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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
Mon Jan 01 2024
Journal Name
Studies In Systems, Decision And Control
The Effect of Using an Accounting Information System Based on Artificial Intelligence in Detecting Earnings Management to Enhance the Sustainability of Economic Units
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This research aims to clarify the importance of an accounting information system that uses artificial intelligence to detect earnings manipulation. The research problem stems from the widespread manipulation of earning in economic entities, especially at the local level, exacerbated by the high financial and administrative corruption rates in Iraq due to fraudulent accounting practices. Since earning manipulation involves intentional fraudulent acts, it is necessary to implement preventive measures to detect and deter such practices. The main hypothesis of the research assumes that an accounting information system based on artificial intelligence cannot effectively detect the manipulation of profits in Iraqi economic entities. The researche

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Publication Date
Sat Oct 25 2025
Journal Name
Iet Networks
An Effective Technique of Zero‐Day Attack Detection in the Internet of Things Network Based on the Conventional Spike Neural Network Learning Method
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ABSTRACT<p>The fast evolution of cyberattacks in the Internet of Things (IoT) area, presents new security challenges concerning Zero Day (ZD) attacks, due to the growth of both numbers and the diversity of new cyberattacks. Furthermore, Intrusion Detection System (IDSs) relying on a dataset of historical or signature‐based datasets often perform poorly in ZD detection. A new technique for detecting zero‐day (ZD) attacks in IoT‐based Conventional Spiking Neural Networks (CSNN), termed ZD‐CSNN, is proposed. The model comprises three key levels: (1) Data Pre‐processing, in this level a thorough cleaning process is applied to the CIC IoT Dataset 2023, which contains both malicious and t</p> ... Show More
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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
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education Program for Type 2 Diabetes Mellitus Patient's Self-efficacy toward Managing Feet at Endocrinology and Diabetes Center in Al-Rusafa Sector
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Objective(s): to assess the effectiveness of educational program on improving diabetic foot self-efficacy concerning managing their feet. Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Diabetic and Endocrinology Center in Baghdad- Rusafa Sector from 2nd of May 2017, to27th June 2018. Non-probability sample of (80) male and female diabetic patients were selected. The study instruments consisted of two major parts: first

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Publication Date
Tue Aug 22 2023
Journal Name
Microbial Science Archives
Unveiling Westiellopsis akinetica: a novel species in the Iraqi habitat, and contrasting its distinctive attributes with Westiellopsis prolifica
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This is the first record of a new species of cyanobacteria Westiellopsis akinetica in the Iraqi environment, Samples were collected on June 2013 and the existence of it was not documented before. We isolated and purified this species ten years ago in Iraq, but we couldn't identify accurately based on all taxonomic handbooks. This is due to the species features being different from the other documented species in the available taxonomic lectures. It resembled many species by morphological characteristics such as Fischerella muscicola, Fischerella thermalis, Westiellopsis biateralis SA16. Westiellopsis interrupta, Westiellopsis persica SA33, Westiellopsis prolifica and Symphyonema bifilamentata. Describing a new species of the Westiellops

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Basic Education
Beta-2-Microglobulin as a Biomarker in Iraqi Female Patients with Autoimmune Thyroid and Renal Autoimmune Thyroid Diseases
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The present study was performed on 80 female subjects between (30-60) years, who attended the Specialized Center for Endocrinology and Diabetes during the period from April to July; 2011. The subjects were divided into 3 groups : controls , non diabetic autoimmune thyroid patients , and non diabetic autoimmune thyroid patient with renal diseases as complication The results showed a significant increase in serum T 3 T4 levels in hyperthyroidism patients, and significant decrease in serum T3,T4 levels in hypothyroidism patients ,while a significant difference in serum TSH levels in hyperthyroidism and hypothyroidism patients when compared to control group The results show also a significant increase in serum antibodies to thyroid peroxidas

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Publication Date
Wed Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Adherence and Beliefs to Adjuvant Hormonal Therapy in Patients with Breast Cancer: A Cross-Sectional Study (Conference Paper) #
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  Breast cancer is the most common cancer among women over the world. To reducing reoccurrence and mortality rates, adjuvant hormonal therapy (AHT) is used for a long period. The major barrier to the effectiveness of the treatment is adherence. Adherence to medicines among patients is challenging. Patient beliefs in medications can be positively or negatively correlated to adherence. Objectives: To investigate the extent of adherence and factors affecting adherence, as well as to investigate the association between beliefs and adherence in women with breast cancer taking AHT. Method: A cross-sectional study included 124 Iraqi women with breast cancer recruited from Middle Euphrates

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Publication Date
Sat Sep 23 2023
Journal Name
Journal Of Cardiovascular And Thoracic Research
Plasminogen activator urokinase receptor as a diagnostic and prognostic biomarker in type 2 diabetic patients with cardiovascular disease
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Introduction: Cardiovascular diseases are the main cause of death among type 2 diabetic patients. Higher levels of plasminogen activator urokinase receptor have been found to predict morbidity and mortality across acute and chronic diseases in the common populace. This study aims to explore the role of serum plasminogen activator urokinase receptor levels as a cardiometabolic risk factor among type 2 diabetic Iraqi patients. Methods: Seventy type 2 diabetic patients (40 male and 30 female) (mean age: 46.20±7.56 years) participated in this study; 35 patients were with cardiovascular disease and 35 were without cardiovascular disease; their ages range was 40-55 years. In addition, 30 individuals who apparently healthy were selected a

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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
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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