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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
Sun Dec 01 2019
Journal Name
Civil Engineering Journal
Structural Behavior of High Strength Laced Reinforced Concrete One Way Slab Exposed to Fire Flame
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In this study, an experimental investigation had conducted for six high strength laced reinforced concrete one-way slabs to discover the behavior of laced structural members after being exposed to fire flame (high temperature). Self-compacted concrete (SCC) had used to achieve easy casting and high strength concrete. All the adopted specimens were identical in their compressive strength of ( , geometric layout 2000 750 150 mm and reinforcement specifics except those of lacing steel content, three ratios of laced steel reinforcement of (0.0021, 0.0040 and 0.0060) were adopted. Three specimens were fired with a steady state temperature of  for two hours duration and then after the specimens were cooled suddenly by spraying water. The

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Using GIS Technique for evaluating water quality of Abu Zarag marsh during the flood season
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Abstract<p>This research deals with the most important heritage in Iraq, which are the Iraqi marshes, especially Abu Zarag marsh in Al-Nasiriyah city south of Iraq. The research is divided into two parts. The first part deals with evaluating the water quality parameters of Abu Zarag marsh for the period from December 2018 to April 2019 which is the flooding season. The parameters are Temperature, pH, Electrical Conductivity, Total Dissolved Solids, Alkalinity, Total Hardness, Turbidity, Dissolved Oxygen, Sulfate, Nitrate. The second part is a comparison between the water quality parameters during the recent period with the same period during the previous years from 2014 to 2019. The results are </p> ... Show More
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Publication Date
Wed Dec 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Improvement of Surface Roughness Quality for Stainless Steel 420 Plate Using Magnetic Abrasive Finishing Method
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     An experimental study was carried out to improve the surface roughness quality of the stainless steel 420 using magnetic abrasive finishing method (MAF). Four independent operation parameters were studied (working gap, coil current, feed rate, and table stroke), and their effects on the MAF process were introduced. A rotating coil electromagnet was designed and implemented to use with plane surfaces. The magnetic abrasive powder used was formed from 33%Fe and 67% Quartz of (250µm mesh size). The lubricant type SAE 20W was used as a binder for the powder contents. Taguchi method was used for designing the experiments and the optimal values of the selected parameters were found. An empirical equation representing the r

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Publication Date
Wed Sep 22 2021
Journal Name
The Structural Design Of Tall And Special Buildings
Utilizing I‐shaped shear links as dampers to improve the behavior of concentrically braced frames
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Publication Date
Thu Mar 01 2007
Journal Name
Al-khwarizmi Engineering Journal
An investigation into the performance of counter rotating floating ring journal under different working conditions
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The steady state performance of the counter rotating floating ring Journal bearing is analyzed with isothermal finite bearing theory. The effect of different parameters affecting the performance of the bearing (namely speed ratio, clearance ratio and radii ratio), have been investigated. The load carrying capacity of the bearing increasing with decreasing the radii ratio (R2/R1) of the ring and clearance ratio (c1/c2), in the other hand, the coefficient of friction increases with increasing the clearance and radii ratios, while decreases with incre4asing the bearing to journal speed ratio (γ). It is shown during this work that different operating conditions are greatly enhanced the performance

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Publication Date
Wed Jul 01 2020
Journal Name
Journal Of Engineering
Using Adaptive Neuro Fuzzy Inference System to Predict Rate of Penetration from Dynamic Elastic Properties
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Rate of penetration plays a vital role in field development process because the drilling operation is expensive and include the cost of equipment and materials used during the penetration of rock and efforts of the crew in order to complete the well without major problems. It’s important to finish the well as soon as possible to reduce the expenditures. So, knowing the rate of penetration in the area that is going to be drilled will help in speculation of the cost and that will lead to optimize drilling outgoings. In this research, an intelligent model was built using artificial intelligence to achieve this goal.  The model was built using adaptive neuro fuzzy inference system to predict the rate of penetration in

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Publication Date
Fri Jul 01 2022
Journal Name
Journal Of Oral And Maxillofacial Surgery, Medicine, And Pathology
Rhinocerebral mucormycosis: An Iraqi experience of 16 consecutive cases followed up for up ten years
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Publication Date
Sun Mar 01 2020
Journal Name
International Journal For Light And Electron Optics
Optical properties of Ag-doped nickel oxide thin films prepared by pulsed-laser deposition technique
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In this work, pure and Ag-doped nickel oxide (NiO) thin films were deposited on glass substrates with different dopant concentrations (0.1, 0.2, 0.3 and 0.4 wt.%) by pulsed-laser deposition (PLD) technique at room temperature. These films were annealed at temperature of 450 °C. The structural and optical properties of the prepared thin films were studied. It was found that annealing process has lead to increase the transmittance of the deposited films. Also, the transmittance was found to increase with doping concentration of silver in the deposited NiO films. The optical energy gap was decreased from 3.5 to 3.2 eV as the doping concentration was increased to 0.4 %.

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Publication Date
Mon Jan 01 2018
Journal Name
Matec Web Of Conferences
Assessing the performance of commercial Agisoft PhotoScan software to deliver reliable data for accurate3D modelling
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3D models delivered from digital photogrammetric techniques have massively increased and developed to meet the requirements of many applications. The reliability of these models is basically dependent on the data processing cycle and the adopted tool solution in addition to data quality. Agisoft PhotoScan is a professional image-based 3D modelling software, which seeks to create orderly, precise n 3D content from fixed images. It works with arbitrary images those qualified in both controlled and uncontrolled conditions. Following the recommendations of many users all around the globe, Agisoft PhotoScan, has become an important source to generate precise 3D data for different applications. How reliable is this data for accurate 3D mo

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Publication Date
Tue Mar 12 2019
Journal Name
Lubricants
Absorption Wavebands for Discriminating Oxidation Time of Engine Oil as Detected by FT-IR Spectroscopy
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Fourier Transform-Infrared (FT-IR) spectroscopy was used to analyze gasoline engine oil (SAE 5W20) samples that were exposed to seven different oxidation times (0 h, 24 h, 48 h, 72 h, 96 h, 120 h, and 144 h) to determine the best wavenumbers and wavenumber ranges for the discrimination of the oxidation times. The thermal oxidation process generated oil samples with varying total base number (TBN) levels. Each wavenumber (400–3900 cm−1) and wavenumber ranges identified from the literature and this study were statistically analyzed to determine which wavenumbers and wavenumber ranges could discriminate among all oxidation times. Linear regression was used with the best wavenumbers and wavenumber ranges to predict oxidation time.

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