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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 Nov 02 2025
Journal Name
Nursing Science Quarterly
Managing Anger in Persons With Substance Use Disorders: A Global Nursing Perspective
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The management of anger is problematic for many people and it is a particularly important issue for persons with substance use disorders (SUD). The paper reviews the research studies dating back to 2005 on how to help persons with SUD manage anger. The literature reveals that various pharmaceutical and non-pharmacological approaches have been studied to help persons with SUD manage their anger. In chronic and lower risk situations non-pharmacological are the first line approaches, they include anger management training, cognitive-behavioral based treatments, exercising and relaxing, music therapy and empathy. Atypical antipsychotic and medications for opioid use disorders (MOUD) are also widely used. In acute and high risk of violen

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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
Creating a Conductive Surface of the PMMA by Laser Cladding with DWCNT and MWCNTS
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This work studied the electrical and thermal surface conductivity enhancement of polymethylmethacrylate (PMMA) clouded by double-walled carbon nanotubes (DWCNTs) and multi-walled carbon nanotube (MWCNTs) by using pulsed Nd:YAG laser. Variable input factors are considered as the laser energy (or the relevant power), pulse duration and pulse repetition rate. Results indicated that the DWCNTs increased the PMMA’s surface electrical conductivity from 10-15 S/m to 0.813×103 S/m while the MWCNTs raised it to 0.14×103 S/m. Hence, the DWCNTs achieved an increase of almost 6 times than that for the MWCNTs. Moreover, the former increased the thermal conductivity of the surface by 8 times and the later by 5 times.

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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
A Study of Wear Rate Epoxy Resin filled with SiO2 particle and Glass fibers
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This research is devoted to study the effect of different in weight percentage of Sio2 particles and glass fibers (5, 10, 15, 20) wt. % on the wear rate epoxy resin. The results show that the value of hardness increase with the increase for the weight percentage of reinforcing particles and fibers, while the wear rate decrease with the increase the load level of the reinforcing particles and fibers . The largest value of the hardness, and the lowest value of the wear rate for epoxy reinforced with 20% of SiO2, the wear rate increase in general with increasing the applied load.

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Engineering
Evaluation of petrophysical Properties of Zubair formation Luhais oil field Using Well Logging Analysis and Archie Parameters
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well log analysis is used to determine the rock properties like porosity, water saturation, and shale volume. Archie parameters in Archie equation, which sometimes considered constants greatly affect the determination of water saturation, also these parameters may be used to indicate whether the rocks are fractured or not so they should be determined. This research involves well logging analysis for Zubair formation in Luhais field which involves the determination of Archie parameters instead of using them as constant.

The log interpretation proved that the formation is hydrocarbon reservoir, as it could be concluded from Rwa (high values) and water saturation values (low values), the lithology of Zubair from cro

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Publication Date
Fri Sep 01 2023
Journal Name
Al-khwarizmi Engineering Journal
A Study on the Effect of Multistage Toolpath in Fabricating a Customized Cranial Implant in Incremental Sheet Metal Forming
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Incremental sheet forming (ISF) process offers a high degree of flexibility in the manufacturing of different sheet parts, which makes it an ideal candidate for prototype parts as well as efficient at fabricating various customized products at low production costs compared to traditionally used processes. However, parts produced in this process exhibit notable geometrical inaccuracy and considerable thickness reduction. In this paper, the single point incremental sheet forming variant of the process has been implemented to manufacture a highly customized cranial implant starting from the computed tomography (CT) scan data of the patient's anatomy. A methodology, from the modeling to the realization of the implant, is presented and discus

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Publication Date
Wed Dec 18 2019
Journal Name
Baghdad Science Journal
A Modified Approach by Using Prediction to Build a Best Threshold in ARX Model with Practical Application
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The proposal of nonlinear models is one of the most important methods in time series analysis, which has a wide potential for predicting various phenomena, including physical, engineering and economic, by studying the characteristics of random disturbances in order to arrive at accurate predictions.

In this, the autoregressive model with exogenous variable was built using a threshold as the first method, using two proposed approaches that were used to determine the best cutting point of [the predictability forward (forecasting) and the predictability in the time series (prediction), through the threshold point indicator]. B-J seasonal models are used as a second method based on the principle of the two proposed approaches in dete

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Publication Date
Fri Nov 11 2022
Journal Name
Surgical Neurology International
Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review
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Background:

Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review.

Methods:

PubMed database was searched by the following combined formula of medical subjects headings,

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Publication Date
Thu Jan 01 2015
Journal Name
International Journal Of Advanced Research
UV Photovoltaic detector based on Bi doped TiO2 Fabricated by Pulse Laser Deposition
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Pure and doped TiO 2 with Bi films are obtained by pulse laser deposition technique at RT under vacume 10-3 mbar, and the influence of Bi content on the photocvoltaic properties of TiO 2 hetrojunctions is studied. All the films display photovoltaic in the near visible region. A broad double peaks are observed around λ= 300nm for pure TiO 2 at RT in the spectral response of the photocurrent, which corresponds approximately to the absorption edge and this peak shift to higher wavelength (600 nm) when Bi content increase by 7% then decrease by 9%. The result is confirmed with the decreasing of the energy gap in optical properties. Also, the increasing is due to an increase in the amount of Bi content, and shifted to 400nm when annealed at 523

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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
Low-Rate High-Quality Parametric Audio Coder based on Sinusoidal plus Noise Representations
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This paper presents a parametric audio compression scheme intended for scalable audio coding applications, and is particularly well suited for operation at low rates, in the vicinity of 5 to 32 Kbps. The model consists of two complementary components: Sines plus Noise (SN). The principal component of the system is an. overlap-add analysis-by-synthesis sinusoidal model based on conjugate matching pursuits. Perceptual information about human hearing is explicitly included into the model by psychoacoustically weighting the pursuit metric. Once analyzed, SN parameters are efficiently quantized and coded. Our informal listening tests demonstrated that our coder gave competitive performance to the-state-of-the- art HelixTM Producer Plus 9 from

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
Interior Visual Intruders Detection Module Based on Multi-Connect Architecture MCA Associative Memory
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Most recent studies have focused on using modern intelligent techniques spatially, such as those
developed in the Intruder Detection Module (IDS). Such techniques have been built based on modern
artificial intelligence-based modules. Those modules act like a human brain. Thus, they should have had the
ability to learn and recognize what they had learned. The importance of developing such systems came after
the requests of customers and establishments to preserve their properties and avoid intruders’ damage. This
would be provided by an intelligent module that ensures the correct alarm. Thus, an interior visual intruder
detection module depending on Multi-Connect Architecture Associative Memory (MCA)

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