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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
Wed Jan 25 2023
Journal Name
Molecular Simulation
Engineering promising A-π-D type molecules for efficient organic-based material solar cells
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Within this work, to promote the efficiency of organic-based solar cells, a series of novel A-π-D type small molecules were scrutinised. The acceptors which we designed had a moiety of N, N-dimethylaniline as the donor and catechol moiety as the acceptor linked through various conjugated π-linkers. We performed DFT (B3LYP) as well as TD-DFT (CAM-B3LYP) computations using 6-31G (d,p) for scrutinising the impact of various π-linkers upon optoelectronic characteristics, stability, and rate of charge transport. In comparison with the reference molecule, various π-linkers led to a smaller HOMO–LUMO energy gap. Compared to the reference molecule, there was a considerable red shift in the molecules under study (A1–A4). Therefore, based on

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Publication Date
Wed Jun 24 2026
Journal Name
Acta Scientiarum Polonorum Administratio Locorum
Reinvigorating cultural meaning through spatial experience: A triadic model for place-based architectural learning
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Historical cultural environments are a repository of values and symbols that pass down across generations through spatial experiences. Despite their intellectual and cultural potential, their role in fostering belonging and identity has declined; they are often viewed as silent landmarks, isolated from lived experiences. This highlights the need for an integrated model that makes spatial experience a stimulating process for reinvigorating the meaning inherent in historical contexts and reconnecting the new generation with their cultural roots. This research aims to explore how cultural meaning in historical contexts can be reactivated through spatial experience. To achieve this, the study proposes a triadic model – physical encoun

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
A Study of Apelin-36 and GST Levels with Their Relationship to Lipid and Other Biochemical Parameters in the Prediction of Heart Diseases in PCOS Women Patients
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This work studies the role of serum apelin-36 and Glutathione S-transferases (GST) activity in association with the hormonal, metabolic profiles and their link to the risk of cardiovascular disease (CVD) in healthy and patients' ladies with polycystic ovary syndrome (PCOS). A total of fifty-four (PCOS) patients and thirty-one healthy woman as a control have been studied. The PCOS patients were subdivided on the basis of body-mass-index (BMI), into 2-subgroups (the first group was obese-PCOS with BMI ≥ 30 and the second group was non-obese PCOS MBI<30). Fasting-insulin-levels and Lipid-profile, Homeostatic-model assessment-of-insulin-resistance (HOMA-IR), follicle-stimulating-hormone (FSH), luteinizing-hormone (LH), testosterone and

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
Evaluating the Effectiveness of Using the Kinesthetic Teaching Style by Basketball Instructors in Practical Lessons from the Students' Perspective
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Advancements and modernizations introduced into the educational and pedagogical systems have significantly impacted teaching processes and how subjects are presented and explained to students. The focus has shifted to how learners interact with the material they need to learn, providing sufficient opportunities for learning and granting them freedom and self-confidence to achieve learning objectives. The research problem stems from the researcher's experience as a lecturer in the College of Physical Education and Sports Science, particularly in teaching basketball. She observed that some instructors were deficient in using the most effective teaching methods. The researcher formulated her research question based on these observations: "What

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of an Educational Unit According To the Constructive Strategy in Developing Thinking Skills for Fifth Primary Students
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    The current phase distinguish by the rapid scientific development, which pushes individuals to have the necessities of scientific and practical life through the proper scientific thinking which contribute to the development of invention and creativity away from memorizing and indoctrination and encouraging individuals to looking for information and then attempting to process and develop these information instead of being a passive receiver. The investment of minds becomes the logical investment in all societies by preparing the citizen to become able to face life changes and its necessities. It is very important to take care of individuals and develop their mental abilities and thinking skills. The constructive strateg

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Women's Self-care Instructions concerning Wound, Perineal & Urinary System Care post cesarean section in Baghdad teaching hospital
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Aim: to determine the effectiveness of women's self-care instructions on their post cesarean section care in Baghdad
teaching hospital.
Methodology: The present study used quasi-experimental study design in maternity words in Baghdad teaching
hospital. The sample was collected and follow up for the period (15) January 2014 until 15 May 2014 Nonprobability
(purposive sample) of (100) women post cesarean section divided in to two groups (50) women post
cesarean section considered as a study group, and another (50) women post cesarean section considered as the
control one, A questionnaire designed as a tool to collect data fit the purpose of the study a questionnaire include
demographic variables, Reproductive variables

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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of the structural model of learning in the acquisition of geographical concepts among students of the first grade average)
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The current research aims to find out ( the effectiveness of the structural model of learning in the acquisition of geographical concepts at the first grade average students ) , and achieving the goals of research has been formulating the null hypothesis of the following :

    " There is no difference statistically significant when Mistoi (0.5 ) between the mean scores of the collection of students in the experimental group that is studying the general geographical principles " Bonmozj constructivist learning " and the mean scores of the control group , which is considering the same article ," the traditional way " to acquire concepts.

The researcher adopted th

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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
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
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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