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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
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
A New Measurement Scale for Evaluating Health-Related Quality of Life in Men with Prostate Cancer
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Objectives: This study aimed to identify and study most properties of the specific and general health-related
quality-of-life (HRQoL) in prostate cancer patients, as well as creating a new measurement scale for assessing QoL
among prostate cancer patients.
Methodology: A cross sectional (descriptive) study was conducted to evaluate General Quality of life in patients
with prostate cancer. A sample of 100 prostate cancer patients from Al-Amal National hospital for cancer
management and Oncology Center in Baghdad Medical City. This study applied format of General World Health
Organization Quality of Life-BERF questionnaire. The methods used descriptive statistics to evaluate the General
QoL-Improvements, as well as inf

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Heat Transfer Characteristics of a Fluid Flow in Multi Tube Heat Exchanger Fitted with Perforated Fins
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The heat transfer and flow resistance characteristics for air flow cross over circular finned tube heat exchanger has been studied numerically and experimentally. The purpose of the study was to improve the heat transfer characteristics of an annular finned-tube heat exchanger for better performance. The study has concentrated on the effect of the number of perforations and perforations shapes on the heat transfer and pressure drop across a staggered finned tube heat exchanger. The Numerical part of present study has been performed using ANSYS Fluent 14.5 using SST Turbulent model, while the experimental study consist from a test rig with different models of heat exchangers and all required measurement devices were build

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Publication Date
Wed Apr 20 2022
Journal Name
Ibn Al Haitham Journal For Pure And Applied Sciences
Cubic Bipolar Fuzzy Ideals with Thresholds ($α$, $β$), ( 𝛚 ,𝛝) of a Semigroup in KU-algebra
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In this paper, we introduce the concept of cubic bipolar-fuzzy ideals with thresholds (α,β),(ω,ϑ) of a semigroup in KU-algebra as a generalization of sets and in short (CBF). Firstly, a (CBF) sub-KU-semigroup with a threshold (α,β),(ω,ϑ) and some results in this notion are achieved. Also, (cubic bipolar fuzzy ideals and cubic bipolar fuzzy k-ideals) with thresholds (α,β),(ω ,ϑ) are defined and some properties of these ideals are given. Relations between a (CBF).sub algebra and-a (CBF) ideal are proved. A few characterizations of a (CBF) k-ideal with thresholds (α, β), (ω,ϑ) are discussed. Finally, we proved that a (CBF) k-ideal and a (CBF) ideal with thresholds (α, β), (ω,ϑ) of a KU-semi group are equivalent relations.

Publication Date
Thu Jul 11 2024
Journal Name
Maaen Journal For Medical Sciences
Pharmacological Supplements Efficacy in Management of chronic pain associated with Sickle Cell Disease: A narrative review
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Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti

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Publication Date
Tue Mar 21 2023
Journal Name
Biomedical And Pharmacology Journal
Development and Validation of HPLC Method For the Detection of Fusidic Acid Loaded in Non-ionic and Cationic Nanoemulsion-Based Gels
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Fusidic acid (FA) is a well-known pharmaceutical antibiotic used to treat dermal infections. This experiment aimed for developing a standardized HPLC protocol to determine the accurate concentration of fusidic acid in both non-ionic and cationic nano-emulsion based gels. For this purpose, a simple, precise, accurate approach was developed. A column with reversed-phase C18 (250 mm x 4.6 mm ID x 5 m) was utilized for the separation process. The main constituents of the HPLC mobile phase were composed of water: acetonitrile (1: 4); adjusted at pH 3.3. The flow rate was 1.0 mL/minute. The optimized wavelength was selected at 235 nm. This approach achieved strong linearity for alcoholic solutions of FA when loaded at a serial concentrati

