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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 Nov 01 2022
Journal Name
Standards
Observation of a Signal Suppressing Effect in a Binary Mixture of Glycol-Water Contamination in Engine Oil with Fourier-Transform Infrared Spectroscopy
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An in-depth experimental study of the matrix effect of antifreeze (ethylene glycol) and water contamination of engine oil through FT-IR spectroscopy. With a comparison of the percent by volume concentration of contaminated fresh 15W-40 engine oil, there appeared to be a noticeable reduction in the O–H stretching signal in the infrared spectrum when ethylene glycol based antifreeze was included as a contaminant. The contaminants of distilled water, a 50/50 mixture of water and commercial ethylene glycol antifreeze, and straight ethylene glycol antifreeze were compared and a signal reduction in the O–H stretch was clearly evident when glycol was present. Doubling the volume of the 50/50 mixture as compared to water alone still res

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Publication Date
Sun Dec 29 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECT OF DIFF. SUBS. AND SPRAYING WITH K2SIO3 ON THE ROOT AND VEGETATIVE GROWTH OF L. W. PLANTS IN BAGHDAD CITY
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This study was aimed to investigate the response of two types of ornamental herbaceous plants (Wedelia trilobata and Jacobaea maritima 'Cirrus') to different agricultural environments and the application of potassium silicates to the living walls system LWS (Felt layer system) under the climate conditions of Baghdad city. Each experiment involved the cultivation of a different plant species, and the study duration was from September 15, 2021, to August 1, 2022. A Strip-Plot Design experiment was conducted using two factors: factor M with four levels of substrates (50% peatmoss and perlite (M1), 50% Vermicompost and perlite (M2), 50% Water hyacinth compost and perlite (M3), 50% wheat straw compost and perlite (M4)) and factor S with

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Publication Date
Mon Jul 24 2023
Journal Name
Research Journal Of Pharmacy And Technology
Comparison of the effects of Methotrexate and Etanercept on RANKL and OPG as Bone Metabolism Biomarkers in patients with Rheumatoid Arthritis
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Rheumatoid arthritis is an autoimmune diseasecharacterized by chronic inflammationthat affects joints and cartilage. Bone complications such asRA-relatedosteoporosis are one of the most extra-articular manifestations. Many inflammatory mediators are released during RA disease pathophysiology; these mediators stimulate osteoclast genesis of bone by direct effects on RANKL and OPG. The study aimedto measure RANKL, OPG in RA patients treated with Etanercept only and other groups treated with Methotrexate onlyat baseline and after three months to evaluate bone state. An observational case-control prospective study was done on 30 RA patients who received MTX, 30 RA patients who received ETN, and 30 healthy,age-matched control groups. The

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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
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Bayesian and non-Bayesian estimation of the lomax model based on upper record values under weighted LINEX loss function
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In this article, we developed a new loss function, as the simplification of linear exponential loss function (LINEX) by weighting LINEX function. We derive a scale parameter, reliability and the hazard functions in accordance with upper record values of the Lomax distribution (LD). To study a small sample behavior performance of the proposed loss function using a Monte Carlo simulation, we make a comparison among maximum likelihood estimator, Bayesian estimator by means of LINEX loss function and Bayesian estimator using square error loss (SE) function. The consequences have shown that a modified method is the finest for valuing a scale parameter, reliability and hazard functions.

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effect of Educational Program Based on the (Guttmann) Model for Developing Awareness and Emotional Experience among University Students
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Abstract

The aim of the research is to identify the level of awareness and emotional experience among university students and to identify the effect of the educational program based on (Guttmann) model for developing awareness and emotional experience among university students by verifying the validity of the following zero hypotheses: 1) There are no statistically significant differences in the development of awareness and emotional experience among university students at the level of (0.05) between the mean scores of the experimental group in the pre and post-tests. 2) There are no statistically significant differences in the development of awareness and emotional experience among university students at the lev

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Publication Date
Wed Jan 01 2025
Journal Name
Journal Of Nanostructures
The Effects of Different Camphorquinone Concentrations on the Water Sorption and Solubility of an Experimental Green-Based Flowable Resin Composite
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Water sorption (WS) and solubility (S) of the experimental flowable composites (EFCs), made from silica filler of rice husk are important to explore the reaction of EFCs against different oral environments. To investigate the effects of different camphorquinone concentrations on the WS and S of the EFCs. EFCs were fabricated from nanohybrid silica and involved different weights of camphorquinone (CQ) (0.03 g, 0.05 g and 0.075 g) and other materials. 3 groups of 7 disk-like samples of each of the three EFCs and Revolution Formula 2 (RF2) were tested. Before immersion, the volumes were recorded and the mass of each sample was recorded, as m1. During the immersion phase in three different media for 7 days, the weight was recorded as m2. During

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Publication Date
Wed Oct 25 2023
Journal Name
College Of Islamic Sciences
The effect of fainting on a person’s behavior in (worship)
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The Messengers and the Imam of the God-fearing, Muhammad is God, his family, and all of his companions. As for what comes after... Fainting is one of the involuntary symptoms and states that occur to a person when carrying out his life’s tasks suddenly due to his loss of sense and movement, so he loses consciousness for a period of time that is short or may be long, and the person is held accountable and responsible for every moment of his life. He is required to perform duties specified by Sharia law, such as prayer, fasting, and Hajj...and fainting prevents him from performing these actions. We must consider the opinions of jurists and know the legal implications resulting from it. It was said that a person has a capacity that enable

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Publication Date
Wed Nov 28 2018
Journal Name
International Journal Of Engineering &amp; Technology
Modified Strut Effectiveness Factor for FRP-Reinforced Concrete Deep Beams
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A few examinations have endeavored to assess a definitive shear quality of a fiber fortified polymer (FRP)- strengthened solid shallow shafts. Be that as it may, need data announced for examining the solid profound pillars strengthened with FRP bars. The majority of these investigations don't think about the blend of the rigidity of both FRP support and cement. This examination builds up a basic swagger adequacy factor model to evaluate the referenced issue. Two sorts of disappointment modes; concrete part and pulverizing disappointment modes were examined. Protection from corner to corner part is chiefly given by the longitudinal FRP support, steel shear fortification, and cement rigidity. The proposed model has been confirmed util

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Publication Date
Thu Sep 10 2026
Journal Name
Journal Of The Turkish Chemical Society Section A: Chemistry
Synthesis, Antibacterial, Antioxidant, and In Silico Evaluation of New Sulfamethoxazole-Based Schiff Base and Azo Derivatives
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This research involved the preparation of a new Schiff base derivative (1) and azo derivatives (2–7) based on sulfamethoxazole through the coupling reaction of diazonium salt with various phenols. The yields were very high, ranging from 81% to 91%. The synthesis of these compounds was characterized using various techniques such as FT-IR, 1H-NMR and 13C-NMR. The antioxidant activity of these com-pounds was investigated utilizing the DPPH radical scavenging assay. The findings indicated that all compounds possessed antioxidant activity that increased proportionally with increasing concentration, particularly compounds 6 and 7, possibly due to the presence of hydroxyl groups in their structures. The biological activity

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