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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 Jun 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Effect of Adding Alcohols and Gas Velocity on Gas Hold up and Mass Transfer Coefficient in Bubble Columns with Draught Tube
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     The bubble columns are widely used as a two or three phase reactor in industrial chemical process such as absorption, biochemical reactions, coal liquefaction, etc. To design such a column, two main parameters should be taken in consideration, the gas hold-up (), and the liquid phase mass transfer coefficient KLa. The study includes the effect of gas velocity and the addition of alcohols on gas hold-up and mass transfer coefficient in bubble column with draught tube when the length of the column is 1.5m and the ratio of the draught tube diameter to the column diameter equals 0.5 and the air dispersion into the base of the draught tube using a multi hole tuyere is equivalent to a diameter of 0.15 mm and

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Polymorphism study of MTHFR 677C?T and its correlation with oxidative stress and their influence on female infertility in Erbil – Iraq
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This research includes a study of Methylenetetrahydrofolate reductase gene’s allele 677C?T and its correlation with oxidative stress and their impact on female infertility. Fifty infertile women with the range age (23-42) years and twenty five fertile women with the range age (22-39) years as control group living in Erbil city were selected. The serum level of Malondialdehyde (MDA), superoxide dismutase (SOD), prolactin hormone (PRL), Luteinizing hormone (LH), Thyroid stimulating hormone (TSH), Triiodothyronine hormone (T3), and Thyroxine hormone (T4) were measured, also a body mass index (BMI) was calculated. A restriction enzyme (Hinf1) was used to improve the mutation in DNA bands of infertile women. The results showed significant inc

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Mediator Role of Workplace Spirituality in The Relationship Between Psychological Capital and Entrepreneurial Behavior: Field Research in the center of the Iraqi Ministry of Oil
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Abstract

      The research aims to identify the mediator role of  workplace spirituality in the  relationship between psychological capital and entrepreneurial  behavior: field research to a sample opinions from employees at the center of the Iraqi ministry of Oil . The importance of the current research emerged from paucity of studies that have attempted to identify and know the nature of the relationship between the variables as well as trying to find the current address and realistic problem directly affects the performance of employees in the Iraqi oil sector.

 In order to achieve the goal of research the use of the analytical method (quantitative)

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Engineering
Influence of Using Various Percentages of Slag on Mechanical Properties of Fly Ash-based Geopolymer Concrete
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In order to implement the concept of sustainability in the field of construction, it is necessary to find an alternative to the materials that cause pollution by manufacturing, the most important of which is cement. Because factory wastes provide siliceous and aluminous materials and contain calcium such as fly ash and slag that are used in the production of high-strength geopolymer concrete with specifications similar to ordinary concrete, it was necessary for developing this type of concrete that is helping to reduce CO2 (dioxide carbon) in the atmosphere. Therefore, the aim of this study was to study the influence of incorporating various percentages of slag as a replacement for fly ash and the effect of sl

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Publication Date
Wed Feb 01 2023
Journal Name
Heat Transfer
A tubular solar still integrated with a heat pipe
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Abstract<p>The aim of this work is to explore the thermal performance of a tracked tubular solar still (TSS) with a parabolic trough concentrator in Baghdad (33.27° N, 44.37° E) in September 2022. The present tubular still is distinguished by its hexagonal glass cover. The effect of integrating the TSS with a heat pipe, the still tilt angle (10°, 15°), and the depth of saline water inside the still partitions on the productivity of freshwater are investigated. The results showed that using heat pipe enhances the freshwater productivity by 25%–40% and the efficiency by 25%. For the still integrated with heat pipe, as the water depth is increased from 5.5 to 6.5 cm the productivity of freshwater is incre</p> ... Show More
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Publication Date
Tue Aug 15 2017
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
A Prototype and Roadmap for Transition to IPv6 with Performance Evaluation
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The migration from IPv4 to IPv6 can not be achieved in a brief period, thus both protocols co-exist at certain years. IETF Next Generation Transition Working Group (NGtrans) developed IPv4/IPv6 transition mechanisms. Since Iraq infrastructure, including universities, companies and institutions still use IPv4 protocol only. This research article tries to highlight, discuss a required transition roadmap and extend the local knowledge and practice on IPv6. Also, it introduces a prototype model using Packet tracer (network simulator) deployed for the design and implementation of IPv6 migration. Finally, it compares and evaluates the performance of IPv6, IPv4 and dual stack using OPNET based on QoS metrics such as throughput, delay and point to

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Publication Date
Sun Jan 01 2017
Journal Name
International Journal Of Mathematics In Operational Research
A single server fuzzy queues with priority and unequal service rates
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Publication Date
Mon Jul 07 2025
Journal Name
Oxidation Communication
ANAPLASTIC LYMPHOMA KINASE EXPRESSION AND OTHER MARKERS AS A PROGNOSTIC BIOMARKER IN FEMALE PATIENTS WITH BREAST CANCER
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Breast cancer is among the primary causes of death among Iraqi women and is a serious worldwide health concern. ALK or anaplastic lymphoma kinase, is connected to several cancers, including breast cancer.. The goal of this research was to assess the prevalence of anaplastic lymphoma kinase (ALK) with Alkaline phosphatise (ALP) and Lactate dehydrogenase (LDH) together as diagnostic markers. The study comprised 60 patients with metastatic breast cancer and 60 healthy volunteers. The blood levels of the enzymes (ALP), (LDH), and ALK in Iraqi breast cancer patients are compared to those of healthy controls. It was shown that compared to healthy people, patients had breast cancer noticeably greater levels of ALK, ALP, and NDH .These biomarkers m

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Global Trends In Pharmaceutical Sciences
A REVIEW: CEFPODOXIME PROXETIL (DOXEF. PROXETIL) DISCOVERY, PREPARATION, APPLICATIONS AND COMPARISON WITH CEFPODOXIME- CLAVULANIC ACID IN ACTIVITY
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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed rad

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