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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
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Channel state information estimation for reconfigurable intelligent surfaces based on received signal analysis
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<p>Recently, reconfigurable intelligent surfaces have an increasing role to enhance the coverage and quality of mobile networks especially when the received signal level is very weak because of obstacles and random fluctuation. This motivates the researchers to add more contributions to the fields of reconfigurable intelligent surfaces (RIS) in wireless communications. A substantial issue in reconfigurable intelligent surfaces is the huge overhead for channel state information estimation which limits the system’s performance, oppressively. In this work, a newly proposed method is to estimate the angle of arrival and path loss at the RIS side and then send short information to the base station rather than huge overhe

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
Analytical Study of the Royal-Jelly Effect on Sperms Morphological Characteristics and some Liver Function Parameters and their Correlation with some Antioxidants in Male Albino Rats Treated with Pregabalin Drug
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Abstract<p>In recent years, the consideration of natural products as anti-inflammatory and antioxidative treatments has more interested worldwide. Moreover, natural products are easily obtained and are relatively safe the Royal jelly (RJ) is one of them. The current study was carried to evaluate the effects of pregabalin (PGB) on physiological activity of sperms, reproductive hormones assay and some biochemical analysis. Forty (40) male albino rats (10-weeks-old) were divided into four groups (10 rats each): G1 (treated with PGB drug, 150 mg/kg B.wt (Lyrica-Pfizer-Pharmaceutical Industries), G2 (treated with RJ 1g/kg), G3 (treated with PGB drug and RJ together), and G4 control treated with norma</p> ... Show More
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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
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
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
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
A Comparative Study of the Photostabilization of Polyvinyl Chloride with Nano and Micro Nickel Oxide
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NiO nanoparticle synthesis by chemical method and characterized by XRD with crystal size 11.72
nm and grain size 13 nm from FESEM image also NiO micro used ,two NiO as an additive to evaluate the
possibility of producing photodegradable polymers, the practical application of solid-phase photocatalytic
degradation of polyvinyl chloride (PVC- NiO composite films) was investigated. PVC has a negative impact
on the environment since its polymer degrades slowly, yet it has a wide range of industrial applications and
the amount used shows no evidence of diminishing use. Thus, a synthesis of modified PVC- NiO micro and
nano has been studied with 0, 50, 100, 150, 200, 250, and 300 (hours) as irradiation time a

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Publication Date
Thu Jan 12 2023
Journal Name
Mathematics
Dynamical Behavior of a Cancer Growth Model with Chemotherapy and Boosting of the Immune System
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In this study, we set up and analyze a cancer growth model that integrates a chemotherapy drug with the impact of vitamins in boosting and strengthening the immune system. The aim of this study is to determine the minimal amount of treatment required to eliminate cancer, which will help to reduce harm to patients. It is assumed that vitamins come from organic foods and beverages. The chemotherapy drug is added to delay and eliminate tumor cell growth and division. To that end, we suggest the tumor-immune model, composed of the interaction of tumor and immune cells, which is composed of two ordinary differential equations. The model’s fundamental mathematical properties, such as positivity, boundedness, and equilibrium existence, are exami

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Publication Date
Sat Mar 01 2008
Journal Name
Al-khwarizmi Engineering Journal
The Effects of Vortex Generator Types on Heat Transfer and Flow Structure in a Rectangular Duct Flows
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    In this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Improved throughput of Elliptic Curve Digital Signature Algorithm (ECDSA) processor implementation over Koblitz curve k-163 on Field Programmable Gate Array (FPGA)
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            The widespread use of the Internet of things (IoT) in different aspects of an individual’s life like banking, wireless intelligent devices and smartphones has led to new security and performance challenges under restricted resources. The Elliptic Curve Digital Signature Algorithm (ECDSA) is the most suitable choice for the environments due to the smaller size of the encryption key and changeable security related parameters. However, major performance metrics such as area, power, latency and throughput are still customisable and based on the design requirements of the device.

The present paper puts forward an enhancement for the throughput performance metric by p

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Publication Date
Sat Jun 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Anodic Polarization of Mild Steel in Saturated C a(OH)2 Contaminated with NaCl in Presence of NaNO2
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The corrosion  behavior  of mild sleet  in saturated  aerated  and de-aerated  Ca(OH)2 solution  was  investigated  using electrochemical measurements. The work was carried out with small coupons immersed in solutions containing different quantities of NaCl in presence of various NaN02 concentrations as corrosion inhibitors. It has been found thal:(1 ) In presence  of NaCl,  the time required  to reach O2  evolution potential  in de-aerated  Ca(OH)2 polarized  at  10μA/cm 2 is function of inhibitor concentration and it becomes lass as NaN02 increases compared with zero presence indicating the effectiveness of N

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