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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
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Fast lightweight encryption device based on LFSR technique for increasing the speed of LED performance
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LED is an ultra-lightweight block cipher that is mainly used in devices with limited resources. Currently, the software and hardware structure of this cipher utilize a complex logic operation to generate a sequence of random numbers called round constant and this causes the algorithm to slow down and record low throughput. To improve the speed and throughput of the original algorithm, the Fast Lightweight Encryption Device (FLED) has been proposed in this paper. The key size of the currently existing LED algorithm is in 64-bit & 128-bit but this article focused mainly on the 64-bit key (block size=64-bit). In the proposed FLED design, complex operations have been replaced by LFSR left feedback technology to make the algorithm perform more e

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Publication Date
Tue May 06 2025
Journal Name
Aip Conference Proceedings
Enhance the performance of the wind turbine blade based on the blade element momentum theory
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In order to improve the effectiveness, increase the life cycle, and avoid the blade structural failure of wind turbines, the blades need to be perfectly designed. Knowing the flow angle and the geometric characteristics of the blade is necessary to calculate the values of the induction factors (axial and tangential), which are the basis of the Blade Element Momentum theory (BEM). The aforementioned equations form an implicit and nonlinear system. Consequently, a straightforward iterative solution process can be used to solve this problem. A theoretical study of the aerodynamic performance of a horizontal-axis wind turbine blade was introduced using the BEM. The main objective of the current work is to examine the wind turbine blade’s perf

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Publication Date
Tue May 01 2012
Journal Name
Iraqi Journal Of Physics
Early detection of breast cancer mass lesions by mammogram segmentation images based on texture features
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Mammography is at present one of the available method for early detection of masses or abnormalities which is related to breast cancer. The most common abnormalities that may indicate breast cancer are masses and calcifications. The challenge lies in early and accurate detection to overcome the development of breast cancer that affects more and more women throughout the world. Breast cancer is diagnosed at advanced stages with the help of the digital mammogram images. Masses appear in a mammogram as fine, granular clusters, which are often difficult to identify in a raw mammogram. The incidence of breast cancer in women has increased significantly in recent years.
This paper proposes a computer aided diagnostic system for the extracti

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Publication Date
Sat Jan 01 2022
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Construct an efficient distributed denial of service attack detection system based on data mining techniques
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<span>Distributed denial-of-service (DDoS) attack is bluster to network security that purpose at exhausted the networks with malicious traffic. Although several techniques have been designed for DDoS attack detection, intrusion detection system (IDS) It has a great role in protecting the network system and has the ability to collect and analyze data from various network sources to discover any unauthorized access. The goal of IDS is to detect malicious traffic and defend the system against any fraudulent activity or illegal traffic. Therefore, IDS monitors outgoing and incoming network traffic. This paper contains a based intrusion detection system for DDoS attack, and has the ability to detect the attack intelligently, dynami

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Publication Date
Thu Jul 01 2004
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE HAEMOPROTEIDS OF THE AVIAN FAMILY SCOLOPACIDAE IN IRAQ WITH DESCRIPTION OF A NEW SPECIES
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Three scolopacids out of 150 are found infected with Haemoproteus scolopaci Galli-
Valerio 1929 and H. tringae n. sp. A detailed description of the new taxon is presented along
with a comparison of the diagnostic measurements between the two species.

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Publication Date
Fri Jan 01 2021
Journal Name
Biochemical Cellular Archive
detection of anti-helicobacter pylori cag a antibody in sera of patients with eye diseases
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The study conducted to investigate the association between Helicobacter pylori infection and eye diseases (Glaucoma, Cataract, CSR and Uveitis). One hundred and four patients with multiple eye disorders (10-80) years were observed from 10/9/2020 to 18/11/2020 and compared to thirty-one healthy people (19 female and 12 male). Each participant was tested for H. pylori CagAAbs and TNF-α using an enzyme-linked immunosorbent assay (ELISA). The results have shown that there was a non-significant difference (p≥0.05) in the concentration of CagAantibodies in sera of patients with eye diseases except in the case of CSR (central serous chorioretinopathy), which was a significant difference (P≤0.05) compared to the control group. Also, the result

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Publication Date
Thu Jan 01 2009
Journal Name
Bulletin Of Voronezh State University. The Series "linguistics And Intercultural Communication"
The word-formation structure of zoocomposites with a verb base in various types of languages
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Publication Date
Sat Jul 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF MYCETOPHAGOUS NEMATODE APHELENCHUS AVENAE IN IRAQ WITH DESCRIPTION AND TESTING THEIR PROPAGATION ON DIFFERENT FUNGUS CULTURE
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Aphelenchus avenae was isolated from the wheat crown in Summel distract- Duhok, Kurdistan region-Iraq infected by a crown rot disease which is caused by Fusarium spp;    wheat's crown culturing on Potato Dextrose Agar (PDA) and incubating at 25°C A. avenae was found associated with fungal culture which meant that fungal nematode was parasitic on crown rot fungi on wheat crown, this species was described for the first time in Iraq.

Fungal Nematode incubated with Fusarium graminearum, F. oxysporum and Verticillium dahliae reproduce in both solid and liquid media, best results of nematode reproduction were recorded on F. graminearum followed by F. oxy

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
Challenges Faced by Families of Children with Intellectual Disabilities and Its Effect on the Psychological Health in the Asir
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Abstract

This research aims to identify the challenges faced by families of children with intellectual disabilities and to identify the impact of the challenges facing them on the mental health of their children with intellectual disabilities. Based on the following questions: What is the nature of the challenges faced by families of children with disabilities and how do these challenges affect the mental health of their children with intellectual disabilities? The study was conducted on a sample of four families of six children with intellectual disabilities, depending on the degree and type of disability. To achieve the study's objectives, the qualitative approach was used, Because of the importance of accessin

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Publication Date
Mon Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of diabetes mellitus on periodontal health status, salivary flow rate and salivary pH in patients with chronic periodontitis
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Background: Diabetes and periodontitis are considered as chronic diseases with a bidirectional relationship between them. This study aimed to determine and compare the severity of periodontal health status and salivary parameters in diabetic and non-diabetic patients with chronic periodontitis. Materials and Methods: Seventy participants were enrolled in this study. The subjects were divided into three groups: Group I: 25 patients had type 2 diabetes mellitus with chronic periodontitis, Group 2: 25 patients had chronic periodontitis and with no history of any systemic diseases, Group 3: 20 subjects had healthy periodontium and were systemically healthy. Unstimulated whole saliva was collected for measurement of salivary flow rate and pH.

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