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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 Mar 03 2022
Journal Name
Archives Of Rheumatology
Association of tumor necrosis factor-alpha promoter region gene polymorphism at positions -308G/A, -857C/T, and -863C/A with etanercept response in Iraqi rheumatoid arthritis patients
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Objectives: This study aims to evaluate the association between polymorphisms in the promoter region of the tumor necrosis factor-alpha (TNF-α) gene at locations -308G/A, -857C/T, and -863C/A with the tendency of being non-responder to etanercept.

Patients and methods: Between October 2020 and August 2021, a total of 80 patients (10 males, 70 females; mean age: 50 years; range, 30 to 72 years) with rheumatoid arthritis (RA) receiving etanercept for at least six months were included. The patients were divided into two groups responders and non-responders, based on their response after six months of continuous treatment. Following polymerase chain reac

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Publication Date
Wed Apr 19 2023
Journal Name
Lasers In Medical Science
Immunohistochemistry technique for effect of gold nanoparticles, laser, and photodynamic therapy on FoxP1 level in infected mice with mammary adenocarcinoma
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Publication Date
Wed Jun 29 2022
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECT OF OZONE ENRICHMENT AND SPRAYING WITH ORGANIC NUTRIENT ON NUTRIENT AND WATER USE EFFICIENCY AND FERTILIZER PRODUCTIVITY OF BROCCOLI PLANT CULTIVATED HYDROPONICALLY WITH MODIFIED NFT TECHNOLOGY.
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This study was carried out at University of Baghdad - College of Agricultural Engineering Sciences - research station B during the fall season of 2019-2020, in order to evaluate the effect of Ozone enrichment and the foliar application of organic nutrient  on nutrient and water use efficiency and fertilizer productivity of broccoli plant using the modified NFT film technology. A factorial experiment (2*5) was carried out within Nested Design with three replicates. The ozone treatment was distributed into the main plots which consisted of oxygen (O2) and ozone (O3). The foliar application of organic nutrients were distributed randomly within each replicate including five treatments, which were the control treatment (T0), Coconut wat

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Publication Date
Fri Apr 29 2022
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECT OF OZONE ENRICHMENT AND SPRAYING WITH COCONUT WATER AND MORINGA EXTRACT ON VEGETATIVE GROWTH AND YIELD OF BROCCOLI PLANT UNDER HYDROPONIC SYSTEM WITH MODIFIED NFT TECHNOLOGY
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This study was carried out at University of Baghdad - College of Agricultural Engineering Sciences - Research Station B during the autumn season 2019-2020, in order to evaluate the effect of Ozone and the foliar application of coconut water and moringa extract on the growth of broccoli plant grown in modified NFT film technology. A factorial experiment (2*5) was carried out within Nested Design with three replicates. The ozone treatment was distributed into the main plots which consisted of oxygen (O2) and ozone (O3). The foliar application of organic nutrients were distributed randomly within each replicate including five treatments, which were the control treatment (T0), Coconut water with two concentrations of 50 (T1) and 100 ml.

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Publication Date
Tue Oct 01 2019
Journal Name
Ieee Xplore
The Internet of Everything Based Smart Systems: Applications and Challenges
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Smart systems are the trend for modern organizations and should meet the quality of services that expect to produce. Internet of Everything (IoE) helped smart systems to adopt microcontrollers for improving the performance. Analyzing and controlling data in such a system are critical issues. In this study, a survey of IoE systems conducted to show how to apply a suitable model that meets such system requirements. The analysis of some microcontroller boards is explored based on known features. Factors for applying IoE devices have been defined such as connectivity, power consumption, compatibility, and cost. Different methods have been explained as an overview of applying IoE systems. Further, different approaches for applying IoE technology

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Publication Date
Tue Dec 01 2020
Journal Name
Journal Of Engineering
Simulation and Analysis of the OFDM Transceiver Based Commutation System
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As a result of the increase in wireless applications, this led to a spectrum problem, which was often a significant restriction. However, a wide bandwidth (more than two-thirds of the available) remains wasted due to inappropriate usage. As a consequence, the quality of the service of the system was impacted. This problem was resolved by using cognitive radio that provides opportunistic sharing or utilization of the spectrum. This paper analyzes the performance of the cognitive radio spectrum sensing algorithm for the energy detector, which implemented by using a MATLAB Mfile version (2018b). The signal to noise ratio SNR vs. Pd probability of detection for OFDM and SNR vs. BER with CP cyclic prefix with energy dete

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Publication Date
Thu Apr 18 2013
Journal Name
International Journal Of Computer Applications
Design and Simulation of Hartley based Multi Orthogonal Band OFDM
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Recent advances in wireless communication systems have made use of OFDM technique to achieve high data rate transmission. The sensitivity to frequency offset between the carrier frequencies of the transmitter and the receiver is one of the major problems in OFDM systems. This frequency offset introduces inter-carrier interference in the OFDM symbol and then the BER performance reduced. In this paper a Multi-Orthogonal-Band MOB-OFDM system based on the Discrete Hartley Transform (DHT) is proposed to improve the BER performance. The OFDM spectrum is divided into equal sub-bands and the data is divided between these bands to form a local OFDM symbol in each sub-band using DHT. The global OFDM symbol is formed from all sub-bands together using

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Publication Date
Sun Jun 02 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Preparation and Evaluation of Solid Dispersion-Based Bilastine Effervescent Granules
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Background: Bilastine (BLA) is a second-generation H1 antihistamine used to treat allergic rhinoconjunctivitis. Because of its limited solubility, it falls under class II of the Biopharmaceutics Classification System (BSC). The solid dispersion (SD) approach significantly improves the solubility and dissolution rate of insoluble medicines. Objective: To improve BLA solubility and dissolution rate by formulating a solid dispersion in the form of effervescent granules. Methods: To create BLA SDs, polyvinylpyrrolidone (PVP K30) and poloxamer 188 (PLX188) were mixed in various ratios (1:5, 1:10, and 1:15) using the kneading technique. All formulations were evaluated based on percent yield, drug content, and saturation solubility. The fo

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Publication Date
Tue Dec 29 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Electronic Payment System and its impact on the efficiency of the performance of banking: An applied research on a sample of banking sector in Iraq
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The electronic payment systems are considered the most important infrastructure for the work of banks, particularly after a steady and remarkable development in information and communication technology, Which created the reality of the work of the infrastructure for these systems and these systems also become one of the most important components of infrastructure for the work of banks, cause it is one of the most important channels through which the transfer of cash, financial instruments between financial institutions in general and banking in particular.

     In order to achieve the objectives of the research, the most important to identify the concept of electronic payment systems, and its divisions, and th

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Publication Date
Sat Sep 02 2017
Journal Name
Al-khwarizmi Engineering Journal (alkej)
Augmentation of Nanofluids Heat transfer in a Circular Tube with Baffled Winged Twisted Swirl Generator
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