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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
Fri Dec 31 2021
Journal Name
Iraqi Geological Journal
Development of 1D-Synthetic Geomechanical Well Logs for Applications Related to Reservoir Geomechanics in Buzurgan Oil Field
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Knowledge of the distribution of the rock mechanical properties along the depth of the wells is an important task for many applications related to reservoir geomechanics. Such these applications are wellbore stability analysis, hydraulic fracturing, reservoir compaction and subsidence, sand production, and fault reactivation. A major challenge with determining the rock mechanical properties is that they are not directly measured at the wellbore. They can be only sampled at well location using rock testing. Furthermore, the core analysis provides discrete data measurements for specific depth as well as it is often available only for a few wells in a field of interest. This study presents a methodology to generate synthetic-geomechani

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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Geological Journal
Biostratigraphy of the Late Cretaceous-Early Paleocene Succession in Selected Wells, Jambur Oil field, Kirkuk, Northern Iraq
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The Late Cretaceous-Early Paleocene Shiranish and Aliji formations have been studied in three selected wells in Jambur Oil Field (Ja-50, Ja-53, and Ja-67) in Kirkuk, Northeastern Iraq. This study included lithostratigraphy and biostratigraphy. The Late Campanian-Maastrichtian Shiranish Formation consist mainly of thin marly and chalky limestone beds overlain by thin marl beds, with some beds of marly limestone representing an outer shelf basinal environment, the unconformable contact with the above Middle Paleocene-Early Eocene Aliji Formation contain layers of limestone with marly limestone and chalky limestone which represents an outer shelf basinal environment. Five Biozones in the Shiranish Formation were determined which are: 1

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Publication Date
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Using Artificial Neural Network to Predict Rate of Penetration from Dynamic Elastic Properties in Nasiriya Oil Field
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   The time spent in drilling ahead is usually a significant portion of total well cost. Drilling is an expensive operation including the cost of equipment and material used during the penetration of rock plus crew efforts in order to finish the well without serious problems. Knowing the rate of penetration should help in speculation of the cost and lead to optimize drilling outgoings. Ten wells in the Nasiriya oil field have been selected based on the availability of the data. Dynamic elastic properties of Mishrif formation in the selected wells were determined by using Interactive Petrophysics (IP V3.5) software based on the las files and log record provided. The average rate of penetration and average dynamic elastic propert

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Publication Date
Sat Jun 01 2024
Journal Name
Applied Thermal Engineering
Design and optimization of a household photovoltaic/thermal collector with serpentine tube: Energy and exergy analysis
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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
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Study of different geostatistical methods to model formation porosity (Cast study of Zubair formation in Luhais oil field)
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Abstract<p>This study is concerned with making comparison in using different geostatistical methods for porosity distribution of upper shale member - Zubair formation in Luhais oil field which was chosen to study.</p><p>Kriging, Gaussian random function simulation and sequential Gaussian simulation geostatistical methods were adopted in this study. After preparing all needed data which are contour map, well heads of 12 wells, well tops and porosity from CPI log. Petrel software 2009 was used for porosity distribution of mentioned formation in methods that are showed above. Comparisons were made among these three methods in order to choose the best one, the comparing cri</p> ... Show More
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Publication Date
Tue Jul 30 2024
Journal Name
Iraqi Journal Of Science
A Survey on Image Caption Generation in Various Languages
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      The image caption is the process of adding an explicit, coherent description to the contents of the image. This is done by using the latest deep learning techniques, which include computer vision and natural language processing, to understand the contents of the image and give it an appropriate caption. Multiple datasets suitable for many applications have been proposed. The biggest challenge for researchers with natural language processing is that the datasets are incompatible with all languages. The researchers worked on translating the most famous English data sets with Google Translate to understand the content of the images in their mother tongue. In this paper, the proposed review aims to enhance the understanding o

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Publication Date
Tue Jun 23 2015
Journal Name
Journal Of Intelligent &amp; Fuzzy Systems
A note on “separation axioms in fuzzy bitopological spaces”
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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
A Scoping Study on Lightweight Cryptography Reviews in IoT
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The efforts in designing and developing lightweight cryptography (LWC) started a decade ago. Many scholarly studies in literature report the enhancement of conventional cryptographic algorithms and the development of new algorithms. This significant number of studies resulted in the rise of many review studies on LWC in IoT. Due to the vast number of review studies on LWC in IoT, it is not known what the studies cover and how extensive the review studies are. Therefore, this article aimed to bridge the gap in the review studies by conducting a systematic scoping study. It analyzed the existing review articles on LWC in IoT to discover the extensiveness of the reviews and the topics covered. The results of the study suggested that many re

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of accounting disclosure in granting bank financing A field study ona sample of banks operating in the state of Gezira 2022 AD: (دراسة ميدانية على عينة من المصارف العاملة في ولاية الجزيرة 2022م)
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                 The aim of the research is to identify the adequacy of accounting disclosure in granting bank financing in explaining the role of accounting disclosure in granting bank financing by linking the concepts of full, comprehensive and adequate disclosure to bank financing. The impact of full accounting disclosure on granting bank financing, the existence of an impact of comprehensive accounting disclosure on granting bank financing, the existence of an impact of adequate accounting disclosure on granting bank financing, and the research relied on the descriptive approach, the deductive and inductive approach, the inferential analytical approach, a

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