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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
Sat Dec 01 2018
Journal Name
Applied Soft Computing
A new evolutionary algorithm with locally assisted heuristic for complex detection in protein interaction networks
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Publication Date
Wed Nov 30 2022
Journal Name
Animal Biotechnology
A novel deleterious oxytocin variant is associated with the lower twinning ratio in Awassi ewes
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This study aimed to assess the possible association of oxytocin (OXT) gene with reproductive traits in two groups of Awassi ewes that differ in their reproductive potentials. Sheep were genotyped using PCR—single-stranded conformation polymorphism approach. Three genotypes were detected in exon 2, CC, CA, and AA, and a novel SNP was identified with a missense effect on oxytocin (c.188C > A → p.Arg55Leu). A significant (p < 0.01) association of p.Arg55Leu with the twinning rate was found as ewes with AA and CA genotypes exhibited, respectively a lower twinning ratio than those with the wild-type CC genotype. The deleterious impact of p.Arg55Leu was demonstrated by all in silico tools that were utilized to assess the effect of this varian

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Mechanical Engineering Research And Developments
Numerical investigation for Natural Convection in a square Enclosure with partially active thermal sides' wall
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Three-dimensional cavity was investigated numerical in the current study filled with porous medium from a saturated fluid. The problem configuration consists of two insulated bottom and right wall and left vertical wall maintained at constant temperatures at variable locations, using two discretized heaters. The porous cavity fluid motion was represented by the momentum equation generalized model. The present investigation thermophysical parameters included the local thermal equilibrium condition. The isotherms and streamlines was used to examine energy transport and momentum. The meaning of changing parameters on the established average Nusselt number, temperature and velocity distribution are highlighted and discussed.

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Publication Date
Sat Jun 18 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Detrimental Effects of some Antiepileptic Drugs on the Height and Weight of Children with Epilepsy
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Growth is a multifactorial process influenced by genetic, nutritional, hormonal, psychosocial and other factors including the general health of a child. Epilepsy defined as a chronic condition characterized by recurrent clinical events or epileptic seizures, which occur in the absence of a metabolic or toxic disease the drugs that use in the treatment of this condition can affect patients growth due to their mechanisms of action. This study aimed to evaluate the effect of some antiepileptic drugs on growth (height and weight) in children with epilepsy. This work involved 51 newly diagnosed children with a different form of epilepsy (Generalized, absent and partial). Patients divided into three groups according to the treatment (group one

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Publication Date
Wed Mar 13 2019
Journal Name
Al-khwarizmi Engineering Journal
Investigation Microwave Furnace Effects on Mechanical Properties and Fatigue Life of AA 7075-T73 with Dry and Acid Treatments
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Microwave heating is caused by the ability of the materials to absorb microwave energy and convert it to heat. The aim of this study is to know the difference that will occur when heat treating the high strength aluminum alloys AA7075-T73 in a microwave furnace within different mediums (dry and acidic solution) at different times (30 and 60) minutes, on mechanical properties and fatigue life. The experimental results of microwave furnace heat energy showed that there were variations in the mechanical properties (ultimate stress, yielding stress, fatigue strength, fatigue life and hardness) with the variation in mediums and duration times when compared with samples without treatment. The ultimate stress, yielding stress and fatigue streng

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Publication Date
Sat Jun 07 2025
Journal Name
Intelligent Service Robotics
Grasping Stability of a Robotic Gripper with Frictional Self-Locking Mechanism
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The grasping stability of robotic manipulators is crucial to enable autonomous manipulation in an environment where robots are facing obstacles in their route, where abrupt changes in the robot’s speed are induced. These speed variations will produce forces affecting the robotic manipulator, hence its grasping stability. In this research, the grasping stability of a robotic manipulator that functions according to a frictional self-locking mechanism is investigated statically and dynamically. Both theoretical and experimental results showed that the grasped object size, weight, and its orientation inside the gripper have a great effect on grasping stability. Both the theoretical and experimental results indicated that the grasping object p

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Publication Date
Sat Apr 09 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Static Shear Strength of a Non-Prismatic Beam with Transverse Openings
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In this study, a predicated formula is been proposed to find the shear strength of non-prismatic beams with or without openings. It depends on the contributions of concrete shear strength considering the beam depth variation and existing openings, shear steel reinforcements and defines the critical shear section, the effect of diagonal shear reinforcement, the effect of inclined tensile steel reinforcement, and the compression chord influence. The verification of the proposed formula has been conducted on the experimental test results of 26 non-prismatic beams with or without openings at the same loading conditions. The results reflect that the predicted formula finds the shear capacity of non-prismatic beams with openings, it is co

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Life – Style of patients with peptic ulcer A case control study
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Abstract A descriptive (retrospective) (a case-control) study was carried out at Al-Karama Teaching Hospital, Baghdad Teaching Hospital and Surgical Specialties Hospital, and Gastro-Intestinal Tract and Liver (GIT) Hospital for the period of December 1st, 2001 To March 15th 2002. To identify aspects of life-style that may contribute to the occurrence of peptic ulcer (P.U)as risk factors. And to find out the relationship between the demographic characteristic of the group. Non-probability (Purposive) sample of (100) cases who were admitted to the endoscopy department who were later on diagnosed as having

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Publication Date
Wed Oct 31 2018
Journal Name
Al-kindy College Medical Journal
Leigh Syndrome: Report of a Rare Case with Late Onset Presentation
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Leigh's syndrome, or sub acute necrotizing encephalomyelopathy, is a rare inherited neurometabolic disease of infancy and early childhood with variable course and prognosis. Rarely, it occurs in juveniles and adults. The diagnosis is difficult and still remains to challenge the clinicians on the basis of history; hence the role of imaging is very essential. It is the neuroimaging, chiefly the Magnetic Resonance Imaging showing characteristic symmetrical necrotic lesions in the basal ganglia and/or brain stem that leads to the diagnosis. Late-onset varieties are rare and only few cases were reported all over the world. Here, I report a case of late onset (juvenile) Leigh syndrome presenting with an acute polyneuropathy. Neuroimaging confi

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Publication Date
Fri Feb 10 2023
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Delayed Ecoepidemiological Model with Nonlinear Incidence Rate
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In this paper, the general framework for calculating the stability of equilibria, Hopf bifurcation of a delayed prey-predator system with an SI type of disease in the prey population, is investigated. The impact of the incubation period delay on disease transmission utilizing a nonlinear incidence rate was taken into account. For the purpose of explaining the predation process, a modified Holling type II functional response was used. First, the existence, uniform boundedness, and positivity of the solutions of the considered model system, along with the behavior of equilibria and the existence of Hopf bifurcation, are studied. The critical values of the delay parameter for which stability switches and the nature of the Hopf bifurcat

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