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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
Fri Dec 30 2016
Journal Name
International Journal Of Applied Chemistry
Spectrophotometric Determination of Co(II) by Using Ethyl Cyano(2-Methyl Carboxylate Phenyl Azo Acetate) (ECA)
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A new simple and sensitive spectrophotometric method for the determination of trace amount of Co(II) in the ethanol absolute solution have been developed. The method is based on the reaction of Co(II) with ethyl cyano(2-methyl carboxylate phenyl azo acetate) (ECA) in acid medium of hydrochloric acid (0.1 M) givining maximum absorbance at ((λmax = 656 nm). Beer's law is obeyed over the concentration range (5-60) (μg / ml) with molar absorptivity of (1.5263 × 103 L mol-1 cm-1) and correlation coefficient (0.9995). The precision (RSD% ˂ 1%). The stoichiometry of complex was confirmed by Job's method which indicated the ratio of metal to reagent is (2:1). The studied effect of interference elements Zn(II), Cu(II), Na(I), K(I), Ca(II) and Mg

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Publication Date
Fri Sep 30 2016
Journal Name
Al-khwarizmi Engineering Journal
Modeling the removal of Cadmium Ions from Aqueous Solutions onto Olive Pips Using Neural Network Technique
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The uptake of Cd(II) ions from simulated wastewater onto olive pips was modeled using artificial neural network (ANN) which consisted of three layers. Based on 112 batch experiments, the effect of contact time (10-240 min), initial pH (2-6), initial concentration (25-250 mg/l), biosorbent dosage (0.05-2 g/100 ml), agitation speed (0-250 rpm) and temperature (20-60ºC) were studied. The maximum uptake (=92 %) of Cd(II) was achieved at optimum parameters of 60 min, 6, 50 mg/l, 1 g/100 ml, 250 rpm and 25ºC respectively.

Tangent sigmoid and linear transfer functions of ANN for hidden and output layers respectively with 7 neurons were sufficient to present good predictions for cadmium removal efficiency with coefficient of correlatio

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Solving Optimal Control Linear Systems by Using New Third kind Chebyshev Wavelets Operational Matrix of Derivative
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In this paper, a new third kind Chebyshev wavelets operational matrix of derivative is presented, then the operational matrix of derivative is applied for solving optimal control problems using, third kind Chebyshev wavelets expansions. The proposed method consists of reducing the linear system of optimal control problem into a system of algebraic equations, by expanding the state variables, as a series in terms of third kind Chebyshev wavelets with unknown coefficients. Example to illustrate the effectiveness of the method has been presented.

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Publication Date
Wed Mar 27 2013
Journal Name
Journal Of University Of Babylon
Reduce the required time for measuring the permeability of clayey soils by using new manufactured cell
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Reduce the required time for measuring the permeability of clayey soils by using new manufactured cell

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Publication Date
Thu Aug 01 2024
Journal Name
Baghdad Science Journal
APR-246 enhances the anticancer effect of doxorubicin against p53-mutant AsPC-1 pancreatic cancer cells
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سرطان البنكرياس هو مرض ذو معدل وفيات مرتفع، ولا يزال التشخيص المبكر لسرطان البنكرياس يمثل تحديًا. يظل معدل البقاء النسبي لمدة 5 سنوات أقل من 8%، والاستراتيجيات العلاجية غير فعالة في زيادة معدلات بقاء المريض على قيد الحياة. في خلايا سرطان البنكرياس، ارتبطت مقاومة العلاج بالتغيرات الجينية التي تؤدي إلى ظهور مسارات خلوية شاذة؛ ولذلك، هناك ما يبرر ايجاد استراتيجيات جديدة لعلاج هذا المرض. هنا، سعينا لاستكشاف

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Study the Impact Behavior of the Prosthetic Lower Limb Lamination Materials Due to Low Velocity Impactor
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This work involves three parts ,  first part  is manufacturing different types of laminated below knee prosthetic socket materials with different classical laminated materials used in Baghdad center for prosthetic and orthotic (4perlon layers+2carbon fiber layer+4 perlon layers) , two suggested laminated materials(3perlon layers+2carbon fiber layer+3 perlon layers) and (3perlon layers+1carbon fiber layer+3 perlon layers) ) in order to choose perfect laminated socket . The second part tests (Impact test) the laminated materials specimens used in socket manufacturing in order to get the impact properties for each socket materials groups using an experimental rig designed especially for this purpose. The interface pressure between

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Water Process Engineering
Waterworks sludge-filter sand permeable reactive barrier for removal of toxic lead ions from contaminated groundwater
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Publication Date
Sat Jun 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Corrosion Inhibition of Carbon Steel under Two Phase Flow (Water-Petroleum) Simulated by Turbulently Agitated System
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The corrosion of carbon steel in single phase (water with 0.1N NaCl ) and two immiscible phases (kerosene-water) using turbulently agitated system is investigated. The experiments are carried out for Reynolds number (Re) range of 38000 to 95000 corresponding  to rotational velocities from 600 to 1400 rpm using circular disk turbine agitator at 40 0C. In two-phase system test runs are carried out in aqueous phase (water) concentrations of 1 % vol., 5 % vol., 8% vol., and 16% vol. mixed with kerosene at various Re. The effect of Reynolds number (Re), percent of dispersed phase, dispersed drops diameter, and number of drops per unit volume on the corrosion rate is investigated and discussed. Test runs are carried out using two types of

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Publication Date
Mon Nov 01 2021
Journal Name
Energy Reports
Global solar radiation prediction over North Dakota using air temperature: Development of novel hybrid intelligence model
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Publication Date
Sun Mar 01 2020
Journal Name
Astrophysics And Space Science
The compound stream event of March 20-25, 2011 as measured by the STEREO B spacecraft
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Abstract<p>The interaction of interplanetary coronal mass ejections (ICME) with each other and with co-rotating interaction regions (CIR) changes their configuration, dynamics, magnetic field and plasma characteristics and can make space weather forecasting difficult. During the period of March 20–25, 2011, the Solar Terrestrial Relation Observatory (<italic>STEREO</italic> B) encountered a compound stream containing several interacting structures. Our analysis suggests that the stream consists of two ICMEs followed by an embedded ICME/CIR. The sudden appearance of the third ICME within the fast wind side of the CIR causes the proton temperature(<inline-formula><alternatives><tex-math></tex-math></alternatives></inline-formula></p> ... Show More
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