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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
Tue Dec 01 2015
Journal Name
Solar Energy
A review of studies on using nanofluids in flat-plate solar collectors
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Continuous escalation of the cost of generating energy is preceded by the fact of scary depletion of the energy reserve of the fossil fuels and pollution of the environment as developed and developing countries burn these fuels. To meet the challenge of the impending energy crisis, renewable energy has been growing rapidly in the last decade. Among the renewable energy sources, solar energy is the most extensively available energy, has the least effect on the environment, and is very efficient in terms of energy conversion. Thus, solar energy has become one of the preferred sources of renewable energy. Flat-plate solar collectors are one of the extensively-used and well-known types of solar collectors. However, the effectiveness of the coll

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Publication Date
Mon Jan 01 2024
Journal Name
Open Engineering
Using ANN for well type identifying and increasing production from Sa’di formation of Halfaya oil field – Iraq
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Abstract<p>The current study focuses on utilizing artificial intelligence (AI) techniques to identify the optimal locations of production wells and types for achieving the production company’s primary objective, which is to increase oil production from the Sa’di carbonate reservoir of the Halfaya oil field in southeast Iraq, with the determination of the optimal scenario of various designs for production wells, which include vertical, horizontal, multi-horizontal, and fishbone lateral wells, for all reservoir production layers. Artificial neural network tool was used to identify the optimal locations for obtaining the highest production from the reservoir layers and the optimal well type. Fo</p> ... Show More
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Publication Date
Thu Feb 01 2024
Journal Name
Baghdad Science Journal
A New Green Approach of CFIA Technique for Direct Assay with a High Throughput of Sulfamethoxazole Drugs Using Condensation Reaction with NQS Agent
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A new design of manifold flow injection (FI) coupling with a merging zone technique was studied for sulfamethoxazole determination spectrophotometrically. The semiautomated FI method has many advantages such as being fast, simple, highly accurate, economical with high throughput . The suggested method based on the production of the orange- colored compound of SMZ with (NQS)1,2-Naphthoquinone-4-Sulphonic acid Sodium salt in alkaline media NaOH at λmax 496nm.The linearity range of sulfamethoxazole was  3-100  μg. mL-1, with (LOD) was 0.593 μg. mL-1 and the RSD% is about 1.25 and the recovery is 100.73%. All various physical and chemical parameters that have an effect on the stability and development of

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Publication Date
Thu Dec 28 2023
Journal Name
Journal Of Physical Education
Evaluating the academic achievement of graduate students working in the field of physical education from their point of view
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The research aimed to prepare a measure to evaluate the academic achievement of graduates working in the field of physical education from their point of view, to identify the extent to which graduating students benefit from the curriculum of the College of Physical Education and Sports Sciences, University of Baghdad/Al-Jadriya, and to identify the impact of academic subjects in the practical and theoretical fields. The researchers used the descriptive approach in the research procedures as it is an appropriate approach in achieving the research objectives. The following questions are: What are the academic subjects that have the most impact on graduating students? What are the academic subjects that have the least impact on the are

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Publication Date
Thu Dec 28 2023
Journal Name
Journal Of Physical Education
Evaluating the academic achievement of graduate students working in the field of physical education from their point of view
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The research aimed to prepare a measure to evaluate the academic achievement of graduates working in the field of physical education from their point of view, to identify the extent to which graduating students benefit from the curriculum of the College of Physical Education and Sports Sciences, University of Baghdad/Al-Jadriya, and to identify the impact of academic subjects in the practical and theoretical fields. The researchers used the descriptive approach in the research procedures as it is an appropriate approach in achieving the research objectives. The following questions are: What are the academic subjects that have the most impact on graduating students? What are the academic subjects that have the least impact on the are

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Possible role of Spironolactone in a sample of Iraqi patients with acute central serous chorioretinopathy: Spironolactone in acute csr
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Background: Central serous chorioretinopathy (CSCR) is an idiopathic condition aggravated by exogenous or endogenous glucocorticoids. Vascular deregulation in the choroid is a new hypothesis regarding central serous chorioretinopathy occurrence. The inhibition of choroidal mineralocorticoid receptors has a great role in shortening the duration of CSCR by inhibiting choroidal vasodilatation and leak.

Objective:  To assess the effect of oral spironolactone on subretinal fluid, central macular thickness and visual acuity in patients with acute CSCR compared to observation.

Subjects and Methods:  a hospital based, randomized clinical trial carried out at outpatient clinic in Ibn-Alhaitham Teaching E

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
Reaction of Thiols with formaldehyde in Presnce of succinimid and Reduction of Phenyl Tetrazole Derivative with Hydrogen and Borohydraide
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One of most the important compounds which have active hydrogen (substrate) is the thiols which used in a wide field in preparation of Mannich bases . A large number of Mannich bases have been prepared as a biologically active compound (pharmaceutical, pesticides, bactericidal, fungicidal and tuberculostatic) and in order to correlate their structure and reactivity with their pharmacological activity such as . It has been reported that the reaction is easily proceeded by using primary and secondary amine beside formaldehyde. But when we tried the reaction of thiols as substrate and formaldehyde and succinimide instead of amine, the reaction did not proceed to give Mannich base but product were methylenene – bis – sulfide . Mann

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Publication Date
Thu May 01 2014
Journal Name
European Journal Of Pharmacology
The effects of different doses of silibinin in combination with methotrexate on testicular tissue of mice
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Methotrexate (MTX) is widely used chemotherapeutic agent with different side effects including germ cells toxicities. Silibinin is one of the structural isomers of silymarin, with different phytotherapeutic applications, and its possible protective effects against MTX induced germ cells damage were investigated in this work. Twenty five male mice were divided into five groups (n=5) allocated as follows: Group 1 received buffer for five days given by single intraperitoneal (IP) injection per day; Group 2 in addition to buffer for five days, animals received at day five single dose of 20mg/kg of MTX IP. Groups (3, 4, and 5) received respectively, (50, 100, or 150mg/kg body weight) of silibinin IP single daily dose for five days then at day fi

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Publication Date
Wed Mar 20 2024
Journal Name
Journal Of Petroleum Research And Studies
Advanced Machine Learning application for Permeability Prediction for (M) Formation in an Iraqi Oil Field
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Permeability estimation is a vital step in reservoir engineering due to its effect on reservoir's characterization, planning for perforations, and economic efficiency of the reservoirs. The core and well-logging data are the main sources of permeability measuring and calculating respectively. There are multiple methods to predict permeability such as classic, empirical, and geostatistical methods. In this research, two statistical approaches have been applied and compared for permeability prediction: Multiple Linear Regression and Random Forest, given the (M) reservoir interval in the (BH) Oil Field in the northern part of Iraq. The dataset was separated into two subsets: Training and Testing in order to cross-validate the accuracy

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Publication Date
Fri Jan 31 2025
Journal Name
Iraqi Geological Journal
1D Geomechanical Modeling to Detect the Deformation in Mishrif Formation at Nasriyah Oil Field, Iraq
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Knowing the distribution of the mechanical rock properties and in-situ stresses for the field of interest is essential for many applications concerning reservoir geomechanics, including wellbore instability analysis, hydraulic fracturing, sand production, reservoir compaction, subsidence and water/gas injection throughout the filed life cycle. Determining the rock's mechanical properties is challenging because they cannot be directly measured at the borehole. The recovered carbonate core samples are limited and only provide discrete data for specific depths. This study focuses on creating a detailed 1D geomechanical model of the Mishrif reservoir in the Nasriyah oil field to identify the fault regime type for each unit in the format

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