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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 Mar 01 2023
Journal Name
Journal Of Engineering
Effect of a Parked Car Orientation on a Temperature Distribution and Cooling Load Calculation: Experimental Study
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When a vehicle is left parked in the sun for an extended period, the gathered heat causes damage to several interiors within the cabin and causes discomfort for people and animals left inside the car. In the present work, the effect of the orientation of a parked white minibus on temperature distribution and cooling load calculation is studied experimentally in an open environment. Two different cases were studied facing south and facing east. For several hours, the temperature inside the car cabin had been monitored and measured at five separate locations. The cooling load calculations are carried out based on the experimental measurements. The results show that the overheating of parked cars always happens as a result

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Publication Date
Fri Feb 23 2024
Journal Name
Mikrobiolohichnyi Zhurnal
Characterization of Integron Genes of Clinical Isolates of Pseudomonas aeruginosa which Perform Resistance to Antibiotics and Biofilm Formation by these Strains
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Pseudomonas aeruginosa is a bacterium that holds significant clinical and epidemiological significance. It serves as the principal etiological cause of opportunistic infections in individuals with impaired immune systems. Integrons are known to have a notable impact on Gram-negative bacteria, particularly in the context of P. aeruginosa, a bacterium recognized for its ability to develop resistance to antimicrobial drugs. Aim. To systematically characterize and detect integron genes (intI, intII, intIII) with antibiotic-resistant and biofilm-forming capabilities in isolated P. aeruginosa. Methods. A total of 209 samples were collected from Al Yarmouk Teaching Hospital in Baghdad City, Iraq to isolate P. aeruginosa. The process of

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Publication Date
Thu Feb 13 2020
Journal Name
International Journal Of Environmental Research
Synthesis of a Novel Composite Sorbent Coated with Siderite Nanoparticles and its Application for Remediation of Water Contaminated with Congo Red Dye
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Abstract

Re-use of the byproduct wastes resulting from different municipal and industrial activities in the reclamation of contaminated water is real application for green projects and sustainability concepts. In this direction, the synthesis of composite sorbent from the mixing of waterworks and sewage sludge coated with new nanoparticles named “siderite” (WSSS) is the novelty of this study. These particles can be precipitated from the iron(II) nitrate using waterworks sludge as alkaline agent and source of carbonate. Characterization tests using X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) mapping revealed that the coating process was c

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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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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
Thu Jan 01 2026
Journal Name
Open Veterinary Journal
Effect of intravaginal probiotics and enrofloxacin on vaginal microbiota, pH, vaginitis, and fertility in black Iraqi goats synchronized with progesterone impregnated sponges
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Background: The prolonged retention of progesterone-infused intravaginal sponges in estrous synchronization protocols, results in alteration of vaginal microflora, disturbance of vaginal pH, and increased vaginitis in goats. These changes lead to the growth of opportunistic pathogenic bacteria, such as Escherichia coli and Staphylococcus aureus, which need antibiotics to treat this condition. Probiotics have recently been suggested as an alternative method for the maintenance of vaginal health and improving animal fertility. Aim: To investigate the effects of probiotics (Lactobacillus plantarum and L. acidophilus), in compared with enrofloxacin and a control group, on vaginal microflora, vaginal pH, vaginitis incidence, and fertility in

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Publication Date
Sun Jun 01 2008
Journal Name
Baghdad Science Journal
Laboratory study on the effects of nutrient enrichment on a phytoplankton population in Sawa Lake, Iraq
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Nutrient enrichment of Sawa lake water was made using different nitrogen and phosphorus concentrations during autumn and spring at three stations. Different concentrations of nitrogen, phosphorus and N: P ratios were used to test variations in phytoplankton population dynamics. Nitrogen at a concentration of 25 µmole.l-1 and N: P ratio of 10:1 gave highest phytoplankton cell number at all stations and seasons. A total of 64 algal taxa dominated by Bacillariophyceae followed by Cyanophyceae and Chlorophyceae were identified. The values of Shannon index of diversity were more than one in the studied stations.

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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
Wed Nov 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Replacing Formalin with Alcohol and its Effect on Preserved Fish Specimens
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Abstract<p>This study aims to formulate an alternative solution for Formalin for preserving fish as study specimens for long periods. The main reason for finding a solution instead of formalin is to get rid of the negative effects of this solution on those who work with it, as well as to better preserve the bodies of fish. Hence, three new solutions were proposed to replace formalin. Thus, Formalin, in turn, may enter the composition of a small part of these solutions to give better results and for long periods of keeping specimens. All solutions prepared in this study participated in being acidic as in formalin. Two solutions succeeded in compensating for the use of formalin in preserving fish </p> ... Show More
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Publication Date
Sun Jun 01 2025
Journal Name
Chemical Engineering And Processing - Process Intensification
Wastewater treatment through a hybrid electrocoagulation and electro-Fenton process with a porous graphite air-diffusion cathode
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