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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
Fri Jul 01 2016
Journal Name
International Journal Of Modern Trends In Engineering And Research (ijmter)
An image processing oriented optical mark reader based on modify multi-connect architecture (MMCA)
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Optical Mark Recognition (OMR) is the technology of electronically extracting intended data from marked fields, such as squareand bubbles fields, on printed forms. OMR technology is particularly useful for applications in which large numbers of hand-filled forms need to be processed quickly and with a great degree of accuracy. The technique is particularly popular with schools and universities for the reading in of multiple choice exam papers. This paper proposed OMRbased on Modify Multi-Connect Architecture (MMCA) associative memory, its work in two phases: training phase and recognition phase. The proposed method was also able to detect more than one or no selected choice. Among 800 test samples with 8 types of grid answer sheets and tota

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Publication Date
Sun Jun 12 2011
Journal Name
Baghdad Science Journal
An algorithm for binary codebook design based on the average bitmap replacement error (ABPRE)
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In this paper, an algorithm for binary codebook design has been used in vector quantization technique, which is used to improve the acceptability of the absolute moment block truncation coding (AMBTC) method. Vector quantization (VQ) method is used to compress the bitmap (the output proposed from the first method (AMBTC)). In this paper, the binary codebook can be engender for many images depending on randomly chosen to the code vectors from a set of binary images vectors, and this codebook is then used to compress all bitmaps of these images. The chosen of the bitmap of image in order to compress it by using this codebook based on the criterion of the average bitmap replacement error (ABPRE). This paper is suitable to reduce bit rates

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Publication Date
Fri Sep 01 2023
Journal Name
Al-khwarizmi Engineering Journal
High Transaction Rates Performance Evaluation for Secure E-government Based on Private Blockchain Scheme
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The implementation of technology in the provision of public services and communication to citizens, which is commonly referred to as e-government, has brought multitude of benefits, including enhanced efficiency, accessibility, and transparency. Nevertheless, this approach also presents particular security concerns, such as cyber threats, data breaches, and access control. One technology that can aid in mitigating the effects of security vulnerabilities within e-government is permissioned blockchain. This work examines the performance of the hyperledger fabric private blockchain under high transaction loads by analyzing two scenarios that involve six organizations as case studies. Several parameters, such as transaction send ra

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Publication Date
Wed Apr 01 2020
Journal Name
Plant Archives
Land cover change detection using satellite images based on modified spectral angle mapper method
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This research depends on the relationship between the reflected spectrum, the nature of each target, area and the percentage of its presence with other targets in the unity of the target area. The changes occur in Land cover have been detected for different years using satellite images based on the Modified Spectral Angle Mapper (MSAM) processing, where Landsat satellite images are utilized using two software programming (MATLAB 7.11 and ERDAS imagine 2014). The proposed supervised classification method (MSAM) using a MATLAB program with supervised classification method (Maximum likelihood Classifier) by ERDAS imagine have been used to get farthest precise results and detect environmental changes for periods. Despite using two classificatio

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Publication Date
Fri Jul 19 2024
Journal Name
An International Journal Of Optimization And Control: Theories &amp; Applications (ijocta)
Design optimal neural network based on new LM training algorithm for solving 3D - PDEs
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In this article, we design an optimal neural network based on new LM training algorithm. The traditional algorithm of LM required high memory, storage and computational overhead because of it required the updated of Hessian approximations in each iteration. The suggested design implemented to converts the original problem into a minimization problem using feed forward type to solve non-linear 3D - PDEs. Also, optimal design is obtained by computing the parameters of learning with highly precise. Examples are provided to portray the efficiency and applicability of this technique. Comparisons with other designs are also conducted to demonstrate the accuracy of the proposed design.

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Publication Date
Mon Oct 02 2023
Journal Name
Journal Of Engineering
Microgrid Integration Based on Deep Learning NARMA-L2 Controller for Maximum Power Point Tracking
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This paper presents a hybrid energy resources (HER) system consisting of solar PV, storage, and utility grid. It is a challenge in real time to extract maximum power point (MPP) from the PV solar under variations of the irradiance strength.  This work addresses challenges in identifying global MPP, dynamic algorithm behavior, tracking speed, adaptability to changing conditions, and accuracy. Shallow Neural Networks using the deep learning NARMA-L2 controller have been proposed. It is modeled to predict the reference voltage under different irradiance. The dynamic PV solar and nonlinearity have been trained to track the maximum power drawn from the PV solar systems in real time.

Moreover, the proposed controller i

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Evaluation of the Intrinsic Pathway of Coagulation in a Sample of Iraqi Patients with Acute Myocardial Infarction
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Background: Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients. Increased plasma hemostatic markers were noted in acute myocardial infarction, indicating that the blood coagulation system is highly activated in those patients. Aims of the study: To study the level of intrinsic coagulation factors including (FVIII:C, FIX:C ,FXI:C ,FXII:C ) in patients with acute myocardial infarction. Type of the study: Cross –sectional study. Methods: Thirty patients (their age range is 48-68 years) were included in this study (9 female, 21 male) who were just admitted to the coronary care unit in AL-Yarmouk Teaching Hospital and diagnosed as having acute myocardial infarction patients, blood samples were tak

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Publication Date
Mon Jan 01 2024
Journal Name
Computers, Materials &amp; Continua
Improving Video Watermarking through Galois Field &lt;i&gt;GF&lt;/i&gt;(2&lt;sup&gt;4&lt;/sup&gt;) Multiplication Tables with Diverse Irreducible Polynomials and Adaptive Techniques
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Publication Date
Thu Jul 02 2020
Journal Name
Jasep المجلة العربية للعلوم التربوية والنفسية
Critical Thinking-Based Learning: Developments, Trends, and Values
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In recent years, English language teaching and second language acquisition has demonstrated a significant accentuation upon basic reasoning abilities improvement in the language capability advancement. Encouraging a point of view of duty to training basic intuition aptitudes in accordance with the English language courses, this paper gives an account of an investigation directed at theoretical meanings of basic deduction, drifts about the centrality of basic speculation for language educating and associations between critical thinking and language learning. The educators have the focal pretended by basic intuition in successful language teaching method, identified to Ennis’ (2011) critical thinking categories. The skill of thinking critic

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
COMPUTER-BASED ECG SIGNAL ANALYSIS AND MONITORING SYSTEM
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This paper deals with the design and implementation of an ECG system. The proposed system gives a new concept of ECG signal manipulation, storing, and editing. It consists mainly of hardware circuits and the related software. The hardware includes the circuits of ECG signals capturing, and system interfaces. The software is written using Visual Basic languages, to perform the task of identification of the ECG signal. The main advantage of the system is to provide a reported ECG recording on a personal computer, so that it can be stored and processed at any time as required. This system was tested for different ECG signals, some of them are abnormal and the other is normal, and the results show that the system has a good quality of diagno

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