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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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Thu Sep 08 2016
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Telecommunication Systems
Design and simulation analysis of network-based fully distributed mobility management in flattened network architecture
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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Laser
Plasmonic Nanoparticles Decorated Salty Paper Based on SERS Platform for Diagnostic low-Level Contamination: Lab on Paper
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In this research, a low cost, portable, disposable, environment friendly and an easy to use lab-on-paper platform sensor was made. The sensor was constructed using a mixture of Rhodamine-6G and gold nanoparticles also Sodium chloride salt. Drop–casting method was utilized as a technique to make a platform which is a commercial office paper. A substrate was characterized using Field Emission Scanning Electron Microscope, Fourier transform infrared spectroscopy, UV-visible spectrophotometer and Raman Spectrometer. Rh-6G Raman signal was enhanced based on Surface Enhanced Raman Spectroscopy technique utilized gold nanoparticles. High Enhancement factor of Plasmonic commercial office paper reaches up to 0.9 x105 because of local surface pl

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Publication Date
Tue Jul 01 2014
Journal Name
Ieee Transactions On Circuits And Systems I: Regular Papers
Crosstalk-Aware Multiple Error Detection Scheme Based on Two-Dimensional Parities for Energy Efficient Network on Chip
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Achieving reliable operation under the influence of deep-submicrometer noise sources including crosstalk noise at low voltage operation is a major challenge for network on chip links. In this paper, we propose a coding scheme that simultaneously addresses crosstalk effects on signal delay and detects up to seven random errors through wire duplication and simple parity checks calculated over the rows and columns of the two-dimensional data. This high error detection capability enables the reduction of operating voltage on the wire leading to energy saving. The results show that the proposed scheme reduces the energy consumption up to 53% as compared to other schemes at iso-reliability performance despite the increase in the overhead number o

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Publication Date
Mon Feb 25 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effectiveness of the financial analysis in the statement of the ability of financial ratios in the detection of fraud in the financial reports of industrial companies
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This research after financial ratios in the detection of fraud to the financial statements published which enables specialists from the work of their studies and their conclusions to obtain the information they seek on the activities of the entity. Has provided researchers what these relics They then field study to test the validity and sincerity of the findings of the suggestions that have been upheld the need to study all financial ratios extracted in general, organized and used in decision-making processes necessary administrative.And that the financial management attention more financial analysis and extraction of financial ratios and compare them with industry standards taken from historical norms

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Publication Date
Sat Nov 05 2016
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
Image Compression Based on Cubic Bezier Interpolation, Wavelet Transform, Polynomial Approximation, Quadtree Coding and High Order Shift Encoding
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In this study, an efficient compression system is introduced, it is based on using wavelet transform and two types of 3Dimension (3D) surface representations (i.e., Cubic Bezier Interpolation (CBI)) and 1 st order polynomial approximation. Each one is applied on different scales of the image; CBI is applied on the wide area of the image in order to prune the image components that show large scale variation, while the 1 st order polynomial is applied on the small area of residue component (i.e., after subtracting the cubic Bezier from the image) in order to prune the local smoothing components and getting better compression gain. Then, the produced cubic Bezier surface is subtracted from the image signal to get the residue component. Then, t

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Advanced Computer Science And Applications
Proposed an Adaptive Bitrate Algorithm based on Measuring Bandwidth and Video Buffer Occupancy for Providing Smoothly Video Streaming
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Publication Date
Sun Oct 18 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Radiographic follow up for clinical cases of mandibular implant retained overdenture MIR-OD
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Background: The use of osseointegrated fixtures in dentistry has been demonstrated both histologically and clinically to be beneficial in providing long term oral rehabilitation in completely edentulous individual. Most patients suffer from denture instability; particularly with mandibular prosthesis, the use of dental implant will be benefit significantly from even a slight increase in retention. The concept of implanting two to four fixtures in a bony ridge to retain a complete denture prosthesis appealing therefore, as retention, stability and acceptable economic compromise to the expanse incurred with the multiple fixture supported fixed prosthesis. Materials and methods in this study the sample were eight patients selected from a hosp

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Publication Date
Fri Nov 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Prevalence of β-lactam Resistant Klebsiella Pneumoniae Isolates among Clinical Specimensin Baghdad Hospitals
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One hundred forty three of Klebsiellapneumoniae isolates had been collected from some hospitals in Baghdad city. The isolates were taken from different clinical specimens.Antimicrobial susceptibility test was carried out towards fifteen antimicrobial agents by using Vitek2 system with Antimicrobial susceptibility test cards. The results of antibiogram showed that the local isolates were possess highly resistance towards most antimicrobial agents under study. The high resistance wastoAmpicillin while the low resistance was to Imipenem.Two methods were used for detection of Extended Spectrum Beta Lactamases (ESBLs) production; first methods by using of Vitek2 system,thesecondmethods by using of polymerase chain reaction (PCR) technique to dis

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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.

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Evaluation of the Organic-Pollution Based on the Determination of some Polycyclic Aromatic Hydrocarbons(PAHs) in Tigris River Water in 2012 at Baghdad City , Iraq
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This study aims to predict the organic pollution produced from the presence of some polycyclic aromatic hydrocarbons (PAHs) and determination it's concentrations (µg/L , ppb) in Tigris river water by a collection twenty-seven water samples from a selected three stations with nine sampling sites and three depths of water (5 cm , 2 m and 4 m) each site for 4.6 km distance of a geographic studied area which is located between the ( Al-Senak and AL-Sarrafiah bridges ) at Baghdad city – Iraq on May, 2012. The geographic location was determined with a Global Positioning System (GPS) and Geographic Information System (GIS) software program. The concentrations of fourteen components (PAHs) were performed using the reverse phase

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