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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 Dec 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of strategic Supremacy on strategic success A case study in Thi Qar Governorate
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Purpose To test the effect of strategic Supremacy on strategic success A case study in Thi Qar Governorate, methodology/approach – this is a mandatory entry.

a case study was used and applied to the Department managers of Government of the province of Thi Qar, Research limitations/implications – It is clear that the strategic Supremacy variable is not being used effectively to achieve strategic success.

Practical implications – use strategic supremacy positively to Support for strategic success. implementing and monitoring ignorance of them in how to use thi

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Publication Date
Mon Feb 01 2021
Journal Name
Proceedings Of The Institution Of Civil Engineers - Structures And Buildings
Effect of soil saturation on load transfer in a pile excited by pure vertical vibration
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A comparison between the resistance capacity of a single pile excited by two opposite rotary machines embedded in dry and saturated sandy soil was considered experimentally. A small-scale physical model was manufactured to accomplish the experimental work in the laboratory. The physical model consists of: two small motors supplied with eccentric mass 0·012 kg and eccentric distance 20 mm representing the two opposite rotary machines, an aluminum shaft with 20 mm in diameter as the pile, and a steel plate with dimensions of (160 × 160 × 20 mm) as a pile cap. The experimental work was achieved taking the following parameters into consideration, pile embedment depth ratio (L/d; length to diameter) and operating freq

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Publication Date
Tue Mar 01 2022
Journal Name
Journal Of Engineering
A Impact of High Voltage Direct Current Link on Transmission Line in Kurdistan Power System
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Kurdistan power system is expanded along years ago. The electrical power is transmitted through long transmission lines. The main problem of transmission lines is active and reactive power losses. It is important to solve this issue, unless, the most of electrical energy will lost over transmission system. In this study, High Voltage Direct Current links/bipolar connection were connected in a power system to reduce the power losses. The 132kV, 50 Hz, 36 buses Kurdistan power system is used as a study case. The load flow analysis was implemented by using ETAP.16 program in which Newton-Raphson method for three cases. The results show that the losses are reduced after inserted HVDC links.

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Publication Date
Tue Apr 08 2025
Journal Name
Heat Transfer
Experimental Study on the Performance of Gradient Pores Density Metal Foam in a Rectangular Channel
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ABSTRACT<p>Various approaches are employed to enhance the heat transfer coefficient and Nusselt number inside the channels. One of the techniques employed for these enhancements is the utilization of porous media. In the current article, a practical investigation of forced convection heat transfer in a rectangular cross‐section channel (0.05 × 0.1 m<sup>2</sup>) with 0.25 m length is conducted. A heater with a heat flux range (450–6000 W/m<sup>2</sup>) is imposed under a copper plate, and the other sides are covered by insulation layers. The air is considered as a working fluid with <italic>Re</italic> (600–2100). The test section is fully filled with gradient pore</p> ... Show More
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Publication Date
Thu Jun 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of Two Different Colorant Solutions on the Color Stability of Bleached Enamel in Association with CPP-ACPF: An In Vitro Study
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Background: One of the drawbacks of vital teeth bleaching is color stability. The aim of the present study was to evaluate the effects of tea and tomato sauce on the color stability of bleached enamel in association with the application of MI Paste Plus (CPP-ACPF). Materials and Methods: Sixty enamel samples were bleached with 10% carbamide peroxide for two weeks then divided into three groups (A, B and C) of 20 samples each. After bleaching, the samples of each group were subdivided into two subgroups (n=10). While subgroups A1, B1 and C1 were kept in distilled water, A2, B2, and C2 were treated with MI Paste Plus. Then, the samples were immersed in different solutions as follow: A1 and A2 in distilled water (control); B1 and B2 in black

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Publication Date
Tue May 12 2009
Journal Name
World Environmental And Water Resources Congress 2009
Modeling the Evolution of Incised Streams in Hammar Mesopotomian Marsh with Emphasis on the Contribution of Tidal Flow in the Filling Requirements
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Publication Date
Thu Jun 13 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Association of the MDR1 Variants (rs2032582 and rs2032583) with Steroid Response in Iraqi Children with Idiopathic Nephrotic Syndrome
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Background: Several studies linked the development of steroid-resistant nephrotic syndrome (SRNS) to genetic variations in the multidrug resistance 1 (MDR1) gene, though a disparity in findings was underlined among children with different ethnic origins. Objective: This study examined the relationship between MDR1 variants (rs2032582 and rs2032583) and the risk of developing SRNS in Iraqi patients with idiopathic nephrotic syndrome (INS). Methods: This case-control study included children with steroid-sensitive INS (SSNS; n=30) and SRNS (n=30) from the Babylon Hospital for Maternity and Pediatrics. Sanger sequencing was used to determine the participants’ genotypes. Results: The rs2032582 genotypes and alleles were not associated

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Publication Date
Mon Jul 13 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of treatment of intra-bony defects with a mixture of ?-tricalcium phosphate - hydroxyapatite granules and oily calcium hydroxide suspension
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Background: An oily calcium hydroxide formulation proved over the last years to be highly efficient in promoting bone regeneration in closed defects as periapical lesions, cysts, or post-extraction defects. The aim of the present study is the assessment of the outcome of treatment of deep intrabony periodontal defects with an Open Flap Debridement) (OFD) + combination of {(30% Hydroxyapatite HAp + 70% ?-Tricalcium Phosphate granules mixed with an Oily Calcium Hydroxide Suspension (OCHS )} and compare the results with {(OFD) alone)}. The combination of OCHS& TCP was used in humans with a sort of positive results, and more conduction of studies was recommended. Material and method: The sample of this study composed of sixteen patients;

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Publication Date
Wed Jan 01 2025
Journal Name
Anais Da Academia Brasileira De Ciências
Gastrointestinal tract colonization with Candida albicans and mucosal immune response in mice treated with Artemisinin and Fluconazole orally
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Abstract The results showed that after treating <italic>C. albicans</italic> with Artemisinin (0.104 mg/ml) for 3 hours the number of <italic>C. albicans</italic> decreased and affected the morphology hyphae and growth of <italic>Candida</italic> compared with Fluconazole (150 mg/ml) and control (infected mice). The biomarker levels in the tongue showed high levels of MDA and TGFβ (623±1.5pg/ml, 586.1±0.13pg/ml respectively) in (infected mice with fungi). IL-37 was recorded high level (49.21±0.21pg/ml) in (Neoral +Fungi + artemisinin + fluconazole) compared with negative control. The finding biomarker levels in stomach showed high levels of MDA and IL-37 (533.8±1.9, 69.76±0.39pg/ml) in (Neor

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Publication Date
Sun Dec 22 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Prevalence of UGT1A1*93 and ABCC5 Polymorphisms in Cancer Patients Receiving Irinotecan-Based Chemotherapy at Al-Najaf Al-Ashraf
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Irinotecan (CPT-11) is a semisynthetic derivative of the antineoplastic agent camptothecin used in a wide range as an anti-cancer agent in many solid tumors because of its cytotoxic effect through the interaction with the topoisomerase I enzyme. The major limiting factors for irinotecan treatment are its association with potentially life-threatening toxicities including neutropenia and acute or delayed-type diarrhea, results from distinct interindividual and interethnic variability due to gene polymorphism.

This is a cross sectional pharmacogentics study was conducted on 25 cancer patients to estimate the prevalence of UGT1A1*93 and ABCC5 allele single nucleotide polymorphism (SNP) in Iraqi cancer patients treated with irinotecan

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