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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 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
Mon Jan 01 2024
Journal Name
Communications In Computer And Information Science
Enhancing the Performance of Wireless Body Area Network Routing Protocols Based on Collaboratively Evaluated Values
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Wireless Body Area Sensor Network (WBASN) is gaining significant attention due to its applications in smart health offering cost-effective, efficient, ubiquitous, and unobtrusive telemedicine. WBASNs face challenges including interference, Quality of Service, transmit power, and resource constraints. Recognizing these challenges, this paper presents an energy and Quality of Service-aware routing algorithm. The proposed algorithm is based on each node's Collaboratively Evaluated Value (CEV) to select the most suitable cluster head (CH). The Collaborative Value (CV) is derived from three factors, the node's residual energy, the distance vector between nodes and personal device, and the sensor's density in each CH. The CEV algorithm operates i

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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
Wed Jan 01 2025
Journal Name
Progress In Electromagnetics Research Letters
Optimize the Performance of Reconfigurable Antenna Based on Laser Treatment for Sub-6 GHz Applications
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Publication Date
Wed Nov 28 2018
Journal Name
International Journal Of Engineering &amp; Technology
Modified Strut Effectiveness Factor for FRP-Reinforced Concrete Deep Beams
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A few examinations have endeavored to assess a definitive shear quality of a fiber fortified polymer (FRP)- strengthened solid shallow shafts. Be that as it may, need data announced for examining the solid profound pillars strengthened with FRP bars. The majority of these investigations don't think about the blend of the rigidity of both FRP support and cement. This examination builds up a basic swagger adequacy factor model to evaluate the referenced issue. Two sorts of disappointment modes; concrete part and pulverizing disappointment modes were examined. Protection from corner to corner part is chiefly given by the longitudinal FRP support, steel shear fortification, and cement rigidity. The proposed model has been confirmed util

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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
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
Tue Oct 20 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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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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