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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 Oct 01 2011
Journal Name
Journal Of Engineering
SOLAR WATER HEATER WITH SHELL AND HELICAL COILED TUBE HEAT EXCHANGER AS A STORAGE TANK
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In this work an experimental study is performed to evaluate the thermal performance
of locally made closed loop solar hot water system using a shell and helical coiled tube
heat exchanger as a storage tank. Several measurements are taken include inlet and outlet
temperatures of both collectors and supply water and temperature distribution within the
storage tank. This is beside the water flow rate in both collectors and load cycle. The
main parameters of the system are obtained.

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Publication Date
Wed May 08 2024
Journal Name
Journal Of Mathematics And Computer Science
How does media coverage affect a COVID-19 pandemic model with direct and indirect transmission?
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In this paper, a compartmental differential epidemic model of COVID-19 pandemic transmission is constructed and analyzed that accounts for the effects of media coverage. The model can be categorized into eight distinct divisions: susceptible individuals, exposed individuals, quarantine class, infected individuals, isolated class, infectious material in the environment, media coverage, and recovered individuals. The qualitative analysis of the model indicates that the disease-free equilibrium point is asymptotically stable when the basic reproduction number R0 is less than one. Conversely, the endemic equilibrium is globally asymptotically stable when R0 is bigger than one. In addition, a sensitivity analysis is conducted to determine which

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Publication Date
Thu Feb 05 2026
Journal Name
Polymers
A Flexible, Antibacterial Platform: Silver-Tuned Polyvinyl Alcohol with Enhanced Opto-Mechanical and Electrical Properties
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Silver/polyvinyl alcohol (Ag/PVA) nanocomposite films were synthesized via solution casting with varying concentrations of Ag nanoparticles (1–5 wt%). A comprehensive investigation was conducted to understand the influence of Ag content on the structural, optical, mechanical, thermal, electrical, and antibacterial properties of the composites. UV-Vis spectroscopy revealed a red shift in absorption peaks and a reduction in the optical band gap, which decreased from 3.78 eV for pure PVA to 3.37 eV for the 5 wt% Ag composite. FTIR and SEM analyses confirmed successful nanoparticle incorporation and morphological changes. The nanocomposites exhibited enhanced tensile strength, elongation at break, Young’s modulus, and hardness due t

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Publication Date
Thu May 10 2018
Journal Name
Global Journal Of Health Science; Issn 1916-9736 E-issn 1916-9744
Effects of Biological and Non Biological Agents (Disease Modifying Antirheumatic Drugs) on Bone Mineral Density in a Sample of Rheumatoid Arthritis Patients
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Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D

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Publication Date
Sun Sep 06 2015
Journal Name
Baghdad Science Journal
A study of the effect of new cobalt (II) complex and cyclophosphamide drug on (GPT, ALP) activity by using in vivo system
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The present work involved a study the effect of cobalt(II) complex with formula [CoL(H2O)NO3] .4ETOH where L=Nitro [5-(P-nitro phenyl) -4-phenyl-1,2,4 traizole-3-dithiocarbamato hydrazide] aqua. (4) Ethanol and anti-cancer drug - cyclophosphamide on specific activity of two liver enzymes (GPT,ALP) by utilizing an in vivo system in female mice. On the enzymatic level an inhibition in the activity of GPT was noticed in different body organs such as liver, kidney and lung. The inhibition was noticed in both test and cyclophosphamide drug (cp). Mice were treated with three doses of cyclophosphamide (90,180, 250) ?g/ mouse for three days. The same doses were used for the cobalt (II) complex. The liver shows the highest rate of(GPT) inhibition co

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Marketing commission and its role in enhancing the competitive advantage of insurance companies : Applied research on a sample of Iraqi insurance companies
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Abstract:

                 The research aims to improve the insurance service through the marketing commission as a tool that enables the insurance companies to achieve a competitive advantage. The researcher, by observing the challenges faced by insurance companies, insurance agents and brokers, raised the main question of the research: Is there an effect of the marketing commission on the competitive advantage of insurance companies? The data was obtained through the financial statements and annual reports of the research sample companies (the National General Insurance Company, the Iraqi General Insurance Company, Al-Hamra Private

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Publication Date
Thu Jul 27 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Clinicopathological Features of Colorectal Cancer in the Iraqi Population Focusing on Age and Early-Onset of Malignancy: A Descriptive Cross-Sectional Study
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Background: Colorectal cancer (CRC) is one of the top ten most common cancers worldwide. There are multiple risk factors for CRC, one of which is aging. However, in recent years, CRC has been reported in children. Objective: To describe the main characteristics and symptoms of CRC as well as highlight pathologic data for early-onset CRC. Methods: 79 CRC patients were recruited from the Oncology Teaching Hospital in the period February–December 2022. A questionnaire was used to collect demographic and clinical data. Results: 25 (31.6%) of patients were below 50 years of age. 52 (65.8%) patients had tumors in the colon. The most common symptom is bleeding per rectum in both age groups. There was no significant difference in patholog

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Publication Date
Thu Nov 01 2007
Journal Name
University Of Baghdad
The Psychic Experience and its Effects on the Creative Process: A Study in Selected Poems By Allen Ginsberg and David Gascoyne
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Evidences indicate that human beings were preoccupied with extreme forms of mental and psychic experiences long before they were recorded in literature. Greek myths and legends appear to include symbolizations of delusions, mania, and other bizarre forms of thought and behaviuor. The figure of the mad man or woman is analogous to the wild man, or the imaginary being who appears in various forms throughout western literature and art. Various studies refer to the notion of the wild man as a response to a persistent psychological urge. This urge gives an external expression and a valid form to the impulses of reckless physical self-assertion which is believed to be hidden in all of us, but is normally kept under control. Such impulses were exp

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The accuracy of cone-beam computed tomography in the evaluation of boney support of teeth among patients with a unilateral cleft of lip and palate among IraqiPopulation
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Background: To evaluate the bony supports of the teeth adjacent to the area of cleft in patient with unilateral cleft lip and palate and to compare these measurements with the measurements of the same teeth in non-cleft side by using CBCT. Materials and methods: The CBCT scans of 30 patients having cleft lip( unilateral) and palate(unilateral), were analyzed and the measurements of the alveolar bony support for teeth that are adjacent to the cleft area were measured with those teeth located on opposite side (non- clef) side. For each tooth, the measurements will taken for the distance between the( cementoenamel junction) (CEJ) and the bony crest (AC) at the( buccal area) was measured and the thickness of the buccal plate At zero, one, tw

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Publication Date
Sun Jun 27 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Quality of Nursing Care Services Provided to Children under Five Years Based on Integrated Management of Child Health at Primary Health Care Centers in Baquba City
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Objective(s): The study aims to evaluating the quality of nursing care provided to children under five years to compare between quality related to type of health sectors; to determine the quality of nursing care and to compare between such care in Baquba Health Care Sector I and II.

Methodology: A descriptive study is carried out for the period from December 15th 2019 to May 1st 2020. A purposive "non- probability" sample, of (60) staff nurse and (60) children is selected. An adopted questionnaire has been selected for the study which consists of three parts. The first part is nurses’ socio-demographic characteristic; the second part is ch

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