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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
Mon Nov 28 2016
Journal Name
Separation Science And Technology
Using sewage sludge as a permeable reactive barrier for remediation of groundwater contaminated with lead and phenol
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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
Exploring the Challenges of Diagnosing Thyroid Disease with Imbalanced Data and Machine Learning: A Systematic Literature Review
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Thyroid disease is a common disease affecting millions worldwide. Early diagnosis and treatment of thyroid disease can help prevent more serious complications and improve long-term health outcomes. However, thyroid disease diagnosis can be challenging due to its variable symptoms and limited diagnostic tests. By processing enormous amounts of data and seeing trends that may not be immediately evident to human doctors, Machine Learning (ML) algorithms may be capable of increasing the accuracy with which thyroid disease is diagnosed. This study seeks to discover the most recent ML-based and data-driven developments and strategies for diagnosing thyroid disease while considering the challenges associated with imbalanced data in thyroid dise

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Publication Date
Wed Jun 27 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Building Geological Model for Tertiary Reservoir of Exploration Ismail Oil Field, North Iraq
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Geologic modeling is the art of constructing a structural and stratigraphic model of a reservoir from analyses and interpretations of seismic data, log data, core data, etc. ‎[1].

   A static reservoir model typically involves four main stages, these stages are Structural modeling, Stratigraphic modeling, Lithological modeling and Petrophysical modeling ‎[2].

   Ismail field is exploration structure, located in the north Iraq, about 55 km north-west of Kirkuk city, to the north-west of the Bai Hassan field, the distance between the Bai Hassan field and Ismael field is about one kilometer ‎[3].

   Tertiary period reservoir sequences (Main Limestone), which comprise many economica

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Analytical Approach for Load Capacity of Large Diameter Bored Piles Using Field Data
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An analytical approach based on field data was used to determine the strength capacity of large diameter bored type piles. Also the deformations and settlements were evaluated for both vertical and lateral loadings. The analytical predictions are compared to field data obtained from a proto-type test pile used at Tharthar –Tigris canal Bridge. They were found to be with acceptable agreement of 12% deviation.

               Following ASTM standards D1143M-07e1,2010, a test schedule of five loading cycles were proposed for vertical loads and series of cyclic loads to simulate horizontal loading .The load test results and analytical data of 1.95

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Publication Date
Sun Jan 01 2023
Journal Name
Dental Hypotheses
Assessment of Salivary Levels of the RANKL and RANK in Patients with Healthy Gingiva on Reduced Periodontium Versus Periodontitis: An Analytical Cross-Sectional Study
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Publication Date
Sun Mar 01 2015
Journal Name
Journal Of Engineering
Finite Element Investigation on Shear Lag in Composite Concrete-Steel Beams with Web Openings
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In this paper, effective slab width for the composite beams is investigated with special emphasis on the effect of web openings. A three dimensional finite element analysis, by using finite element code ANSYS, is employed to investigate shear lag phenomenon and the resulting effective slab width adopted in the classical T-beam approach. According to case studies and comparison with limitations and rules stipulated by different standards and codes of practice it is found that web openings presence and panel proportion are the most critical factors affecting effective slab width, whereas concrete slab thickness and steel beam depth are less significant. The presence of web opening reduces effective slab width by about 21%.

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Publication Date
Sun Dec 04 2016
Journal Name
Baghdad Science Journal
Biochemical Study on Anti Thyroid Peroxidase in Type 2 Diabetic patients with thyroid disorders
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Type 2 diabetes mellitus (T2DM) is the most frequent endocrinal disease commonly associated with thyroid disorders .The study is conducted at the Specialized Center for Endocrinology and Diabetes in Baghdad ,during December 2014 up to October 2015.This study was done to investigate the prevalence of anti- thyroid peroxidase (Anti-TPO) antibody in patients suffered from type 2 diabetes with thyroid disorders .The study groups included a total number of 80 subjects consisting of 60 type 2 diabetic patients divided into 20 hyperthyroidism subjects (group 1) ,20 hypothyroidism subjects (group 2), 20 euthyroidism subjects (group 3) and 20 healthy controls (group 4) . The fasting blood samples were analyzed for (T3,T4,TSH) by using Vitek Immuno d

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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The effect of rehabilitation exercises with body weight and rubber resistance on the range of motion and the strength of the sprained ankle muscles in female rugby players
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The study aimed to prepare a set of qualifying exercises to improve the muscular strength of the muscles surrounding the ankle joint by applying different resistances according to the nature of the movement of this joint, which is one of the second moving joints (flexion, extension and rotation of the right and left) in order to increase the efficiency of all muscles working on this joint according to those movements and identification On the impact of these exercises and assume that there will be statistical differences between the two tests of the research sample. The researcher used the semi-articulated experimental method with a pre- and post-test for one group. The injury was evaluated on the women's national team players durin

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Publication Date
Sat Jun 06 2020
Journal Name
Journal Of The College Of Education For Women
Spatial Analysis of Soil Characteristics and its Effect on Determining the Susceptibility of lands of the RasheedRegion: A Study in Soil Geography
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Twelve pends were selected and distributed on three verticals transects paths on the Tigers river in Al Rasheed county.Passing through land covers, that classified and covers the whole region. Based on the 8 Landsat of the year 2015. It was oriental classified by using Erdas 10.2 . The pedons were distributed on the area of each varicty of these classes. the series of soil according of the transect series (DW74,MMg,DMu6 , Df96) respectively were represented P1 , P2 , P3 , P4  .

The second transits series(DM97,MM5,DM96,DF115) respectively were  represented P5 , P6 , P7 , P8  .The third  transits series(DM46,MMg,MF12,MM11) re

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Publication Date
Fri Aug 30 2024
Journal Name
Iraqi Journal Of Science
The Dissipation of the Kinetic Energy for 2D Bounded Flow by Using Moment-Based Boundary Conditions with Burnett Order Stress for LBM
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     In this article, the lattice Boltzmann method with two relaxation time  (TRT)  for the  D2Q9 model is used to investigate numerical results for 2D flow. The problem is performed to show the dissipation of the kinetic energy rate and its relationship with the enstrophy growth for 2D dipole wall collision. The investigation is carried out for normal collision and oblique incidents at an angle of . We prove the accuracy of moment -based boundary conditions with slip and Navier-Maxwell slip conditions to simulate this flow. These conditions are under the effect of Burnett-order stress conditions that are consistent with the discrete Boltzmann equation. Stable results are found by using this kind of boundary condition where d

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