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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 Sep 11 2022
Journal Name
Electronics
IoT-Based Motorbike Ambulance: Secure and Efficient Transportation
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The predilection for 5G telemedicine networks has piqued the interest of industry researchers and academics. The most significant barrier to global telemedicine adoption is to achieve a secure and efficient transport of patients, which has two critical responsibilities. The first is to get the patient to the nearest hospital as quickly as possible, and the second is to keep the connection secure while traveling to the hospital. As a result, a new network scheme has been suggested to expand the medical delivery system, which is an agile network scheme to securely redirect ambulance motorbikes to the nearest hospital in emergency cases. This research provides a secured and efficient telemedicine transport strategy compatible with the

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Publication Date
Sun Apr 30 2023
Journal Name
Al-kindy College Medical Journal
Circulating Interleukin-23 Levels in Rheumatoid Arthritis and its Relationship to Disease Activity: a Systematic Review with Meta-Analysis
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Background: Rheumatoid arthritis (RA) is a chronic and systemic autoimmune disease that is characterized by severe synovial inflammation, cartilage erosion, bone loss, and generalized vasculopathy. Although the immunologic mechanism of RA is still unclear, it is now thought to be a primarily Th17-driven disease. Along with other factors, IL-23 stimulates the expansion of Th17 cells from naive CD4+ T cells.

Objective: The objective of this study is to assess the circulating levels of interleukin (IL)-23 in rheumatoid arthritis (RA) and determine the correlation between plasma/serum IL-23 levels and disease activity. So, we performed a systematic review with meta-analysis comparing

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Publication Date
Mon Mar 23 2020
Journal Name
Journal Of Engineering
Experimental Investigation of Thermal Performance of a Solar Chimney Provided with a Porous Absorber Plate
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Experimental investigation of the influence of inserting the metal foam to the solar chimney to induce natural ventilation are described and analyzed in this work. To carry out the experimental test, two identical solar chimneys (without insertion of metal foam and with insertion of metal foam) are designed and placed facing south with dimensions of length× width× air gap (2 m× 1 m× 0.2 m). Four incline angles are tested (20o,30o,45o,60o) for each chimney in Baghdad climate condition (33.3o latitude, 44.4o longitude) on October, November, December 2018. The solar chimney performance is investigated by experimentally recording absorber pl

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Publication Date
Wed May 14 2025
Journal Name
Journal Of Applied Mathematics
Role of Wind and Fear on the Dynamic of a Prey and Two Competing Predators
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An essential tool for studying the web is its ability to show how energy moves through an ecosystem. Understanding and elucidating the relationship between species variety and their placement within the inclusive trophic dynamics is also beneficial. A food web ecological model with prey and two rival predators under fear and wind flow conditions is developed in this article. The boundedness and positivity of the system’s solution are established mathematically. The stability and existence constraints of the system’s equilibria are examined. The proposed system’s persistence limitations are established. Additionally, the bifurcation analysis of every potential equilibrium is examined using the Sotomayor theorem. To describe the

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Publication Date
Thu Dec 31 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
EVALUATING THE QUALITY OF IMPORTED AND LOCAL FLOUR IN TERMS OF QUALITY WITH IRON AND FOLIC ACID AND ITS COMPLIANCE WITH IRAQI STANDARD: EVALUATING THE QUALITY OF IMPORTED AND LOCAL FLOUR IN TERMS OF QUALITY WITH IRON AND FOLIC ACID AND ITS COMPLIANCE WITH IRAQI STANDARD
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Food fortification has an important and necessary role in compensating for the shortage of nutritional micronutrients, especially in developing and least developed countries. So, 12 samples of flour available in the local market, whether imported or locally produced flour, were obtained during 2019. The amount of base metal of the necessary iron element in the flour models studied which are available in local markets, measured by spot testing and was compared with the values ​​that should be added according to the specification Iraqi standard. Results revealed the qualitative evaluation of iron in locally produced flour does not conform to the Iraqi standard and is almost free of any reinforcement. While the percentage of imp

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Publication Date
Tue Jan 20 2026
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Effects of a Chelated Multi-Micronutrient Nanofertilizer on the Liver ofAlbino Rats: A Biochemical and Histopathological Assessment
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Nanofertilizers offer a promising solution to increase crop yields amid increasing population pressure. Yet  there have been safety concerns about their use, particularly in challenging conditions. This work was designed to assess the toxicological effects of a chelated multi-micronutrient nanofertilizer on albino rats (Rattus norvegicus) as non-target organisms, focusing on the liver, which has important metabolic functions. Thirty-five animals were weighed and randomly divided into 5 groups (n=7). A negative control group was included, and four experimental groups (C1-C4) were given the test item. The dosing regimen for the experimental groups was 15 oral doses of nanofertilizer every other day for 29 days. All the groups were

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Publication Date
Fri Jun 03 2022
Journal Name
Military Medical Science Letters
COVID-19 AMONG A SAMPLE OF IRAQI PATIENTS WITH RHEUMATIC DISEASES: A MULTICENTER STUDY
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Publication Date
Thu Jun 26 2014
Journal Name
Engineering Optimization
A new modified differential evolution algorithm scheme-based linear frequency modulation radar signal de-noising
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The main intention of this study was to investigate the development of a new optimization technique based on the differential evolution (DE) algorithm, for the purpose of linear frequency modulation radar signal de-noising. As the standard DE algorithm is a fixed length optimizer, it is not suitable for solving signal de-noising problems that call for variability. A modified crossover scheme called rand-length crossover was designed to fit the proposed variable-length DE, and the new DE algorithm is referred to as the random variable-length crossover differential evolution (rvlx-DE) algorithm. The measurement results demonstrate a highly efficient capability for target detection in terms of frequency response and peak forming that was isola

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Publication Date
Fri Dec 01 2017
Journal Name
2017 11th Asian Control Conference (ascc)
Super-twisting based integral sliding mode control applied to a rotary flexible joint robot manipulator
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In this paper, a single link flexible joint robot is used to evaluate a tracking trajectory control and vibration reduction by a super-twisting integral sliding mode (ST-ISMC). Normally, the system with joint flexibility has inevitably some uncertainties and external disturbances. In conventional sliding mode control, the robustness property is not guaranteed during the reaching phase. This disadvantage is addressed by applying ISMC that eliminates a reaching phase to ensure the robustness from the beginning of a process. To design this controller, the linear quadratic regulator (LQR) controller is first designed as the nominal control to decide a desired performance for both tracking and vibration responses. Subsequently, discontinuous con

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Publication Date
Mon Oct 01 2012
Journal Name
2012 Ieee International Conference On Circuits And Systems (iccas)
A survey of on-chip monitors
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Systems on Chips (SoCs) architecture complexity is result of integrating a large numbers of cores in a single chip. The approaches should address the systems particular challenges such as reliability, performance, and power constraints. Monitoring became a necessary part for testing, debugging and performance evaluations of SoCs at run time, as On-chip monitoring is employed to provide environmental information, such as temperature, voltage, and error data. Real-time system validation is done by exploiting the monitoring to determine the proper operation of a system within the designed parameters. The paper explains the common monitoring operations in SoCs, showing the functionality of thermal, voltage and soft error monitors. The different

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