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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 2017
Journal Name
International Journal Of Mathematics In Operational Research
A single server fuzzy queues with priority and unequal service rates
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Publication Date
Tue Aug 15 2017
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
A Prototype and Roadmap for Transition to IPv6 with Performance Evaluation
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The migration from IPv4 to IPv6 can not be achieved in a brief period, thus both protocols co-exist at certain years. IETF Next Generation Transition Working Group (NGtrans) developed IPv4/IPv6 transition mechanisms. Since Iraq infrastructure, including universities, companies and institutions still use IPv4 protocol only. This research article tries to highlight, discuss a required transition roadmap and extend the local knowledge and practice on IPv6. Also, it introduces a prototype model using Packet tracer (network simulator) deployed for the design and implementation of IPv6 migration. Finally, it compares and evaluates the performance of IPv6, IPv4 and dual stack using OPNET based on QoS metrics such as throughput, delay and point to

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Publication Date
Thu Mar 01 2012
Journal Name
Advances In Materials Physics And Chemistry
Study the Effect of Irradiation Time and HF Concentration on Porosity of Porous Silicon and Study Some of the Electrical Properties of Its Based Device
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ABSTRACT Porous silicon has been produced in this work by photochemical etching process (PC). The irradiation has been achieved using ordinary light source (150250 W) power and (875 nm) wavelength. The influence of various irradiation times and HF concentration on porosity of PSi material was investigated by depending on gravimetric measurements. The I-V and C-V characteristics for CdS/PSi structure have been investigated in this work too.

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Publication Date
Fri Apr 30 2021
Journal Name
Iraqi Geological Journal
Geological Model for Mauddud Reservoir Khabaz Oil Field
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The Mauddud reservoir, Khabaz oil field which is considered one of the main carbonate reservoirs in the north of Iraq. Recognizing carbonate reservoirs represents challenges to engineers because reservoirs almost tend to be tight and overall heterogeneous. The current study concerns with geological modeling of the reservoir is an oil-bearing with the original gas cap. The geological model is establishing for the reservoir by identifying the facies and evaluating the petrophysical properties of this complex reservoir, and calculate the amount of hydrocarbon. When completed the processing of data by IP interactive petrophysics software, and the permeability of a reservoir was calculated using the concept of hydraulic units then, there

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Publication Date
Fri Oct 01 2021
Journal Name
Journal Of Engineering
Influence of Using Various Percentages of Slag on Mechanical Properties of Fly Ash-based Geopolymer Concrete
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In order to implement the concept of sustainability in the field of construction, it is necessary to find an alternative to the materials that cause pollution by manufacturing, the most important of which is cement. Because factory wastes provide siliceous and aluminous materials and contain calcium such as fly ash and slag that are used in the production of high-strength geopolymer concrete with specifications similar to ordinary concrete, it was necessary for developing this type of concrete that is helping to reduce CO2 (dioxide carbon) in the atmosphere. Therefore, the aim of this study was to study the influence of incorporating various percentages of slag as a replacement for fly ash and the effect of sl

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Publication Date
Wed Apr 01 2015
Journal Name
Al–bahith Al–a'alami
The Educational Role of Children's Programs in Libyan TV An Analytical -Field Study of "Flowers of Life" Program
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Television contributes children the acquisition of knowledge, moral and social values through programs that are offered to them and the extent of the focus on the effective aspects of life in the age of the target stage. The subject of this research aims to know the children programs in Libya television through a comprehensive analytical study of the program entitled “zihur al-hayat” within the broadcast season from April 1, 2004 to June 30, 2004. It also focuses on trying to identify the Libyan television policy in broadcast educational content through the children's programs in the prevailing political and social conditions during the period of study as well as knowing the opinions of the children's sample under study in Al-Baidhaa

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Publication Date
Sun Apr 17 2016
Journal Name
Al-academy
Stimuli effectiveness of teaching aids in the development of the technical capacity of secondary school students in the technical configuration items: ليلى شويل حسين
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The importance of culture moot ( visual ) in the community , serves as the conceptual basis for the technical and aesthetic awareness , as all the fields of art represents a kind of social consciousness can not be separated from the practice of performance and awareness of it. That the link between what you do image that expresses the cognitive aspects and performance , and what is reflected on the receiver by turning the event into a set of symbols and meanings that have a correlation relationship to society , education, and other fields. Therefore must provide " material conditions and psychological " that helps the learner to interact effectively and with the active elements of the learning environment in the classroom and gain

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Publication Date
Tue Jul 02 2024
Journal Name
Edge Computing Architecture - Architecture And Applications For Smart Cities
Safety Assurance in IoT-Based Smart Homes
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A smart home’s safety is a very urgent question due to several causes. This chapter analyzes current directions of smart house system safety technologies in use nowadays. Current studies are dedicated to the integration of Internet of Things (IoT) into smart home systems; critical situations that may arise; and specifications of sensors in the smart home system. The huge number of connected devices and the capacity embedded within these devices to direct demand resources make deliberate attacks on them and/or inadvertent downfall events such as abrupt bad interactions between connected devices, mechanical failure of devices, and unsuccessful communication may lead to IoT-based systems entering unreliable and threatening physical s

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education Program for Type 2 Diabetes Mellitus Patient's Self-efficacy toward Managing Feet at Endocrinology and Diabetes Center in Al-Rusafa Sector
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Objective(s): to assess the effectiveness of educational program on improving diabetic foot self-efficacy concerning managing their feet. Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Diabetic and Endocrinology Center in Baghdad- Rusafa Sector from 2nd of May 2017, to27th June 2018. Non-probability sample of (80) male and female diabetic patients were selected. The study instruments consisted of two major parts: first

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
The effectiveness of visual intelligence strategy in the collection of students in the Department of Art Education in the perspective material: أسامة حسن عبد علي الصفار
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Select the researcher discussed problem of asking the following : Do you use visual intelligence strategy effective in the collection of students in the Department of Art Education in the foreseeable material ? The research aims to " measure the effectiveness of the strategy in the collection of visual intelligence students in the Department of Art Education in the foreseeable material ". To verify the objective of this research was identify hypotheses zero to measure the level of achievement in the foreseeable material second grade students in the Department of Art Education - Faculty of Fine Arts . The population of the research students in the Department of Art Education / Faculty of Fine Arts at the University of Baghdad who are stud

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