such as fault segments in the urban area such as the Merawa and Shaqlawa Cities. The use of different types of data such as fault systems, drainage patterns (previously mapped), lineament, and lithological contacts with spatial resolution of 30m was combined through a process of integration and index overlay modeling technique for producing the susceptibility map of fault segments in the study area. GIS spatial overlay technique was used to determine the spatial relationships of all the criteria (factors) and subcriteria (classes) within layers (maps) to classify and map the potential ar

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