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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
Sun Jun 01 2014
Journal Name
Journal Of Water Resource And Hydraulic Engineering (jwrhe)
Large Scale Field Physical Model Simulation of Roseires Dam-Break, Sudan
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Physically based modeling approach has been widely developed in recent years for the simulation of dam failure process due to the lack of field data. This paper provides and describes a physically-based model depending on dimensional analysis and hydraulic simulation methods for estimating the maximum water level and the wave propagation time from breaching of field test dams. The field physical model has been constructed in Dabbah city to represent the collapse of the Roseires dam in Sudan. Five cases of a dam failure were studied to simulate water flood conditions by changing initial water height in the reservoir (0.8, 1.0, 1.2, 1.4 and 1.5 m respectively).The physical model working under five cases, case 5 had the greatest influence of t

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Publication Date
Wed Dec 30 2009
Journal Name
Iraqi Journal Of Physics
Two-dimensional Crystallization of Silica nanospheres using Coplanar DC Electric field
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Two-dimensional crystal has been achieved and controlled
with the aid of DC electric field applied between two electrodes at 5
millimeters separating distance between them. Sol-gel method has
been used to prepared nanosilica particle which used in this work as
well as TiO2 nanopaowder. The assembly of the silica particles is
due to the interaction between the electrical force, the particles
dipole, and the interaction between the particles themselves. When a
DC voltage is applied, the particles accumulated and crystallized on
the surface between the electrodes. The Light diffraction
demonstrates that the hexagonal crystal is always oriented with one
axis along the direction of the field. The particles disass

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Publication Date
Tue Dec 01 2009
Journal Name
Iraqi Journal Of Physics
Two-dimensional Crystallization of Silica nanospheres using Coplanar DC Electric field
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Abstract:Two-dimensional crystal has been achieved and controlled with the aid of DC electric field applied between two electrodes at 5 millimeters separating distance between them. Sol-gel method has been used to prepared nanosilica particle which used in this work as well as TiO2 nanopaowder. The assembly of the silica particles is due to the interaction between the electrical force, the particles dipole, and the interaction between the particles themselves. When a DC voltage is applied, the particles accumulated and crystallized on the surface between the electrodes. The Light diffraction demonstrates that the hexagonal crystal is always oriented with one axis along the direction of the field. The particles disassemble when the field is

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Publication Date
Thu Jan 30 2020
Journal Name
Journal Of Engineering
The The Optimum Reservoir Performance of Nahr Umr/Ratawi Oil Field
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Reservoir study has been developed in order to get a full interesting of the Nahr Umr formation in Ratawi oil field. Oil in place has been calculated for Nahr Umr which was 2981.37 MM BBL. Several runs have been performed to get matching between measured and calculated of oil production data and well test pressure. In order to get the optimum performance of Nahr Umr many strategies have been proposed in this study where vertical and horizontal wells were involved in addition to different production rates. The reservoir was first assumed to be developed with vertical wells only using production rate of (80000–125000) STB/day. The reservoir is also proposed to produce using horizontal wells besides vertical wells with pr

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Publication Date
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Calculating heterogeneity of Majnoon Field/Hartha Reservoir using Lorenz Coefficient method
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Abstract<p>One of the principle concepts to understand any hydrocarbon field is the heterogeneity scale; This becomes particularly challenging in supergiant oil fields with medium to low lateral connectivity and carbonate reservoir rocks.</p><p>The main objectives of this study is to quantify the value of the heterogeneity for any well in question, and propagate it to the full reservoir. This is a quite useful specifically prior to conducting detailed water flooding or full field development studies and work, in order to be prepared for a proper design and exploitation requirements that fit with the level of heterogeneity of this formation.</p><jats></jats> ... Show More
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Publication Date
Tue Dec 01 2015
Journal Name
Journal Of Economics And Administrative Sciences
A Comparison Between Some Estimator Methods of Linear Regression Model With Auto-Correlated Errors With Application Data for the Wheat in Iraq
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This research a study model of linear regression problem of autocorrelation of random error is spread when a normal distribution as used in linear regression analysis for relationship between variables and through this relationship can predict the value of a variable with the values of other variables, and was comparing methods (method of least squares, method of the average un-weighted, Thiel method and Laplace method) using the mean square error (MSE) boxes and simulation and the study included fore sizes of samples (15, 30, 60, 100). The results showed that the least-squares method is best, applying the fore methods of buckwheat production data and the cultivated area of the provinces of Iraq for years (2010), (2011), (2012),

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Synthesis of Multifunctional Polymers Based on Tert-Butyl Acrylamide/Octyl Acrylate as Lubricant Additives and Adsorbents for Copper Ion from Aqueous Solution
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Two homopolymeric and three copolymeric additives for base oil were synthesized using octyl acrylate (OA) and tert-butyl acrylamide (TBA) monomers. The two additives named P1 and P2 are the homopolymers of TBA and OA, respectively, whereas copolymeric additives named Co1, Co2, and Co3 were synthesized by varying the ratios of TBA:OA as 1:3, 3:1 and 1:1, respectively. The prepared polymers were characterized by Fourier Transform Infrared (FTIR). Based on the solubility of synthesized polymers in base oil and reactivity ratios of TBA/OA copolymer (0.222, 0.434) calculated by Fineman-Ross method, P2, Co1, Co2 and Co3 were selected to evaluate their performance as pour point depressant (PPD), viscosity improver (VII), and anticorrosion addit

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Publication Date
Sat Feb 07 2026
Journal Name
Sensing And Imaging
Manufacturing and Improving Reduced Graphene Oxide (rGO) Membranes for Use as Highly Sensitive Humidity Sensors Based on the Mechanism of Proton Conductivity
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Publication Date
Thu Aug 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Study on Strength Behavior of Expansive Soil Stabilized with Dune Sand and Sodium Silicate
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Abstract<p>When designing structures constructed on soil that undergoes volumetric changes due to variations in its moisture content, the upward pressure exerted by the soil poses a risk to the safety of the facilities. A significant number of researchers are looking into solutions to either treat these soils or lessen the detrimental consequences they have. One treatment option involves stabilizing these soils by adding low-expansion soil or materials, which can impact their swell characteristics. This study aimed to investigate the effect that the addition of dune sand and sodium silicate material would have on the swellability and strength behaviour of swellable bentonite soil. Soil samples w</p> ... Show More
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Publication Date
Thu Nov 21 2019
Journal Name
Journal Of Engineering
Comparative Permeability Estimation Method and Identification of Rock Types using Cluster Analysis from Well Logs and Core Analysis Data in Tertiary Carbonate Reservoir-Khabaz Oil Field
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Characterization of the heterogonous reservoir is complex representation and evaluation of petrophysical properties and application of the relationships between porosity-permeability within the framework of hydraulic flow units is used to estimate permeability in un-cored wells. Techniques of flow unit or hydraulic flow unit (HFU) divided the reservoir into zones laterally and vertically which can be managed and control fluid flow within flow unit and considerably is entirely different with other flow units through reservoir. Each flow unit can be distinguished by applying the relationships of flow zone indicator (FZI) method. Supporting the relationship between porosity and permeability by using flow zone indictor is ca

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