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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 21 2019
Journal Name
Journal Of Engineering
A Neural Networks based Predictive Voltage-Tracking Controller Design for Proton Exchange Membrane Fuel Cell Model
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In this work, a new development of predictive voltage-tracking control algorithm for Proton Exchange Membrane Fuel Cell (PEMFCs) model, using a neural network technique based on-line auto-tuning intelligent algorithm was proposed. The aim of proposed robust feedback nonlinear neural predictive voltage controller is to find precisely and quickly the optimal hydrogen partial pressure action to control the stack terminal voltage of the (PEMFC) model for N-step ahead prediction. The Chaotic Particle Swarm Optimization (CPSO) implemented as a stable and robust on-line auto-tune algorithm to find the optimal weights for the proposed predictive neural network controller to improve system performance in terms of fast-tracking de

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
A Linear Programming Method Based Optimal Power Flow Problem for Iraqi Extra High Voltage Grid (EHV)
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The objective of an Optimal Power Flow (OPF) algorithm is to find steady state operation point which minimizes generation cost, loss etc. while maintaining an acceptable system performance in terms of limits on generators real and reactive powers, line flow limits etc. The OPF solution includes an objective function. A common objective function concerns the active power generation cost. A Linear programming method is proposed to solve the OPF problem. The Linear Programming (LP) approach transforms the nonlinear optimization problem into an iterative algorithm that in each iteration solves a linear optimization problem resulting from linearization both the objective function and constrains. A computer program, written in MATLAB environme

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Publication Date
Sat Oct 01 2022
Journal Name
Case Studies In Thermal Engineering
Comparative assessment of the performance and combustion attributes of a free piston linear generator fuelled with CNG and CNG-CO2
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Publication Date
Tue Aug 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Foliar Spray of Zinc and Irrigating with Smoking-Water on Growth of Citrus Rootstock C35
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This study was conducted in fruit production lathe house of the Department Of Horticulture And Landscape Gardening, in the station (B), College Of Agricultural Engineering Sciences, University Of Baghdad, Al-Jaadria for 8 months, began from 1/3/2019 to 1/9/2019 to investigate the responses of C35 Citrus rootstock to influence of foliar spraying of zinc and irrigation with smoking-water at 2 years old saplings. the study included two factors, first factor was three concentrations of Zinc Element Z0(0 mg.l-1), Z1(50 mg.l-1) and Z2(75 mg.l-1) that sprays at leave. The second factor was watering saplings with smoke-water in three concentrations S0(0 vol.vol-1), S1(0.1 vol.vol-1) and (0.2vol.vol-1), and their interaction. The experiment was fact

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Publication Date
Mon Apr 10 2023
Journal Name
Current Microbiology
Influence of Light Color on Power Generation and Microalgae Growth in Photosynthetic Microbial Fuel Cell with Chlorella Vulgaris Microalgae as Bio-Cathode
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Publication Date
Thu Aug 31 2017
Journal Name
Journal Of Engineering
The Effect of Cyclic Bending Loads on Crack Growth in Pipes for Inclined and Transverse Cracks with or Without Internal Pulsing Pressure
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In the present research a new test rig has been proposed to be suitable for different cyclic loads such as cyclic bending, cyclic torsion, proportional and non proportional loads. In this work the efforts were concentrated on the cyclic bending loads concerning cracked pipes with or without internal pulsing pressure to study crack propagation in small bore pipes (up to 1'') for transverse or inclined cracks. The rig simulates the real service conditions under different stresses by means the least dangerous case will be suggested, so the experiments were considered for copper pipe, and the results have been tabulated and drawn to demonstrate the crack growth behavior as well as to justify the outcomes practically, consequently the durabil

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Publication Date
Tue Jan 09 2018
Journal Name
Iraqi Journal Of Cancer And Medical Genetics
Photodynamic Action of low power He-Ne laser on photosensitized human Hep-2 and AMN3 cell lines with Hematoporphyrin derivative in vitro
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Photodynamic Action (PDA) by using appropriate wavelength of irradiation conjugated with porphyrin derivatives is a powerful mechanism of tumor destruction. Hematoporphyrin derivative has been shown to selectively localize in neoplastic cells and then cause destruction of them by generation of singlet oxygen when activated by low power He-Ne laser. Light which used in this study has been emitting from this laser has a wavelength equal to 632.8 nm (red light). Doses of laser had been varied from 3.6 J/cm2 to 14.4 J/cm2 . The beam of laser adjusted with a modified tissue culture plate. Cell lines had exposed to Hematoporphyrin D (HpD) for 24 hours before Laser exposure, their concentrations were varied from 5 µg/ml to 80 µg/ml. Resu

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Publication Date
Thu Dec 01 2022
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
A self-balancing platform on a mobile car
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<span lang="EN-US">In the last years, the self-balancing platform has become one of the most common candidates to use in many applications such as flight, biomedical fields, and industry. In this paper, the physical prototype of a proposed self-balancing platform that described the self-balancing attitude in the (X-axis, Y-axis, or biaxial) under the influence of road disturbance has been introduced. In the physical prototype, the inertial measurement unit (IMU) sensor will sense the disturbance in (X-axis, Y-axis, and biaxial). With the determined error, the corresponding electronic circuit, DC servo motors, and the Arduino software, the platform overcame the tilt angle(disturbance). Optimization of the proportional-integral-

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Publication Date
Sat Aug 27 2022
Journal Name
International Journal Of Health Sciences
Heterocyclic compounds-based liquid crystals: Synthesis and mesomorphic properties
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A series of liquid crystals comprising a heterocyclics dihydro pyrrole and 1,2,3-triazole rings [VII]-[X] were synthesized by many steps starting from a reaction of 3,3'-dimethyl-[1,1'-biphenyl]- 4,4'-diamine with chloroacetyl chloride in a mixture of solutions DMF and TEA to synthesise the compounds [I], then the compounds [I] reacted with malononitrile in 1,4-dioxane and TEA solutions to produce compounds [II], then the first step is repeated with compound [II] where it reacted with chloroacetyl chloride in mixture of DMF and TEA to give compound [III], this compound reacted with sodium azide in the presence of sodium chloride and DMF as solvent to produce the compound [IV], which reacted with acrylic acid by a 1.3 dipolar reaction in sol

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Publication Date
Thu May 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Channel Estimation and Prediction Based Adaptive Wireless Communication Systems
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Wireless channels are typically much more noisy than wired links and subjected to fading due to multipath  propagation which result in ISI and hence high error rate. Adaptive modulation is a powerful technique to improve the tradeoff between spectral efficiency and Bit Error Rate (BER). In order to adjust the transmission rate, channel state information (CSI) is required at the transmitter side.

In this paper the performance enhancement of using linear prediction along with channel estimation to track the channel variations and adaptive modulation were examined. The simulation results shows that the channel estimation is sufficient for low Doppler frequency shifts (<30 Hz), while channel prediction is much more suited at

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