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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
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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Publication Date
Mon Mar 01 2021
Journal Name
Al-khwarizmi Engineering Journal
Building a High Accuracy Transfer Learning-Based Quality Inspection System at Low Costs
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      Products’ quality inspection is an important stage in every production route, in which the quality of the produced goods is estimated and compared with the desired specifications. With traditional inspection, the process rely on manual methods that generates various costs and large time consumption. On the contrary, today’s inspection systems that use modern techniques like computer vision, are more accurate and efficient. However, the amount of work needed to build a computer vision system based on classic techniques is relatively large, due to the issue of manually selecting and extracting features from digital images, which also produces labor costs for the system engineers.       In this research, we pr

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Publication Date
Mon Mar 01 2021
Journal Name
Al-khwarizmi Engineering Journal
Building a High Accuracy Transfer Learning-Based Quality Inspection System at Low Costs
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      Products’ quality inspection is an important stage in every production route, in which the quality of the produced goods is estimated and compared with the desired specifications. With traditional inspection, the process rely on manual methods that generates various costs and large time consumption. On the contrary, today’s inspection systems that use modern techniques like computer vision, are more accurate and efficient. However, the amount of work needed to build a computer vision system based on classic techniques is relatively large, due to the issue of manually selecting and extracting features from digital images, which also produces labor costs for the system engineers.

  &nbsp

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Publication Date
Tue Aug 06 2013
Journal Name
Robotica
Function approximation technique-based adaptive virtual decomposition control for a serial-chain manipulator
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SUMMARY<p>The virtual decomposition control (VDC) is an efficient tool suitable to deal with the full-dynamics-based control problem of complex robots. However, the regressor-based adaptive control used by VDC to control every subsystem and to estimate the unknown parameters demands specific knowledge about the system physics. Therefore, in this paper, we focus on reorganizing the equation of the VDC for a serial chain manipulator using the adaptive function approximation technique (FAT) without needing specific system physics. The dynamic matrices of the dynamic equation of every subsystem (e.g. link and joint) are approximated by orthogonal functions due to the minimum approximation errors produced. The contr</p> ... Show More
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Publication Date
Sat Dec 30 2023
Journal Name
Traitement Du Signal
Optimizing Acoustic Feature Selection for Estimating Speaker Traits: A Novel Threshold-Based Approach
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Publication Date
Mon Oct 03 2022
Journal Name
International Journal Of Interactive Mobile Technologies (ijim)
A New Feature-Based Method for Similarity Measurement under the Linux Operating System
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This paper presents a new algorithm in an important research field which is the semantic word similarity estimation. A new feature-based algorithm is proposed for measuring the word semantic similarity for the Arabic language. It is a highly systematic language where its words exhibit elegant and rigorous logic. The score of sematic similarity between two Arabic words is calculated as a function of their common and total taxonomical features. An Arabic knowledge source is employed for extracting the taxonomical features as a set of all concepts that subsumed the concepts containing the compared words. The previously developed Arabic word benchmark datasets are used for optimizing and evaluating the proposed algorithm. In this paper,

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Publication Date
Sun Jan 04 2026
Journal Name
Iraqi Journal Of Biotechnology
The Frequency of Some Colibactin Genes Amongst the Clinical Strains of E. coli Isolated From Urinary Tract Infections in Iraq
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Escherichia coli has been recognized worldwide as the most common causative agent for severe infections of the urinary tract. Colibactin is a genotoxin produced through a gene cluster called polyketide synthase (pks) island by members of Enterobacteriaceae. Limited information is available about the frequency of colibactin in E. coli isolates in Iraq. Hence, this study aimed to examine the frequency of some colibactin genes (CIbA and CIbQ) in clinical isolates of E. coli obtained from urinary tract infections (UTIs) in Iraq. Between October 2023 and January 2024, 120 urine samples were collected from females diagnosed with UTIs in Iraqi hospitals. 70 E. coli isolates were isolated after identification by biochemical methods and confirmed by

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Publication Date
Wed Sep 20 2023
Journal Name
Journal Of Applied And Natural Science
Detection of some virulence genes (esp, agg, gelE, CylA) in Enterococcus faecalis isolated from different clinical cases at Baghdad
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The virulent genes are the key players in the ability of the bacterium to cause disease. The products of such genes that facilitate the successful colonization and survival of the bacterium in or cause damage to the host are pathogenicity determinants. This study aimed to investigate the prevalence of virulence factors (esp, agg, gelE, CylA) in E. faecalis isolated from diverse human clinical collected in Iraqi patient , as well as to assess their ability to form biofilm and to determine their haemolytic and gelatinase activities. Thirty-two isolates of bacteria Enterococcus faecalis were obtained, including 15 isolates (46.87%) of the urine, 6 isolates (18.75%) for each of the stool and uterine secretions, and 5 isolates (15.62%) of the wo

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Publication Date
Fri Sep 30 2022
Journal Name
International Journal Of Health Sciences
Relation of retinol binding protein4, visfatin and vitamin a in obese and non obese Iraqi patients with non alcoholic fatty liver disease
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One of the most common public liver diseases over the world is fatty liver which contain alcoholic and non-alcoholic fatty liver. One-fourth among general population are impact Non-Alcoholic Fatty Liver Disease (NAFLD) in the worldwide.Retinol binding protein 4 (RBP4) is known as an adipokine, mainly synthesized and secreted from the liver and form adipose tissues. RBP4 acts as a transporter and specifically bound to retinol from liver to others tissues. Visfatin is an adipocytokine and mainly produced from visceral fat tissue, skeletal muscles as well as liver. Vitamin A absorbed, transported as retinyl esters to the liver then hydrolyzed to the retinol form and storage in hepatic stellate cells (HSCs) after reesterified with rigly

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Publication Date
Sat Oct 17 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Congenitally missing and supernumerary teeth among a group of 3-12 years old children with cleft lip and/ or palate in Iraq
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Background: There are many congenital anomalies associated with cleft lip and/or palate. This research is to study the prevalence of congenitally missing teeth and supernumerary teeth in this population group. Materials and Method: One hundred eight cleft lip and/or palate Iraqi patients had participated in this study (57 male, 51 female), 3-12 years of age. 26 of them had orthopantomogram were within (6-12) years of age were inspected for congenitally missing teeth and supernumerary teeth. Patients whom age range 3-5 years were checked for the congenitally missing teeth by clinical examination with strongly insisting the teeth were not missed due to caries or trauma. Results: There were 19(73.076%) patients with 41 congenitally missing tee

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