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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
Tue Sep 01 2015
Journal Name
Nano Science And Nano Technology
Preparation CuInSe2 (CIS) by arrested precipitation method as alight absorption layer of photovoltaic solar-cells
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The CuInSe2 (CIS) nanocrystals are synthesized by arrested precipitation from molecular precursors are added to a hot solvent with organic cap- ping ligands to control nanocrystal formation and growth. CIS thin films deposited onto glass substrate by spray - coating, then selenized in Ar- atmosphere to form CIS thin films. PVs were made with power conversion efficiencies of 0.631% as -deposited and 0.846% after selenization, for Mo coated, under AM 1.5 illumination. X-ray diffraction (XRD) and energy dispersive spectroscopy (EDS) analysis it is evident that CIS have the chalcopyrite structure as the major phase with a preferred orientation along (112) direction and the atomic ratio of Cu : In : Se in the nanocrystals is nearly 1 : 1 : 2

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Publication Date
Fri Oct 01 2021
Journal Name
Civil Engineering Journal
Steel Fiber Enhancement upon Punching Shear Strength of Concrete Flat Plates Exposed to Fire Flame
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In this study, the effect of fire flame on the punching shear strength of steel fiber reinforced concrete flat plates was experimentally investigated using nine half-scale specimens with dimensions of 1500×1500 mm and a total thickness of 100 mm. The main investigated variables comprised the steel fiber volume fraction 0, 1, and 1.5% and the burning steady state temperature 500 and 600 °C. The specimens were divided into three groups, each group consists of three specimens. The specimens in the first group were tested with no fire effect to be the reference specimens, while the others of the second and third groups were tested after being exposed to fire-flame effect. The adopted characteristics of the fire test were; (one hour) b

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Publication Date
Mon Aug 14 2023
Journal Name
Mammalia
First record of the Small Indian Mongoose <i>Urva auropunctatus</i> (Hodgson 1836) from Syria
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Abstract<p>The Small Indian Mongoose <italic>Urva auropunctata</italic> (Hodgson 1836) is a small carnivore native to Iraq and South Asia; however, it has been widely introduced worldwide. The species has never been reported in Syria; however, it was suspected to occur in the extreme eastern parts of the country, but no confirmed records were made. In 2021–2022, several sightings were notified during <italic>in situ</italic> surveys in Deir ez-Zor Province in eastern Syria which confirm the first occurrence of the Small Indian Mongoose in the country.</p>
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Publication Date
Sun Jun 30 2024
Journal Name
Wasit Journal For Pure Sciences
Design Polynomial IIR Digital Filters of the Integer Parameters Space Use to Compress Image Data
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Polynomial IIR digital filters play a crucial role in the process of image data compression. The main purpose of designing polynomial IIR digital filters of the integer parameters space and introduce efficient filters to compress image data using a singular value decomposition algorithm. The proposed work is designed to break down the complex topic into bite-sized pieces of image data compression through the lens of compression image data using Infinite Impulse Response Filters. The frequency response of the filters is measured using a real signal with an automated panoramic measuring system developed in the virtual instrument environment. The analysis of the output signal showed that there are no limit cycles with a maximum radius

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Removal Color Study of Toluidine Blue dye from Aqueous Solution by using Photo-Fenton Oxidation
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The degradation of Toluidine Blue dye in aqueous solution under UV irradiation is investigated by using photo-Fenton oxidation (UV/H2O2/Fe+). The effect of initial dye concentration, initial ferrous ion concentration, pH, initial hydrogen peroxide dosage, and irradiation time are studied. It is found put that the removal rate increases as the initial concentration of H2O2 and ferrous ion increase to optimum value ,where in we get more than 99% removal efficiency of dye at pH = 4 when the [H2O2] = 500mg / L, [Fe + 2 = 150mg / L]. Complete degradation was achieved in the relatively short time of 75 minutes. Faster decolonization is achieved at low pH, with the optimal value at pH 4 .The concentrations of degradation dye are detected by spectr

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Publication Date
Mon Jul 10 2023
Journal Name
Journal Of Engineering
Uptake of Fluoride from Water Using Recycled Raw Beef Bone as an Environmently Freindly Waste
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Excessive intake of fluoride, mainly through drinking water is a serious health hazard affecting humans worldwide. In this study, the defluoridation capacities of locally available raw waste beef bones have been estimated. Several experimental parameters including contact time, pH, bone dose, fluoride initial concentration, bone grains size, agitation rate, and the effect of co-existence of anions in actual samples of wastewater were studied for fluoride removal from aqueous solutions. Results indicated excellent fluoride removal effeciency up to 99.7% at fluoride initial concentration of 10 mg F/L and 120 min contact time. Maximum fluoride uptake was obtained at neutral pH range 6-7. Fluoride removal kinetic was well described by the ps

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Publication Date
Fri Mar 10 2023
Journal Name
Proceedings Of The Pakistan Academy Of Sciences: B. Life And Environmental Sciences
Characterization of Titanium dioxide (TiO2 ) Nanoparticles Biosynthesized using Leuconostoc spp. Isolated from Cow’s Raw Milk
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Nanotechnology is a continually expanding field for its uses and applications in multiple areas i.e. medicine, science, and engineering. Biosynthesis is straightforward, less-toxicity, and cost-effective technology. TiO2 NPs biosynthesis has attained consideration in recent decades. In this study, probiotic bacteria were isolated from cow’s raw milk samples, and then were identified by using the Vitek2 system; as Leuconostoc spp. included Leuconostoc mesenteroides subsp. mesenteroides (Leu.1), Leuconostoc mesenteroides subsp. cremoris (Leu.4), and Leuconostoc pseudomesenteroides (Leu.14). All Leuconostoc spp. isolates showed an ability for TiO2 NPs bio-production, after being incubated at anaerobic conditions (30 o C/ 24 h) in DeM

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Publication Date
Fri Jan 01 2021
Journal Name
Ieee Access
Total Dissolved Salt Prediction Using Neurocomputing Models: Case Study of Gypsum Soil Within Iraq Region
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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi Journal Of Physics
Monte Carlo Simulation for Bremsstrahlung Buildup Factor Produced by Absorption of Y-91 Beta Rays
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This paper presents the first data for bremsstrahlung buildup factor (BBUF) produced by the complete absorption of Y-91 beta particles in different materials via the Monte Carlo simulation method. The bremsstrahlung buildup factors were computed for different thicknesses of water, concrete, aluminum, tin and lead. A single relation between the bremsstrahlung buildup factor BBUF with both the atomic number Z and thickness X of the shielding material has been suggested.

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Publication Date
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Removal of COD from Petroleum refinery Wastewater by Electro-Coagulation Process Using SS/Al electrodes
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Abstract<p>In the present study, the effectiveness of a procedure of electrocoagulation for removing chemical oxygen demand (COD) from the wastewater of petroleum refinery has been evaluated. Aluminum and stainless steel electrodes were used as a sacrificial anode and cathode respectively. The effect of current density (4-20mAcm<sup>−2</sup>), pH (3-11), and NaCl concentration (0-4g/l) on efficiency of removal of chemical oxygen demand was investigated. The results have shown that increasing of current density led to increase the efficiency of COD removal while increasing NaCl concentration resulted in decreasing of COD removal efficiency. Effect of pH was found to be lowering COD re</p> ... Show More
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