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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 Oct 18 2022
Journal Name
Arab World English Journal For Translation & Literary Studiesissn: 2550-1542 |www.awej-tls.org17awej For Translation & Literary Studies,
The impact of landscape on the emotional shift in Tayo’s Character: A Study of memory and displacement in Leslie Marmon Silko’s Ceremony
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This paper examines the decolonizing methods used by Leslie Marmon Silko in her novel Ceremony (1977) to heal the indigenous people from the patriarchal traditions of the white hegemony. This study aims to emphasize the vulnerable responses of the Pueblo people to the memories of the clan and to highlight Silko’s methods to sustain the history and lifestyle of the indigenous people. Therefore, Silko’s novel can be situated historically and culturally within memory-studies. To analyze the contrasting behaviors of characters, this paper projects the relationship between the collective patriarchal doctrines and that of the individual within the framework of memory studies. Theories of Jan and Aleida Assmann are used here to explore the

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Publication Date
Sat Sep 21 2013
Journal Name
Nonlinear Dynamics
BER performance enhancement for secure wireless optical communication systems based on chaotic MIMO techniques
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Publication Date
Fri Sep 27 2024
Journal Name
Journal Of Applied Mathematics And Computational Mechanics
Fruit classification by assessing slice hardness based on RGB imaging. Case study: apple slices
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Correct grading of apple slices can help ensure quality and improve the marketability of the final product, which can impact the overall development of the apple slice industry post-harvest. The study intends to employ the convolutional neural network (CNN) architectures of ResNet-18 and DenseNet-201 and classical machine learning (ML) classifiers such as Wide Neural Networks (WNN), Naïve Bayes (NB), and two kernels of support vector machines (SVM) to classify apple slices into different hardness classes based on their RGB values. Our research data showed that the DenseNet-201 features classified by the SVM-Cubic kernel had the highest accuracy and lowest standard deviation (SD) among all the methods we tested, at 89.51 %  1.66 %. This

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Publication Date
Wed Jun 01 2022
Journal Name
Baghdad Science Journal
WOAIP: Wireless Optimization Algorithm for Indoor Placement Based on Binary Particle Swarm Optimization (BPSO)
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Optimizing the Access Point (AP) deployment has a great role in wireless applications due to the need for providing an efficient communication with low deployment costs. Quality of Service (QoS), is a major significant parameter and objective to be considered along with AP placement as well the overall deployment cost. This study proposes and investigates a multi-level optimization algorithm called Wireless Optimization Algorithm for Indoor Placement (WOAIP) based on Binary Particle Swarm Optimization (BPSO). WOAIP aims to obtain the optimum AP multi-floor placement with effective coverage that makes it more capable of supporting QoS and cost-effectiveness. Five pairs (coverage, AP deployment) of weights, signal thresholds and received s

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Publication Date
Fri Dec 01 2023
Journal Name
Iraqi Journal Of Physics
Gas Sensor for Hazardous Nitrogen Dioxide Based on TiO2 Nanotube Synthesis via Electrochemical Method
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Because of the quick growth of electrical instruments used in noxious gas detection, the importance of gas sensors has increased. X-ray diffraction (XRD) can be used to examine the crystal phase structure of sensing materials, which affects the properties of gas sensing. This contributes to the study of the effect of electrochemical synthesis of titanium dioxide (TiO2) materials with various crystal phase shapes, such as rutile TiO2 (R-TiO2NTs) and anatase TiO2 (A-TiO2NTs). In this work, we have studied the effect of voltage on preparing TiO2 nanotube arrays via the anodization technique for gas sensor applications. The results acquired from XRD, energy dispersion spectro

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Publication Date
Fri Dec 01 2023
Journal Name
Iraqi Journal Of Physics
Gas Sensor for Hazardous Nitrogen Dioxide Based on TiO2 Nanotube Synthesis via Electrochemical Method
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Because of the quick growth of electrical instruments used in noxious gas detection, the importance of gas sensors has increased. X-ray diffraction (XRD) can be used to examine the crystal phase structure of sensing materials, which affects the properties of gas sensing. This contributes to the study of the effect of electrochemical synthesis of titanium dioxide (TiO2) materials with various crystal phase shapes, such as rutile TiO2 (R-TiO2NTs) and anatase TiO2 (A-TiO2NTs). In this work, we have studied the effect of voltage on preparing TiO2 nanotube arrays via the anodization technique for gas sensor applications. The results acquired from XRD, energy dispersion spectroscopy (EDX), and field emission scanning electron microscopy

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Computational And Theoretical Nanoscience
Solution for Multi-Objective Optimisation Master Production Scheduling Problems Based on Swarm Intelligence Algorithms
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The emphasis of Master Production Scheduling (MPS) or tactic planning is on time and spatial disintegration of the cumulative planning targets and forecasts, along with the provision and forecast of the required resources. This procedure eventually becomes considerably difficult and slow as the number of resources, products and periods considered increases. A number of studies have been carried out to understand these impediments and formulate algorithms to optimise the production planning problem, or more specifically the master production scheduling (MPS) problem. These algorithms include an Evolutionary Algorithm called Genetic Algorithm, a Swarm Intelligence methodology called Gravitational Search Algorithm (GSA), Bat Algorithm (BAT), T

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Publication Date
Wed Sep 02 2020
Journal Name
Iraqi Journal Of Applied Physics
Heterojunction Solar Cell Based on Highly-Pure Nanopowders Prepared by DC Reactive Magnetron Sputtering
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In this work, a novel design for the NiO/TiO2 heterojunction solar cells is presented. Highly-pure nanopowders prepared by dc reactive magnetron sputtering technique were used to form the heterojunctions. The electrical characteristics of the proposed design were compared to those of a conventional thin film heterojunction design prepared by the same technique. A higher efficiency of 300% was achieved by the proposed design. This attempt can be considered as the first to fabricate solar cells from highly-pure nanopowders of two different semiconductors.

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Publication Date
Mon Jan 01 2024
Journal Name
Applied And Computational Mathematics
Reliable computational methods for solving Jeffery-Hamel flow problem based on polynomial function spaces
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Publication Date
Fri Dec 31 2021
Journal Name
International Journal Of Intelligent Engineering And Systems
Performance Analysis for Hybrid Massive MIMO FSO/RF Links Based on Efficient Channel Codes
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