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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
Tue Mar 05 2024
Journal Name
International Journal Of Science And Research (ijsr)
Evaluation of Adherence to Methotrexate in a Sample of Iraqi Patients with Rheumatoid Arthritis Receiving Anti - TNF Medications
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Publication Date
Sun Jun 01 2025
Journal Name
Journal Of Engineering
Numerical Study of Convective Heat Transfer in a Rectangular Channel Inserted with Metal Foam of Gradient Pore Density
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Metal foam has recently been used in many engineering applications, such as solar collectors, heat exchangers, and cooling of electronic devices, which calls for studying different cases of using metal foam in these applications. The current study conducts a numerical analysis of heat transfer and fluid flow characteristics for air in a rectangular channel filled with high-porosity copper foam. The study examined the thermal performance for two cases of gradient pore density, which are arranged as (10-20-40) PPI and (40-20-10) PPI. These cases were compared with two other cases for constant pore density, 10 and 40 PPI, and empty cases. The ANSYS FLUENT 20.0 employed the Darcy-Forchheimer extended Brickman model in the two-dimensiona

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
The influence of Ali (may Allah be pleased with him) on interpretation: The influence of Ali (may Allah be pleased with him) on interpretation
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Abstract:
Through the research, I have briefly discussed the life of Imam Ali and
indicated the interpretation of the Qur'an by language and terminology, the
importance and characteristics of Sahabas', may Allah be pleased with them,
interpretation of the Qur'an. Also, the sayings of Imam Ali, wich included the
explanatory interpretation of the Qur'an by the Qura'n, Sunnah, language, and
correct opinion. I have also indicated the reasons of the Quran's revelation
and the readings of the Qura'n that had been received from him including the
interpretive meaning these readings revealed. Finally, I concluded my
research with the most important results and recommends.

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Publication Date
Fri Apr 25 2014
Journal Name
Journal Of Kufa For Nursing Science
Environmental Effects On Women's With Spontaneous Abortion
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Background: spontaneous abortion constitutes one of the most important adverse pregnancy outcomes affecting human reproduction, and its risk factors are not only affected by biological, demographic factors such as age, gravidity, and previous history of miscarriage,but also by individual women’s personal social characteristics, and by the larger social environment. Objective:To identifyEnvironmental effects on Women's with Spontaneous Abortion. Methodology:Non-probability(purposive sample)of(200) women, who were suffering from spontaneous abortion in maternity unitfrom four hospitals at Baghdad City which include Al-ElwiaMaternity Teaching Hospital, and Baghdad Teaching Hospital at Al-Russafa sector. Al–karckhMaternityHospita

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Agricultural And Statistical Sciences
ON ERROR DISTRIBUTION WITH SINGLE INDEX MODEL
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In this paper, the error distribution function is estimated for the single index model by the empirical distribution function and the kernel distribution function. Refined minimum average variance estimation (RMAVE) method is used for estimating single index model. We use simulation experiments to compare the two estimation methods for error distribution function with different sample sizes, the results show that the kernel distribution function is better than the empirical distribution function.

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Publication Date
Thu Jan 29 2026
Journal Name
Journal Of Interdisciplinary Mathematics
Efficient design of neural network based on modified LM training algorithm for solving nonlinear 4th order 3D-PDEs 
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Authors in this work design efficient neural networks, which are based on the modified Levenberg - Marquardt (LM) training algorithms to solve non-linear fourth - order three -dimensional partial differential equations in the two kinds in the periodic and in the non-periodic - Periodic. Software reliability growth models are essential tools for monitoring and evaluating the evolution of software reliability. Software defect detection events that occur during testing and operation are often treated as counting processes in many current models. However, when working with large software systems, the error detection process should be viewed as a random process with a continuous state space, since the number of faults found during testin

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Sun Oct 15 2017
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Research Journal Of Applied Sciences, Engineering And Technology
Optimization of IPv6 Protocol Independent Multicast-Sparse Mode Multicast Routing Protocol based on Greedy Rendezvous Point Selection Algorithm
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Publication Date
Tue Aug 27 2024
Journal Name
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Preparing the Electrical Signal Data of the Heart by Performing Segmentation Based on the Neural Network U-Net
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Research on the automated extraction of essential data from an electrocardiography (ECG) recording has been a significant topic for a long time. The main focus of digital processing processes is to measure fiducial points that determine the beginning and end of the P, QRS, and T waves based on their waveform properties. The presence of unavoidable noise during ECG data collection and inherent physiological differences among individuals make it challenging to accurately identify these reference points, resulting in suboptimal performance. This is done through several primary stages that rely on the idea of preliminary processing of the ECG electrical signal through a set of steps (preparing raw data and converting them into files tha

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Publication Date
Thu Jun 30 2022
Journal Name
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Using a hybrid SARIMA-NARNN Model to Forecast the Numbers of Infected with (COVID-19) in Iraq
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Coronavirus disease (COVID-19) is an acute disease that affects the respiratory system which initially appeared in Wuhan, China. In Feb 2019 the sickness began to spread swiftly throughout the entire planet, causing significant health, social, and economic problems. Time series is an important statistical method used to study and analyze a particular phenomenon, identify its pattern and factors, and use it to predict future values. The main focus of the research is to shed light on the study of SARIMA, NARNN, and hybrid models, expecting that the series comprises both linear and non-linear compounds, and that the ARIMA model can deal with the linear component and the NARNN model can deal with the non-linear component. The models

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Crossref
Publication Date
Mon Dec 01 2014
Journal Name
Al-mansour Journal /issue( 22 )
A Thematic Reading of John Bunyan's The Pilgrim's Progress with Introductory References to Islam in English Literature
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The importance of this study lies in shedding the light on the impact of Islam and Prophet Mohammed (peace be upon him) on the western culture and English literature in particular. While some writers were looking at Islam as a dangerous element, others were completely taken by the oriental spirit of Arabic and Islamic culture and glorifying it. Writers from Chaucer to later ones mostly make references to this impact showing how vast was the gap of misunderstanding between the east and the West. Thus, this study aims at breaking the barrier between East and West in its three sections as it introduces the meaning of Islam and its common features with other religions in the first section. The second section briefly presents writers’ reflecti

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