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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
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Creative accounting practices for supply contracts and the role of internal audit in reducing them: An exploratory study on a sample of industrial companies in Iraq
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Abstract:

                The internal control is the tool through which it is possible to verify and ensure the implementation of tasks in accordance with the established plans and programs and to evaluate the level of performance that is implemented within the different companies.

A guarantee from the supplier with the absence of a specialized technical committee that follows up the stages of implementing the contract and disbursing all amounts of financial dues to the supplier before completing the implementation of the contract and overlooking the non-implementation of some clauses of the contract by the committee in charge of

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Publication Date
Tue Oct 01 2013
Journal Name
Radioelectronics And Communications Systems
BER performance enhancement for secure wireless communication systems based on DCSK-MIMO techniques under Rayleigh fading channel
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There has been a growing interest in the use of chaotic techniques for enabling secure communication in recent years. This need has been motivated by the emergence of a number of wireless services which require the channel to provide very low bit error rates (BER) along with information security. As more and more information is transacted over wireless media, there has been increasing criminal activity directed against such systems. This paper investigates the feasibility of using chaotic communications over Multiple-Input-Multiple-Output (MIMO) channels. We have studied the performance of differential chaos shift keying (DCSK) with 2×2 Alamouti scheme and 2×1 Alamouti scheme for different chaotic maps over additive white Gaussian noise (

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Publication Date
Mon Jan 01 2024
Journal Name
2nd International Conference For Engineering Sciences And Information Technology (esit 2022): Esit2022 Conference Proceedings
Room temperature flexible sensor based on F-MWCNT modified by polypyrrole conductive polymer for NO2 gas detection
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This project sought to fabricate a flexible gas sensor based on a short functionalized multi-walled carbon nanotubes (f-MWCNTs) network for nitrogen dioxide gas detection. The network was prepared by filtration from the suspension (FFS) method and modified by coating with a layer of polypyrrole conductive polymer (PPy) prepared by the oxidative chemical polymerization to improve the properties of the network. The structural, optical, and morphological properties of the f-MWCNTs and f-MWCNTs/PPy network were studied using X-ray diffraction (XRD), Fourie-transform infrared (FTIR), with an AFM (atomic force microscopy). XRD proved that the structure of f-MWCNTs is unaffected by the synthesis procedure. The FTIR spectra verified the existence o

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Fractally Generated Microstrip Bandpass Filter Designs Based on Dual-Mode Square Ring Resonator for Wireless Communication Systems
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A novel fractal design scheme has been introduced in this paper to generate microstrip bandpass filter designs with miniaturized sizes for wireless applications. The presented fractal scheme is based on Minkowski-like prefractal geometry. The space-filling property and self-similarity of this fractal geometry has found to produce reduced size symmetrical structures corresponding to the successive iteration levels. The resulting filter designs are with sizes suitable for use in modern wireless communication systems. The performance of each of the generated bandpass filter structures up to the 2nd iteration has been analyzed using a method of moments (MoM) based software IE3D, which is widely adopted in microwave research and in

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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
Tapered Splicing Points SMF-PCF-SMF Structure based on Mach-Zehnder interferometer for Enhanced Refractive Index Sensing
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Photonic crystal fiber interferometers (PCFIs) are widely used for sensing applications. This work presented solid core-PCFs based on Mach-Zehnder modal interferometer for sensing refractive index. The general structure of sensor was applied by splicing short lengths of PCF in both sides with conventional single mode fiber (SMF-28).To apply modal interferometer theory collapsing technique based on fusion splicing used to excite higher order modes (LP01 and LP11). A high sensitive optical spectrum analyzer (OSA) was used to monitor and record the transmitted wavelength. This work studied a Mach-Zahnder interferometer refractive index sensor based on splicing point tapered SMF-PCF-SMF. Relation between refractive index sensitivity and tape

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Publication Date
Tue Sep 04 2018
Journal Name
Al-khwarizmi Engineering Journal
Modified Elman Neural-PID Controller Design for DC-DC Buck Converter System Based on Dolphin Echolocation Optimization
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This paper describes a new proposed structure of the Proportional Integral Derivative (PID) controller based on modified Elman neural network for the DC-DC buck converter system which is used in battery operation of the portable devices. The Dolphin Echolocation Optimization (DEO) algorithm is considered as a perfect on-line tuning technique therefore, it was used for tuning and obtaining the parameters of the modified Elman neural-PID controller to avoid the local minimum problem during learning the proposed controller. Simulation results show that the best weight parameters of the proposed controller, which are taken from the DEO, lead to find the best action and unsaturated state that will stabilize the Buck converter system performan

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Robust Color Image Encryption Scheme Based on RSA via DCT by Using an Advanced Logic Design Approach
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Information security in data storage and transmission is increasingly important. On the other hand, images are used in many procedures. Therefore, preventing unauthorized access to image data is crucial by encrypting images to protect sensitive data or privacy. The methods and algorithms for masking or encoding images vary from simple spatial-domain methods to frequency-domain methods, which are the most complex and reliable. In this paper, a new cryptographic system based on the random key generator hybridization methodology by taking advantage of the properties of Discrete Cosine Transform (DCT) to generate an indefinite set of random keys and taking advantage of the low-frequency region coefficients after the DCT stage to pass them to

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Publication Date
Sun Feb 02 2025
Journal Name
Engineering, Technology &amp; Applied Science Research
An Enhanced Document Source Identification System for Printer Forensic Applications based on the Boosted Quantum KNN Classifier
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Document source identification in printer forensics involves determining the origin of a printed document based on characteristics such as the printer model, serial number, defects, or unique printing artifacts. This process is crucial in forensic investigations, particularly in cases involving counterfeit documents or unauthorized printing. However, consistent pattern identification across various printer types remains challenging, especially when efforts are made to alter printer-generated artifacts. Machine learning models are often used in these tasks, but selecting discriminative features while minimizing noise is essential. Traditional KNN classifiers require a careful selection of distance metrics to capture relevant printing

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Publication Date
Sat Dec 17 2011
Journal Name
Journal Of Engineering
Effect of Steering Wheel Vibration on drivers Hands in a Two-Wheel Drivers Hand tractor
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The paper presents research results of the vibration transmitted from the steering wheel of the tractor with a 2-wheel drive to the driver’s hands. The vibration measurements were carried out on the tractor randomly chosen from the collage of agriculture / university of Baghdad. Before testing the tractor was examined and adjusted following the producer’s recommendations. The vibration levels were measured during the operation tillage at idling and at full load .The field was 31.7 m above level sea. Soil was treated at soil constant moisture (17-20 %) with depth of plowing (17 cm). During operation the weather temperature was measured (15 C) and humidity was ( 27 % ) The vibration level on the steering wheel was measured and analyzed .T

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
Effect of Steering Wheel Vibration on drivers Hands in a Two-Wheel Drivers Hand tractor
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The paper presents research results of the vibration transmitted from the steering wheel of the
tractor with a 2-wheel drive to the driver’s hands. The vibration measurements were carried out on the
tractor randomly chosen from the collage of agriculture / university of Baghdad. Before testing the
tractor was examined and adjusted following the producer’s recommendations. The vibration levels
were measured during the operation tillage at idling and at full load .The field was 3١٫٧ m above level
sea. Soil was treated at soil constant moisture (1٧-20 %) with depth of plowing (١٧ cm). During
operation the weather temperature was measured (15 C) and humidity was ( 27 % ) The vibration level
on the steering whee

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