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Publication Date
Tue Jun 20 2023
Journal Name
Bulletin Of The Iraq Natural History Museum
REVISION OF THE GENUS XYLOCOPA LATREILLE, 1802 (HYMENOPTERA, APIDAE) WITH A NEW RECORD OF SPECIES IN IRAQ
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In this study, the genus Xylocopa Latreille, 1802 (Hymenoptera: Apidae) was revised. There were 4 species registered in our investigations: X. hottentotta Smith, 1854; X. olivieri Lepeletier, 1841; X. pubescens Spinola, 1838 and X. valga Gerstäcker, 1872, the first species was described as being found for the first time for the insect fauna of Iraq, which were obtained from Solanum melogena L. flowers. Key to the species was constructed and supported by figures of the main diagnostic characters and some morphological features, illustrated and compared with other species, which are recorded in the current survey.

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Publication Date
Wed Aug 31 2011
Journal Name
Ibn Al- Haitham J. For Pure & Appl. Sci
Effect Of Some Enzymes Activity In Liver Diseases From Patients Of Salmonella Paratyphi A With Iraqi Woman.
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This present study demonstrated that liver was involved in 14 %of typhoid patients manifesting with hepatomegaly. Elevation of serum enzymes in typhoid fever was presumably of a muscular origin, while elevation of liver enzyme was relatively less common. This study was performed on 30 female patients diagnosed by ultrasound (US) of abdomen, with paratyphoid A, ranged between (20-40) years compared with 30 healthy control .Patients volunteers were treated with appropriate antibiotics for 14 days and investigations were repeated 2-3 week after completion of treatment. Patients had clinical and biochemical evidence of hepatic dysfunction. The spectrum of hepatic involvement included hepatomegaly , jaundice, derangement of various hepatic func

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Publication Date
Tue Mar 01 2022
Journal Name
Iraqi Journal Of Physics
Preparation of a Composite of Copper Oxide Nanoparticles with Carbon by Exploding Graphite Rod in Aqueous Suspension
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In this work, the effect of preparing a composite of copper oxide nanoparticles with carbon on some of its optical properties was studied. The composite preparing process was carried out by exploding graphite electrodes in an aqueous suspension of copper oxide. The properties of the plasma which is formed during the explosion were studied using emission spectroscopy in order to determine the most important elements that are present in the media. The electron’s density and their energy, which is the main factor in the composite process, were determined. The particle properties were studied before and after the exploding process. The XRD showed an additional peak in the copper oxides pattern corresponding to the hexagonal graphite struct

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
THE ONCOGENIC EFFECT OF EBV/HPV CO-INFECTION IN A GROUP OF IRAQI WOMEN WITH CERVICAL CARCINOMA
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The current paper was designed to find the possible synergic effect of EBV infection with the HPV-16 in Iraqi women suffering from cervical carcinoma. This retrospective study involved paraffinized blocks of two groups. The research included 30 carcinomatous cervical tissues and 15 samples from normal cervical biopsies. After sectioning using positively charged slides, immunohistochemistry (IHC) was performed to detect anti-Epstein Barr Virus LMP1 and Human papillomavirus type 16 primary antibodies. Sixty-three percentage (19 out of 30) of the studies group showed positive overexpression as shown in with a significant association of the expression with cervical cancer with a significant association (p = 0). The co-infection of the EBV and H

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Publication Date
Mon Mar 29 2021
Journal Name
Journal Of Engineering
Experimental Investigation of Thermal Performance of Aluminum Foil Coated with Polyester in a Direct Evaporative Cooling System
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An experimental study was carried out for an evaporative cooling system in order to investigate the effect of using an aluminum pad coated with fabric polyester. In the present work, it was considered to use a new different type of cooling medium and test its performance during the change in the wet-bulb temperature and dry-bulb temperature of the supply air outside of the pad, the relative humidity of the supply air, the amount of air supplied (300-600) CFM and also the change of the amount of circulated water (1.75, 2.5, 4.5) liter per minute. A decrease in the WBT of the air was obtained, whereas the WBT of the air entering the pad was 26.5 . In contrast, the WBT of the outside air had reached 23  even though eva

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