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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 Jun 06 2026
Journal Name
Journal Of Composites Science
Performance-Based Evaluation of Nanomaterials for Enhancing Moisture Damage Resistance in Asphalt Concrete
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Moisture-induced damage is one of the primary causes of premature distress in asphalt pavements, leading to reduced service life and increased maintenance costs. Although nanomaterials have shown potential in enhancing asphalt performance, the underlying composite interaction mechanisms among nanomaterials, asphalt binder, and aggregate phases under moisture exposure are still not fully understood. In addition, comparative evaluations under consistent experimental conditions remain limited. This study investigates the influence of five nanomaterials: nano-silica (NS), nano-alumina (NA), nano-titanium dioxide (NT), nano-zinc oxide (NZ), and carbon nanotubes (CNT) on the physical and mechanical properties of asphalt binders and mixtur

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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Dentistry
The in-vitro development of novel enzyme-based chemo-mechanical caries removal agents
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Objectives: Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. Methods: The novel agents were prepared using different concentrations of bromelain (10–40 wt. %), with and without 0.1–0.3 wt. % chloramine T or 0.5–1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficie

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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Dentistry
The in-vitro development of novel enzyme-based chemo-mechanical caries removal agents
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Objectives Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. Methods The novel agents were prepared using different concentrations of bromelain (10–40 wt. %), with and without 0.1–0.3 wt. % chloramine T or 0.5–1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficiency

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Publication Date
Sat Apr 01 2023
Journal Name
Egyptian Journal Of Veterinary Sciences
Effect of Crocin on the Spermatogenesis Indices of Mice Testis: A Histopathological and Histomorphological Study
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Publication Date
Mon Jan 01 2024
Journal Name
Aims Energy
The impact of different compression ratios on emissions, and combustion characteristics of a biodiesel engine
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<p>The current work investigated the combustion efficiency of biodiesel engines under diverse ratios of compression (15.5, 16.5, 17.5, and 18.5) and different biodiesel fuels produced from apricot oil, papaya oil, sunflower oil, and tomato seed oil. The combustion process of the biodiesel fuel inside the engine was simulated utilizing ANSYS Fluent v16 (CFD). On AV1 diesel engines (Kirloskar), numerical simulations were conducted at 1500 rpm. The outcomes of the simulation demonstrated that increasing the compression ratio (CR) led to increased peak temperature and pressures in the combustion chamber, as well as elevated levels of CO<sub>2</sub> and NO mass fractions and decreased CO emission values un

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Publication Date
Tue Jan 18 2022
Journal Name
Heat Transfer
Effect of receiver geometry on the optical and thermal performance of a parabolic trough collector
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Abstract<p>In this study, the optical and thermal performance of a Parabolic Trough Collector PTC system is investigated theoretically. A series of numerical simulations and theoretical analysis has been conducted to investigate the effect of the receiver geometry and location relative to the focal line on its optical performance. The examined receiver geometries are circular, square, triangular, elliptical and a new design of circular‐ square named as channel receiver. The thermal performance of PTC is studied for different flow rates from (0.27 to 0.6 lpm) theoretically. Results showed that the best optical design is the channel receiver with an optical efficiency of 84% while the worst is the elliptical </p> ... Show More
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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Measurement of economic returns and environmental and social for green sector trade A prospective study in institutions of Basra to focus on the electricity sector
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        Environmental risk growing Become challenge "and a matter of controversy and concern to many of those concerned with environment, social, economic, and the same happens with the administrative rather than in isolation for this movement, as the issues of climate change Disturbed and troubled him, especially after what caused the risk of destruction, and irresponsibility , chaos, and the futility of resources, crops, fields,  nature and homes and reactors, and after what happened in Japan from the scourge of "Hurricane tsunami " and earthquakes successive accompanied him and what became of him by surprise catastrophic affected the economy and the univ

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Publication Date
Thu Oct 12 2023
Journal Name
Journal Of Pakistan Association Of Dermatologists
Association of Human Herpesvirus Type 8 (HHV-8) expression in patients with Kaposi’s sarcoma: A clinico-immunohistochemical study
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Abstract Background: Kaposi’s sarcoma (KS) is an angioproliferative neoplastic disorder that occurs in different epidemiological forms. Human Herpesvirus type 8 (HHV-8) is established as a causative agent of KS that has been mentioned in textbooks and literature. In the last two decades, KS cases were up searched through many Iraqi medical researches which have been published, but unfortunately, none of which had confirmed this association. Objectives: To assess the association of latent nuclear antigen-1(LANA-1) of HHV-8 among KS patients with clinicopathological parameters and to evaluate if this procedure is valuable for diagnosing this disease through the first immunohistochemical study in Iraq. Methods: This is a clinico-immunohis

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Publication Date
Sun Jul 01 2018
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
KEY TO THE SPECIES OF THE ORTHETRUM NEWMAN, 1833 (ODONATA, LIBELLULIDAE) WITH A NEW RECORD SPECIES IN IRAQ
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This paper provides an identification key to the species of Orthetrum Newman, 1833 (Odonata, Libellulidae), including six species that were collected from different localities in Iraq.

 

    The species of O. anceps (Schneider, 1845) is registered as a new record in Iraq; the most important characters which are used in diagnostic key are included

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Publication Date
Fri Aug 01 2014
Journal Name
Int. J. Mod. Eng. Res
Exact solutions for MHD flow of a viscoelastic fluid with the fractional Burgers’ model in an annular pipe
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This paper presents an analytical study for the magnetohydrodynamic (MHD) flow of a generalized Burgers’ fluid in an annular pipe. Closed from solutions for velocity is obtained by using finite Hankel transform and discrete Laplace transform of the sequential fractional derivatives. Finally, the figures are plotted to show the effects of different parameters on the velocity profile.

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