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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 2011
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Laminar Free Convection in Three Dimensional Inclined Porous Annulus with Fins on the Inner Cylinder
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An experimental and numerical study was carried out to investigate the heat transfer by natural convection in a three dimensional annulus enclosure filled with porous media (silica sand) between two inclined concentric cylinders with (and without) annular fins attached to the inner cylinder under steady state condition. The experiments were carried out for a range of modified Rayleigh number (0.2 ≤Ra*≤ 11) and extended to Ra*=500 for numerical study and for annulus inclination angle of (δ = 0˚, 30˚, 60˚ and 90˚). The numerical study was to give the governing equation under assumptions that used Darcy law and Boussinesq’s approximation and then it was solved numerically using finite difference approximation. It was found that t

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Multi-pages structure for Six Sigma performance matrix based on the technical characteristics of balanced performance and methodology Al-Sigma for measuring corporate performance: Suggestion vision
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Accelerates operating managements in the facilities contemporary business environment toward redefining processes and strategies that you need to perform tasks of guaranteeing them continue in an environment performance dominated by economic globalization and the circumstances of uncertainty attempt the creation of a new structure through multiple pages seek to improve profitability and sustainable growth in performance in a climatefocuses on the development of institutional processes, reduce costs and achieve customer satisfaction to meet their demands and expectations are constantly changing. The research was presented structural matrix performance combines methodology Alsigma in order to improve customer satisfaction significantly bet

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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using Lean Accounting in Simplifying and Modifying Financial Reports (Focus on Value Stream): A practical Study in AL- Hayat Soft Drinks and Mineral Water Company
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With the advent of the globalization, the rapid development in technology and the intensity of competition companies attemptto maintain competition advantages and retain customers. The traditional methods in managerial accounting become irrelevance to achieve the objectives of these companies especially with the rapid changes in modern manufacturing environment .Thus there is a need to new tools in accounting such as lean accounting, which is considered as a costing method that support creating value for the customer by costing the entire value stream, eliminating waste in the accounting process, reduced lead time, improved quality, lowered time delivery and increased available capacity. Using value stream focuses not only on the waste&n

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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Success Of The Project Management In light of the Learning Organization Characteristics field reserche for the opinion of simple of worker at the State Commission For Road and Bridge
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Publication Date
Fri Jun 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Contribution of Privatization in Tax Revenues: an applied research on a sample of filling stations
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The tax revenues achieved through projects of transition to private sector are regarded as an important source for using in achieving political, economic and social objectives. Since Iraq is heading towards free market economy, new strategies should be adopted to reform the taxation system from by a qualified taxation management office and to activate the taxation policy and to reconsider legislation in relation to the aware of the legible to the importance of disclosure of their taxable real income in order to arrive at contribution of privatization in the taxation revenues for the important role effect on economic activities. In the light of the above, the research is based upon a hypothesis which stipulates that privatization contribu

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Publication Date
Fri Mar 01 2013
Journal Name
International Journal Of Recent Research And Review
Influence of Discharge Pressure on the Plasma Parameter in a Planar Dc-Sputtering Discharge of Argon
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Abstract- Plasma parameters in a planar dc-sputtering discharge in argon were measured by cylindrical electrostatic probe (Langmuir probe).Electron density, electron temperature, floating potential, and space potential were monitored as a function of working discharge pressure. Electrostatic probe and supporting circuit were described and used to plot the current – voltage characteristics. Plasma properties were inferred from the current-voltage characteristics of a single probe positioned at the inter-cathode space. Typical values are in the range of (10-16 -10-17) m-3 and (2.93 – 5.3) eV for the electron density and the electron temperature respectively.

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Publication Date
Thu Dec 31 2020
Journal Name
Political Sciences Journal
Effects of international variables on the principle of citizenship in Arab countries: "Kuwait as a Model"
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The principle of citizenship has international dimensions that affect the application of the principle, such as the structure of the international system, and the control of the concepts of globalization, international organizations which played an important role in the consolidation of this principle.

The problem of the study revolves around the effects of international variables on the principle of citizenship in Kuwait during the period 1991-2018.

The study used several indicators, such as: the rule of law, achieving the principle of separation of powers, the right to form parties, the application of the law of nationality, and racial discrimination, women's rights, and freedom of expression.

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Publication Date
Mon Jun 01 2020
Journal Name
مجلة العلوم و التكنولوجية للنشاطات البدنية و الرياضية/ الجزائر
The effect of using the five-finger strategy on learning movement chain on a balance beam in the artistic gymnastics of women
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Abstract: The aim of the research identify the effect of using the five-finger strategy in learning a movement chain on the balance beam apparatus for students in the third stage in the College of Physical Education and Sports Science, as well as to identify which groups (experimental and controlling) are better in learning the kinematic chain on the balance beam device, has been used The experimental approach is to design the experimental and control groups with pre-and post-test. The research sample was represented by third-graders, as the third division (j) was chosen by lot to represent the experimental group, and a division Third (i) to represent the control group, after which (10) students from each division were tested by lot to repr

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Publication Date
Sat Apr 01 2017
Journal Name
Desalination
Heat transfer coefficients and yield analysis of a double-slope solar still hybrid with rubber scrapers: An experimental and theoretical study
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Publication Date
Thu Jan 06 2022
Journal Name
Chemical Papers
A solvent collection technique using dispersive liquid–liquid microextraction coupled with spectrophotometry for the trace determination of folic acid in pure, dosage forms and flaxseed
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A simple, rapid and environmentally friendly dispersive liquid–liquid microextraction method-based spectrophotometric method for the trace determination of folic acid has been developed. The proposed method is based on the formation of a deep yellow product via reaction of folic acid and 1,2-naphthoquine-4-sulfonate at pH = 9. The formed complex was extracted using a mixture of chloroform and ethanol. Then, the tiny organic droplets were measured at λ = 520 nm. At the optimum conditions, linearity was ranged from 0.05 to 1.5 μg/mL for the standard and samples, with a linear correlation coefficient of 0.9996. The detection limits were 0.02, 0.027, 0.03, 0.02 and 0.04 μg/mL for standard, tablet (5 mg), tablet (1 mg), syrup and fl

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