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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 Nov 02 2017
Journal Name
Iraqi Journal Of Laser
Enhancement the Sensitivity of Humidity Sensor Based on an Agarose Coating Transmission-Type Photonic Crystal Fiber Interferometer
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Photonic Crystal Fiber Interferometers (PCFIs) are widely used for sensing applications. This work presents the fabrication and the characterization of a relative humidity sensor based on a polymer-coated photonic crystal fiber that operates in a Mach- Zehnder Interferometer (MZI) transmission mode. The fabrication of the sensor involved splicing a short (1 cm) length of Photonic Crystal Fiber (PCF) between two single-mode fibers (SMF). It was then coated with a layer of agarose solution. Experimental results showed that a high humidity sensitivity of 29.37 pm/%RH was achieved within a measurement range of 27–95%RH. The sensor also showed good repeatability, small size, measurement accuracy and wide humidity range. The RH sensitivity o

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Publication Date
Sun Mar 01 2026
Journal Name
Case Studies In Thermal Engineering
Dynamic thermal modelling of energy storage unit based on PCM under single or two-phase flow conditions
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Phase change materials are extensively studied for use in low-, mid-, and high-temperature applications due to their melting and solidification temperatures, latent heat, and thermophysical properties. This work aims to explore the energy stored, or released and their duration for the energy storage unit formed of a phase change material surrounding a tube within which a hot or cold, single or Two-Phase fluid flows, serving as a heat source or sink. The 3D axial transient thermal analysis of the energy storage unit is performed using the finite element method via a MATLAB-developed computer program. The effects of single- or Two-Phase fluid flow on temperature distribution, solidification, melting duration, and energy stored within phase ch

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Laser
Generation of True Random TTL Signals for Quantum Key-Distribution Systems Based on True Random Binary Sequences
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A true random TTL pulse generator was implemented and investigated for quantum key distribution systems. The random TTL signals are generated by low cost components available in the local markets. The TTL signals are obtained by using true random binary sequences based on registering photon arrival time difference registered in coincidence windows between two single – photon detectors. The true random TTL pulse generator performance was tested by using time to digital converters which gives accurate readings for photon arrival time. The proposed true random pulse TTL generator can be used in any quantum -key distribution system for random operation of the transmitters for these systems

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Engineering
Development of Bridges Maintenance Management System based on Geographic Information System Techniques (Case study: Al-Muthanna \ Iraq)
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A Geographic Information System (GIS) is a computerized database management system for accumulating, storage, retrieval, analysis, and display spatial data. In general, GIS contains two broad categories of information, geo-referenced spatial data and attribute data. Geo-referenced spatial data define objects that have an orientation and relationship in two or three-dimensional space, while attribute data is qualitative data that can be counted for recording and analysis. The main aim of this research is to reveal the role of GIS technology in the enhancement of bridge maintenance management system components such as the output results, and make it more interpretable through dynamic colour coding and more sophisticated visualization

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Operational assessment of biological wastewater treatment using advanced return-mass reactors based on principal component cluster analysis
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Abstract<p>In this study, field results data were conducted, implemented in 64 biofilm reactors to analyses extract organic matter nutrients from wastewater through a laboratory level nutrient removal process, biofilm layer moving process using anaerobic aerobic units. The kinetic layer biofilm reactors were continuously operating in Turbo 4BIO for BOD COD with nitrogen phosphorous. The Barakia plant is designed to serve 200,000 resident works on biological treatment through merge two process (activated sludge process, moving bed bio reactio MBBR) with an average wastewater flow of 50,000 m3/day the data were collected annually from 2017-2020. The water samples were analysis in the central labor</p> ... Show More
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Publication Date
Tue Dec 31 2013
Journal Name
Al-khwarizmi Engineering Journal
Design of an Adaptive PID Neural Controller for Continuous Stirred Tank Reactor based on Particle Swarm Optimization
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 A particle swarm optimization algorithm and neural network like self-tuning PID controller for CSTR system is presented. The scheme of the discrete-time PID control structure is based on neural network and tuned the parameters of the PID controller by using a particle swarm optimization PSO technique as a simple and fast training algorithm. The proposed method has advantage that it is not necessary to use a combined structure of identification and decision because it used PSO. Simulation results show the effectiveness of the proposed adaptive PID neural control algorithm in terms of minimum tracking error and smoothness control signal obtained for non-linear dynamical CSTR system.

