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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
Wed Jan 01 2014
Journal Name
The Scientific World Journal
Heat Transfer Enhancement of Laminar Nanofluids Flow in a Circular Tube Fitted with Parabolic-Cut Twisted Tape Inserts
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Numerical investigation has been carried out on heat transfer and friction factor characteristics of copper-water nanofluid flow in a constant heat-fluxed tube with the existence of new configuration of vortex generator using Computational Fluid Dynamics (CFD) simulation. Two types of swirl flow generator: Classical twisted tape (CTT) and Parabolic-cut twisted tape (PCT) with a different twist ratio (y= 2.93, 3.91 and 4.89) and different cut depth (w= 0.5, 1.0 and 1.5 cm) with 2% and 4% volume concentration

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
An open cloud-based platform for the creation and delivery of smart applications and services
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Abstract<p>With the increasing integration of computers and smartphones into our daily lives, in addition to the numerous benefits it offers over traditional paper-based methods of conducting affairs, it has become necessary to incorporate one of the most essential facilities into this integration; namely: colleges. The traditional approach for conducting affairs in colleges is mostly paper-based, which only increases time and workload and is relatively decentralized. This project provides educational and management services for the university environment, targeting the staff, the student body, and the lecturers, on two of the most used platforms: smartphones and reliable web applications by clo</p> ... Show More
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Publication Date
Mon Dec 11 2017
Journal Name
Al-khwarizmi Engineering Journal
Design and Implementation for 3-DoF SCARA Robot based PLC
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Abstract 

This paper presents mechanical and electrical design, and implementation  process of industrial robot, 3-DoF type SCARA (selective compliment assembly robot arm),with two rotations and one translation used for welding applications.The design process also included the controller design which was based on PLC(programmable logic controller) as well as selection of mechanical and electrical components.The challenge was to use the available components in Iraq with reasonable costs. The robot mentioned is fully automated using programmable logic controller PLC(Zelio type SR3-B261BD),with 16inputs and 10 outputs. The PLC was implemented in FBD logic to obtain three different automatic motions with hi

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Publication Date
Tue Jan 17 2023
Journal Name
International Journal Of Online And Biomedical Engineering (ijoe)
Private Backend Server Software-Based Telehealthcare Tracking and Monitoring System
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In these recent years, the world has witnessed a kind of social exclusion and the inability to communicate directly due to the Corona Virus Covid 19 (COVID-19) pandemic, and the consequent difficulty of communicating with patients with hospitals led to the need to use modern technology to solve and facilitate the problem of people communicating with each other. healthcare has made many remarkable developments through the Internet of things (IOT) and cloud computing to monitor real-time patients' data, which has enabled many patients' lives to be saved. this paper presents the design and implementation of a Private Backend Server Software based on an IoT health monitoring system concerned emergency medical services utilizing biosenso

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Publication Date
Thu Apr 30 2020
Journal Name
The Asian Esp Journal
A Linguistic Study of ''and'' (و) in Arabic and English.
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The conjunctive ''and'' and its Arabic counterpart ''و'' are discourse markers that express certain meanings and presuppose the presence of other elements in discourse. They are indispensable aids to both the text writers and readers. The present study aims to show that such cohesive ties help the writer to organize his main argument and communicate his ideas vividly and smoothly. They also serve as explicit signals that help readers unfold text and follow its threads as realized in the progression of context. The researcher has utilized the Quirk Model of Semantic Implication for data analysis. A total of 42 (22 for English and 20 for Arabic) political texts selected from different elite newspapers in both Arabic and English for the analy

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Publication Date
Fri Jan 13 2023
Journal Name
World Academy Of Sciences Journal
Potential effects of miR‑146 expression in relation to malondialdehyde as a biomarker for oxidative damage in patients with breast cancer
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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Kinetic Modeling of Electromembrane Extraction of Copper using a Novel Electrolytic Cell Provided with a Supported Liquid Membrane
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   The aim of this study is to investigate the kinetics of copper removal from aqueous solutions using an electromembrane extraction (EME) system. To achieve this, a unique electrochemical cell design was adopted comprising two glass chambers, a supported liquid membrane (SLM), a graphite anode, and a stainless-steel cathode. The SLM consisted of a polypropylene flat membrane infused with 1-octanol as a solvent and bis(2-ethylhexyl) phosphate (DEHP) as a carrier. The impact of various factors on the kinetics constant rate was outlined, including the applied voltage, initial pH of the donor phase solution, and initial copper concentration. The results demonstrated a significant influence of the applied voltage on enhancing the rate of c

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Publication Date
Tue Dec 30 2025
Journal Name
Iraqi Journal Of Science
Blending a New Polymers Containing Oxadiazole Ring with PVA: Synthesis , Thermal Analysis and Biological Activity
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This study focused on the synthesis of novel polymers incorporating the 1,3,4-oxadiazole ring. Four polymers were specifically prepared by blending polymers (6-9) with polyvinyl alcohol (PVA) in defined ratios, resulting in the formation of blended polymers (10-13). The synthesized polymers were characterized using Fourier Transform Infrared (FTIR) spectroscopy and proton nuclear magnetic resonance (1H-NMR). The results showed that the structure aligned with the proposed synthetic polymers. Furthermore, the physical and thermal properties were studied using scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC). Additionally, the biological activity was examined against two s

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Publication Date
Tue Dec 30 2025
Journal Name
Iraqi Journal Of Science
Blending a New Polymers Containing Oxadiazole Ring with PVA: Synthesis , Thermal Analysis and Biological Activity
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This study focused on the synthesis of novel polymers incorporating the 1,3,4-oxadiazole ring. Four polymers were specifically prepared by blending polymers (6-9) with polyvinyl alcohol (PVA) in defined ratios, resulting in the formation of blended polymers (10-13). The synthesized polymers were characterized using Fourier Transform Infrared (FTIR) spectroscopy and proton nuclear magnetic resonance (1H-NMR). The results showed that the structure aligned with the proposed synthetic polymers. Furthermore, the physical and thermal properties were studied using scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and Differential Scanning Calorimetry (DSC). Additionally, the biological activity was examined against two s

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Publication Date
Mon Aug 17 2020
Journal Name
Biochemical And Cellular Archives
SERUM FERRITIN AS A BIOMARKER FOR THYROID GLAND (HYPO AND HYPER) THYRODISM WITH METABOLIC SYNDROME
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