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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
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Estimation of Serum CD200 and CD200R1 Levels in a Sample of Iraqi Women with Breast Cancer: Their Role as Diagnostic and Prognostic Markers
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Breast cancer is a disease in which cells in the breast grow out of control. CD200 is a cell surface glycoprotein expressed on many cells, it belongs to the immunoglobulin family (Ig) and have a great role in the regulation of inflammation in autoimmunity. CD200 is the ligand for CD200R1 receptor. To determine if serum level of CD200 and its receptor CD200R1 can be used as a diagnostic and prognostic marker in patients with breast cancer.This case control study was carried out at Oncology Teaching Hospital – Medical city in Baghdad. Six groups were enrolled, four groups were confirmed with breast cancer stage (I, II, III and IV), fifth group (benign) and sixth group was control (healthy individual). Serum is divided to me

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
information and communication technologies and their impact on changed the financial reporting system In a Sample in Iraqi banks
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paid recent developments in the information and communications technology and the accompanying developments in the global market to pay particular accounting information users to demand more sophistication in terms of corporate financial reporting systems, which led to the emergence of a new type of reporting (financial reporting in real time). where is the information and communications technology mainstay Nations for the development and progress, thanks to the development of technology that have made the transmission of information easily conducted and high speed to all who need it, communication is instantaneous and the flow of information via the internet dramatically exceeded the border temporal and spatial anywhere in the w

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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
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Development of East Baghdad Oil Field By Clusters of Horizontal Wells
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There are varieties of reasons lead for drilling horizontal wells rather than verticals. Increasing the recovery of oil, especially from thin or tight reservoir permeability is the most important parameter.

East Baghdad oil field considered as a giant field with approximately more than 1billion barrel of a proved reserves accompanying recently to low production rate problems in many of the existing wells.

   It is important to say that presence of of  horizontal wells in East Baghdad field especially by converting some of already drilled wells by re-entry drilling horizontal sections may provide one of best solutions for the primary development stage in East Baghdad field which may be followed by drilling n

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Publication Date
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Development of East Baghdad Oil Field By Clusters of Horizontal Wells
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There are varieties of reasons lead for drilling horizontal wells rather than verticals. Increasing the recovery of oil, especially from thin or tight reservoir permeability is the most important parameter. East Baghdad oil field considered as a giant field with approximately more than 1billion barrel of a proved reserves accompanying recently to low production rate problems in many of the existing wells.    It is important to say that presence of of  horizontal wells in East Baghdad field especially by converting some of already drilled wells by re-entry drilling horizontal sections may provide one of best solutions for the primary development stage in East Baghdad field which may be followed by drilling new horizont

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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
Field Study of Novel Storage Tank of Solar Water Heating System
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In this paper thermo-hydrodynamic characteristics were investigated experimentally for a new type shell-helical coiled tube heat exchanger used as a storage tank of closed loop solar water heater system. Triple concentric helical coils were made of copper tubes of (12.5mm OD and 10mm ID) with coils diameter of (207, 152.2, 97mm) for outer, middle and inner coils respectively. The experiments were carried out during a clear sky days of (March and April 2012). The parameters studied in this work are: history of average temperature of shell side of the storage tank, collector heat gain, heat rejected from coils to shell side of the storage tank, collector efficiency, thermal effectiveness of the heat exchanger (storage tank), and pressure d

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Employment cost management tools in the fast-track method Of the constructionindustries for the purpose of rationalizing costs: An applied research in the Shatt al-Diwaniya transference project General Authority for projects of irrigation and reclamation
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The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms

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Publication Date
Tue Aug 23 2022
Journal Name
Frontiers In Energy Research
Evaluation of T-Shaped Fins With a Novel Layout for Improved Melting in a Triple-Tube Heat Storage System
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The effects of T-shaped fins on the improvement of phase change materials (PCM) melting are numerically investigated in vertical triple-tube storage containment. The PCM is held in the middle pipe of a triple-pipe heat exchanger while the heat transfer fluid flows through the internal and external pipes. The dimension effects of the T-shaped fins on the melting process of the PCM are investigated to determine the optimum case. Results indicate that while using T-shaped fins improves the melting performance of the PCM, the improvement potential is mainly governed by the fin’s body rather than the head. Hence, the proposed T-shaped fin did not noticeably improve melting at the bottom of the PCM domain; additionally, a flat fin is ad

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Publication Date
Thu Jul 01 2021
The spontaneous emission performance of a quantum emitter coupled to a hybrid plasmonic waveguide with specified output polarization for on-chip plasmonic single-photon source
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Publication Date
Tue May 11 2021
Journal Name
Photonics And Nanostructures - Fundamentals And Applications
The spontaneous emission performance of a quantum emitter coupled to a hybrid plasmonic waveguide with specified output polarization for on-chip plasmonic single-photon source
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Nowadays, most of the on-chip plasmonic single-photon sources emit an unpolarized stream of single photons that demand a subsequent polarizer stage in a practical quantum cryptography system. In this paper, we numerically demonstrated the coupling of the light emitted from a quantum emitter (QE) at 700 nm wavelength to the propagation mode supported by an on-chip hybrid plasmonic waveguide (HPW) polarization rotator. Our results proved that the light emitted is linearly polarized at 0º, 45º/−45º, and 90º with propagation lengths of 5 μm, 3.3 μm, and 3.9 μm, respectively. Moreover, high power-conversion efficiency was obtained from an applied transverse magnetic (TM) mode (0º-polarization) to a transverse electric (TE) (90º-polari

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