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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
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
Study on the effect of methotraxate drug on Retinol-Binding Protein 4 (RBP4), nesfatin and some trace elements in Iraqi male patients with rheumatoid arthritis
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Methotrexate (MTX) is one of the most effective medications to treat rheumatoid arthritis (RA).Aserum of 60 Iraqi male patients suffering from RA as (G1) was newly diagnosis and the same patient in G1 after taking MTX as G2 and 40 Iraqi male healthy control as G3. Nesfatin-1 (Nf-1) is belong to the adipokine family withpleiotropic effect. Nf-1 has been found in different tissues, including stomach, pancreas, bone cells, cartilage and heart. Retinol binding protein (RBP4) was known as transpoter of retinol from its storage sites in the liver to the extrahepatic tissues. Moreover, RBP4 acts as adipokine and contributes in the pathophsyology of prototypic inflammatory disease, rheumatoid arthritis (RA). The results showed a significant increas

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Publication Date
Wed Feb 01 2023
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Bitcoin Prediction with a hybrid model
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In recent years, Bitcoin has become the most widely used blockchain platform in business and finance. The goal of this work is to find a viable prediction model that incorporates and perhaps improves on a combination of available models. Among the techniques utilized in this paper are exponential smoothing, ARIMA, artificial neural networks (ANNs) models, and prediction combination models. The study's most obvious discovery is that artificial intelligence models improve the results of compound prediction models. The second key discovery was that a strong combination forecasting model that responds to the multiple fluctuations that occur in the bitcoin time series and Error improvement should be used. Based on the results, the prediction acc

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Publication Date
Wed Jun 01 2022
Journal Name
Baghdad Science Journal
A Tile with Nested Chain Abacus
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This study had succeeded in producing a new graphical representation of James abacus called nested chain abacus. Nested chain abacus provides a unique mathematical expression to encode each tile (image) using a partition theory where each form or shape of tile will be associated with exactly one partition.Furthermore, an algorithm of nested chain abacus movement will be constructed, which can be applied in tiling theory.

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Publication Date
Tue Feb 28 2023
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Bitcoin Prediction with a hybrid model
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. In recent years, Bitcoin has become the most widely used blockchain platform in business and finance. The goal of this work is to find a viable prediction model that incorporates and perhaps improves on a combination of available models. Among the techniques utilized in this paper are exponential smoothing, ARIMA, artificial neural networks (ANNs) models, and prediction combination models. The study's most obvious discovery is that artificial intelligence models improve the results of compound prediction models. The second key discovery was that a strong combination forecasting model that responds to the multiple fluctuations that occur in the bitcoin time series and Error improvement should be used. Based on the results, the prediction a

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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
Thu Aug 17 2017
Journal Name
Journal Of Health, Medicine And Nursing
Adherence to Guidelines of Secondary Prevention in patients with Ischemic Heart Disease in a Tertiary Cardiac Center
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Coronary heart disease (CHD) is the leading cause of death in United State (U.S.). Controlling of modifiable risk factors such as smoking, hypertension (HT), diabetes mellitus (D.M.), dyslipidemia, physical inactivity & obesity will prevent other serious cardiovascular complications

Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Determination of Nickel and Cobalt in Cosmetic Products Marketed in Iraq Using Spectrophotometric and Microfluidic Paper-based Analytical Device (µPADs) Platform
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Two quantitative, environment-friendly and easily monitored assays for Ni (II) and Co (III) ions analysis in different lipstick samples collected from 500-Iraqi dinars stores located in Baghdad were introduced. The study was based on the reaction of nickel (II) ions with dimethylglyoxime (DMG) reagent and the reaction of cobalt (III) ions with 1-nitroso-2-naphthol (NN) reagent to produce colored products. The color change was measured by spectrophotometric method at 565 nm and 430 nm for Ni and Co, respectively, with linear calibration graphs in the concentration range 0.25-100 mg L-1 (Ni) and 0.5-100 mg L-1 (Co) and LOD and LOQ of 0.11 mg L-1 and 0.36 mg L-1 (Ni), and 0.15 mg L-1 an

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Publication Date
Fri Mar 30 2012
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Numerical Analysis of Laminar Natural Convection in Square Enclosure with and without Partitions and Study Effect of pPartition on the Flow Pattern and Heat Transfer
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The problem of steady, laminar, natural convective flow in an square enclosure with and without partitions is considered for Rayleigh number (103-106) and Prandtl number (0.7). Vertical walls were maintained isothermal at different temperatures while horizontal walls and the partitions were insulated. The length of partition was taken constant. The number of partitions were placed on horizontal surface in staggered arrangement from (1– 3) and ratio of partition thickness (H/L= 0.033, 0.083, 0.124). The problem is formulated in terms of the vorticity-stream function procedure. A numerical solution based on a program in Fortran 90 with the finite difference method is obtained. Representative results illustrating the effects of the thickn

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Publication Date
Wed Dec 14 2022
Journal Name
Journal Of Optical Communications
Deployment of multiservice code in FSO-based hybrid subcarrier system
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Abstract<p>This research aims to investigate and improve multi-user free space optic systems (FSO) based on a hybrid subcarrier multiplexing spectral amplitude coding-optical code division multiple access (SCM-SAC-OCDMA) technique using MS code with a direct decoding technique. The performance is observed under different weather conditions including clear, rain, and haze conditions. The investigation includes analyzing the proposed system mathematically using MATLAB and OptiSystem software. The simulation is carried out using a laser diode. Furthermore, the performances of the MS code in terms of angles of bit rate, beam divergence and noise are evaluated based on bit error rate (BER), received </p> ... Show More
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Publication Date
Fri Nov 01 2019
Journal Name
Civil Engineering Journal
Time-Cost-Quality Trade-off Model for Optimal Pile Type Selection Using Discrete Particle Swarm Optimization Algorithm
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The cost of pile foundations is part of the super structure cost, and it became necessary to reduce this cost by studying the pile types then decision-making in the selection of the optimal pile type in terms of cost and time of production and quality .So The main objective of this study is to solve the time–cost–quality trade-off (TCQT) problem by finding an optimal pile type with the target of "minimizing" cost and time while "maximizing" quality. There are many types In the world of piles but  in this paper, the researcher proposed five pile types, one of them is not a traditional, and   developed a model for the problem and then employed particle swarm optimization (PSO) algorithm, as one of evolutionary algorithms with t

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