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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 Jan 09 2023
Journal Name
2023 15th International Conference On Developments In Esystems Engineering (dese)
Inverse Kinematics Optimization for Humanoid Robotic Legs Based on Particle Swarm Optimization
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Calculating the Inverse Kinematic (IK) equations is a complex problem due to the nonlinearity of these equations. Choosing the end effector orientation affects the reach of the target location. The Forward Kinematics (FK) of Humanoid Robotic Legs (HRL) is determined by using DenavitHartenberg (DH) method. The HRL has two legs with five Degrees of Freedom (DoF) each. The paper proposes using a Particle Swarm Optimization (PSO) algorithm to optimize the best orientation angle of the end effector of HRL. The selected orientation angle is used to solve the IK equations to reach the target location with minimum error. The performance of the proposed method is measured by six scenarios with different simulated positions of the legs. The proposed

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Publication Date
Mon Aug 31 2015
Journal Name
Journal Of Theoretical And Applied Information Technology
EXAM QUESTIONS CLASSIFICATION BASED ON BLOOM’S TAXONOMY COGNITIVE LEVEL USING CLASSIFIERS COMBINATION
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Publication Date
Fri Dec 01 2023
Journal Name
Al-khwarizmi Engineering Journal
PDF Comparison based on Various FSO Channel Models under Different Atmospheric Turbulence
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Recently, wireless communication environments with high speeds and low complexity have become increasingly essential. Free-space optics (FSO) has emerged as a promising solution for providing direct connections between devices in such high-spectrum wireless setups. However, FSO communications are susceptible to weather-induced signal fluctuations, leading to fading and signal weakness at the receiver. To mitigate the effects of these challenges, several mathematical models have been proposed to describe the transition from weak to strong atmospheric turbulence, including Rayleigh, lognormal, Málaga, Nakagami-m, K-distribution, Weibull, Negative-Exponential, Inverse-Gaussian, G-G, and Fisher-Snedecor F distributions. This paper extensive

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
Photonic Crystal Fiber Pollution Sensor Based on the Surface Plasmon Resonance Technology
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Photonic Crystal Fiber (PCF) based on the Surface Plasmon Resonance (SPR) effect has been proposed to detect polluted water samples. The sensing characteristics are illustrated using the finite element method. The right hole of the right side of PCF core has been coated with chemically stable gold material to achieve the practical sensing approach. The performance parameter of the proposed sensor is investigated in terms of wavelength sensitivity, amplitude sensitivity, sensor resolution, and linearity of the resonant wavelength with the variation of refractive index of analyte. In the sensing range of 1.33 to 1.3624, maximum sensitivities of 1360.2 nm ∕ RIU and 184 RIU−1 are achieved with the high sensor resolutions of 7

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Publication Date
Sun Dec 31 2023
Journal Name
Iraqi Geological Journal
Optimization of Horizontal Well Location and Completion to Improve Oil Recovery for an Iraqi Field
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Exploitation of mature oil fields around the world has forced researchers to develop new ways to optimize reservoir performance from such reservoirs. To achieve that, drilling horizontal wells is an effective method. The effectiveness of this kind of wells is to increase oil withdrawal. The objective of this study is to optimize the location, design, and completion of a new horizontal well as an oil producer to improve oil recovery in a real field located in Iraq. “A” is an oil and gas condensate field located in the Northeast of Iraq. From field production history, it is realized the difficulty to control gas and water production in this kind of complex carbonate reservoir with vertical producer wells. In this study, a horizont

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Publication Date
Fri Jul 03 2026
Journal Name
Iraqi Journal Of Applied Physics
Preparation and Characterization of Silicon Dioxide Nanostructures by DC Reactive Closed-Field Unbalanced Magnetron Sputtering
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Publication Date
Sat Apr 25 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
A Questionnaire-Based Survey Assessment of Iraqi Dentists Using Repair Versus Replacement of Defective Composite Restoration
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Tooth restoration one of the most common procedures in dental practice. The replacement of the entire restoration leads to loss of tooth structure and increase risk of pulp injury; replacement is also time consuming and costly. According to the minimally invasive approach when minimal defects, repair is the better choice than the total replacement of the restoration. This study aims to evaluate repair rating versus replacement treatment procedure for defective composite fillings among Iraqi dentists. Material and methodology: A questionnaire survey were designed and distributed to 184 post-graduate dentists in Iraq. The inquiry pertained general information; including their clinical experience in years, their preference in terms of direct c

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Publication Date
Fri Jul 03 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Salivary Leptin and Resistin Levels in Type Two Diabetic Patients with Chronic Periodontitis (A Comparative Study)
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Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in eac

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Publication Date
Wed Jan 01 2020
Journal Name
Plant Archives
A novel finding of il-9 genetic polymorphism (rs17317275) and serum level in rheumatoid arthritis patients infected with CMV
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RA is a complex chronic disease, primarily affects the lining of the synovial joints and can cause progressive disability, premature death, and socioeconomic burdens. The clinical manifestations of symmetrical joint involvement include arthralgia, swelling, redness, and even limiting the range of motion. The pathogenesis is not known therefore the study included Rheumatoid arthritis (RA) is one of systemic inflammatory diseases that characterized by a progressive disabling course. The study included patients suffering from RA and as healthy controls. immunological and genetic factor were evaluated in each subject by using serum level of cytokine and genetic factor. The etiopathology of the disease is not well known for this reason the study

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Publication Date
Sun Apr 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Irisin Level in Iraqi Patients with Type 2 Diabetes and Pre-Diabetes Status as a Predictive Factor
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      The prevalence of diabetes is increasing rapidly and is now recognized as a significant global health problem. Diabetes occurs when a person does not produce enough insulin due to an imbalance in insulin production. This can lead to the failure of organs and tissues such as the kidneys, heart, blood vessels, eyes, nerves, and kidneys. As a result, early diagnosis and classification of type 2 diabetes mellitus (T2DM) are critical to aiding physician assessments. Subsequently, the current study aims to determine irisin levels in patients with T2DM and pre-DM as early predictors for disease cases. The current study included 138 subjects divided into three groups based on fasting blood glucose (FBG) and glycosylated hemoglobi

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