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Publication Date
Tue Oct 02 2018
Journal Name
Iraqi Journal Of Physics
Enhancement the sensitivity of humidity sensor based on an agarose infiltration reflection-type photonic crystal fiber interferometer
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Photonic Crystal Fiber Interferometers (PCFIs) are widely used for sensing applications. This work presents the fabrication and study the characterization of a relative humidity sensor based on a polymer-infiltrated photonic crystal fiber that operates in a Mach- Zehnder Interferometer (MZI) reflection mode. The fabrication of the sensor only involves splicing and cleaving Photonic Crystal Fiber (PCF) with Single Mode Fiber (SMF). A stub of (LMA-10) PCF spliced to SMF (Corning-28). In the splice regions. The PCFI sensor operation based on the adsorption and desorption of water vapour at the silica-air interface within the PCF. The sensor shows a high sensitivity to RH variations from (27% RH - 95% RH), with a change in its reflected powe

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Ijarah and lease ending with ownership and its implications for the bank's profits: A case study in the Emirates Islamic Bank and Emirates NBD
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The formula of Ijarah and Ijarah ending with ownership is one of the investment formulas in Islamic banks, so this research has shed light on it in order to benefit from the experiences of the research sample banks, This research aims to find a reliable way for Iraqi Islamic banks, namely (leasing and leasing ending with ownership) in order to invest their money without usurious interests, The problem of the research emerges through the lack of awareness of the Iraqi Islamic banks to work with different Islamic financing formulas and their inability to invest their money through the adoption of their administrations for different formulas, including the leasing, and this is reflected in the decrease and fluctuation of its profits, Theref

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Publication Date
Mon Sep 01 2025
Journal Name
Euphrates Journal Of Agricultural Science
Effect of Coating Hatching Eggs with Nanoparticles and Carboxymethyl Cellulose and Storage periods on Hatchability and Quality of Hatched Chicks
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The current research aimed to conducting two experiments to study the effect of coating hatching eggs with nano-titanium dioxide (nano-TiO2) and nano-silica dioxide (nano-SiO2) particles and their mixture with carboxymethyl cellulose (CMC) on the characteristics of hatching percentage, embryo growth inside the egg. The study was conducted in the Department of Animal Production, College of Agriculture, Tikrit University for the period from 19/3/2023 to 17/9/2024. It aimed to evaluate the coating of hatching eggs with Nano-TiO2 and Nano-SiO2 particles and their mixture with carboxymethyl cellulose CMC on the qualities of hatching percentage, embryo growth inside the egg, as well as trying to obtain the best and longest storage method for fert

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Publication Date
Thu Jan 25 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECTS OF MINERAL FERTILIZATION AND SPRAYING WITH SALICYLIC ACID AND AMINO ACIDS ON THE GROWTH AND PRODUCTIVITY OF INDUSTRIAL POTATOES
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This experiment was carried out at a private field in the eastern Radwaniyah Baghdad for the fall season 2020/2021 and spring 2021 to study the effects of adding mineral fertilizers, spraying salicylic acid and amino acids on some growth traits and yield of industrial potato plants. 200 kg N h-1 , 100 kg P2O5 h-1, 100 kg K2O h-1 and F2 consist of 275 kg N h-1, 180 kg P2O5 h-1, 200 K2O h-1 and F3 consist of 350 kg N h-1, 360 kg P2O5 h-1, 300 K2O h-1 and salicylic acid in three concentrations of 0,50 and 100 mg L-1 ( S1, S2, S3) and amino acids in three concentrations of 0, 1.25 and 2.5 ml L-1 ( A1, A2 , A3) It was carried out as a factorial split plot experiment, where the fertilizer levels (F1, F2 and F3) are in the main plot and th

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