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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
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Taxonomy of Memory Usage in Swarm Intelligence-Based Metaheuristics
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Metaheuristics under the swarm intelligence (SI) class have proven to be efficient and have become popular methods for solving different optimization problems. Based on the usage of memory, metaheuristics can be classified into algorithms with memory and without memory (memory-less). The absence of memory in some metaheuristics will lead to the loss of the information gained in previous iterations. The metaheuristics tend to divert from promising areas of solutions search spaces which will lead to non-optimal solutions. This paper aims to review memory usage and its effect on the performance of the main SI-based metaheuristics. Investigation has been performed on SI metaheuristics, memory usage and memory-less metaheuristics, memory char

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Publication Date
Sat Apr 30 2016
Journal Name
Environmental Science And Pollution Research
Risk-based prioritization of pharmaceuticals in the natural environment in Iraq
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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Women's Self-care Instructions concerning Wound, Perineal & Urinary System Care post cesarean section in Baghdad teaching hospital
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Aim: to determine the effectiveness of women's self-care instructions on their post cesarean section care in Baghdad
teaching hospital.
Methodology: The present study used quasi-experimental study design in maternity words in Baghdad teaching
hospital. The sample was collected and follow up for the period (15) January 2014 until 15 May 2014 Nonprobability
(purposive sample) of (100) women post cesarean section divided in to two groups (50) women post
cesarean section considered as a study group, and another (50) women post cesarean section considered as the
control one, A questionnaire designed as a tool to collect data fit the purpose of the study a questionnaire include
demographic variables, Reproductive variables

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of an Educational Unit According To the Constructive Strategy in Developing Thinking Skills for Fifth Primary Students
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    The current phase distinguish by the rapid scientific development, which pushes individuals to have the necessities of scientific and practical life through the proper scientific thinking which contribute to the development of invention and creativity away from memorizing and indoctrination and encouraging individuals to looking for information and then attempting to process and develop these information instead of being a passive receiver. The investment of minds becomes the logical investment in all societies by preparing the citizen to become able to face life changes and its necessities. It is very important to take care of individuals and develop their mental abilities and thinking skills. The constructive strateg

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
Evaluating the Effectiveness of Using the Kinesthetic Teaching Style by Basketball Instructors in Practical Lessons from the Students' Perspective
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Advancements and modernizations introduced into the educational and pedagogical systems have significantly impacted teaching processes and how subjects are presented and explained to students. The focus has shifted to how learners interact with the material they need to learn, providing sufficient opportunities for learning and granting them freedom and self-confidence to achieve learning objectives. The research problem stems from the researcher's experience as a lecturer in the College of Physical Education and Sports Science, particularly in teaching basketball. She observed that some instructors were deficient in using the most effective teaching methods. The researcher formulated her research question based on these observations: "What

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Publication Date
Sun Sep 15 2024
Journal Name
Iraqi Journal Of Pharmaceutical Sciences( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation and In vitro/Ex vivo Evaluation of Nanoemulsion-Based in Situ Gel for Intranasal Delivery of Lasmiditan
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Lasmiditan (LAS) was formulated as a nanoemulsion based in situ gel (NEIG)with the aim of improving its oral bioavailability via application intranasally. The solubility of LAS in oils, emulsifiers, and co-emulsifiers was determined to identify nanoemulsion (NE)components. Phase diagrams were constructed to identify the area of nanoemulsification. LAS NE was formulated using the spontaneous nanoemulsification method. Four NEs (F19, F24, F31, and F34) containing 7-15 % oleic acid (OA) as an oily phase, 40-55% labrasol (LR), and transcutol (TC) as emulsifier mixture at (1:1), (2:1), (3:1), and (1:2) ratio with 30-53 % (w/w) aqueous phase, having suitable optical transparency of 95–98%, globule size of 104-140 nm and polydisper

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Publication Date
Wed Nov 01 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Formulation and in vitro /in vivo Evaluation of Silymarin Solid Dispersion- Based Topical Gel for Wound Healing
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Silybum marianum, from which silymarin (SM) is extracted, is a medicinal herb. In the Biopharmaceutics Classification System, it is of the class II type, meaning it is almost completely insoluble in water. It has a number of therapeutic properties, including anti-inflammatory as well as properties that promote wound healing.

This research target is to promote the dissolution and solubility of SM by employing a technique called solid dispersion and then incorporating the formula of solid dispersion into a topical gel that can be used for wound healing.

 

Solid dispersion is a technique used to enhance solubility and dissolve pharmaceuticals that are not water-soluble. This method is widely used because of its low cos

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Pakistan Association Of Dermatologists
The role of epigenetics in immunosuppression in patients with infectious diseases as a fascinating applied observation
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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Enhancing Nitrate Ion Removal from Water using Fixed Bed Columns with Composite Chitosan-based Beads
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    Water contamination is a pressing global concern, especially regarding the presence of nitrate ions. This research focuses on addressing this issue by developing an effective adsorbent for removing nitrate ions from aqueous solutions. two adsorbents Chitosan-Zeolite-Zirconium (Cs-Ze-Zr composite beads and Chitosan-Bentonite-Zirconium Cs-Bn-Zr composite beads were prepared. The study involved continuous experimentation using a fixed bed column with varying bed heights (1.5 and 3 cm) and inlet flow rates (1 and 3 ml/min). The results showed that the breakthrough time increased with higher bed heights for both Cs-Ze-Zr and Cs-Bn-Zr composite beads. Conversely, an increase in flow rate led to a decrease in breakthrough time. Notab

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Publication Date
Thu Dec 01 2022
Journal Name
Ieee Transactions On Human-machine Systems
Myoelectric Control With Fixed Convolution-Based Time-Domain Feature Extraction: Exploring the Spatio–Temporal Interaction
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