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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 16 2025
Journal Name
Journal Of Kufa For Chemical Sciences
Review Article Miscellaneous Azo Dyes: A Review on Recent Advancements and Applications
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The dyes Azo have a lengthy history and are a vital part of our daily lives. There are numerous potentials uses for these substances and their derivatives in various industries and environmental and biological research. In this study conversion of various azo compounds into other derivatives, complexes, and polymers was accomplished. This review included examining the chemistry reactions, synthesis, and applications of azo dye ligands and their complexes, mentioned spectral, analytical, thermal, and morphology methods of investigation, and confirmed by mass fragment mechanisms for some azo dyes and metal complexes. One of the aims of this review is to explain the role of these azo dye derivatives and the effect of metal complexes on leather

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Publication Date
Tue Dec 02 2025
Journal Name
Journal Of Kufa For Chemical Sciences
Review Article: Miscellaneous Azo Dyes: A Review on Recent Advancements and Applications
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The dyes Azo have a lengthy history and are a vital part of our daily lives. There are numerous potentials uses for these substances and their derivatives in various industries and environmental and biological research. In this study conversion of various azo compounds into other derivatives, complexes, and polymers was accomplished. This review included examining the chemistry reactions, synthesis, and applications of azo dye ligands and their complexes, mentioned spectral, analytical, thermal, and morphology methods of investigation, and confirmed by mass fragment mechanisms for some azo dyes and metal complexes. One of the aims of this review is to explain the role of these azo dye derivatives and the effect of metal complexes on leather

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Publication Date
Tue Jun 14 2022
Journal Name
Iraqi Journal Of Industrial Research
Biofuel Production and Its Impact on Global Food Security: A Review Article
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The aim of this study is to shed light on the importance of biofuels as an alternative to conventional energy, in addition to the importance of preserving agricultural crops, which are the main source of this fuel, to maintain food security, especially in developing countries. The increase in global oil prices, in addition to the fear of global warming, are among the main factors that draw the world’s attention to searching for alternative sources of traditional energy, which are sustainable on the one hand, and on the other hand reduce carbon emissions. Therefore, the volume of global investment in renewable energy in general, and in liquid biofuels and biomass in particular, has increased. Global fears emerged that the excessive

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Publication Date
Wed Jun 29 2022
Journal Name
Journal Of The College Of Education For Women
The Chicago School in Urban Sociology: A Socio-Historical Approach on the Pragmatic Thought Influence as a Theoretical Frame of Reference in it-1892-2020
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The present theoretical study analyzes the legacy of the Chicago School of Urban Sociology and evaluates it in the light of the growth and development of Chicago City and the establishment of sociology in it. Sociology has become an academic discipline recognized in the United States of America in the late nineteenth century, particularly, after the establishment of the first department of sociology in the University of Chicago in 1892. That was during the period of the rapid industrialization and sustainable growth of the Chicago City. The Chicago School relied on Chicago City in particular, as one of the American cities that grew and expanded rapidly in the first two decades of the twentieth century. At the end of the nineteenth centur

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Publication Date
Wed Feb 01 2023
Journal Name
Baghdad Science Journal
3-D Packing in Container using Teaching Learning Based Optimization Algorithm
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The paper aims to propose Teaching Learning based Optimization (TLBO) algorithm to solve 3-D packing problem in containers. The objective which can be presented in a mathematical model is optimizing the space usage in a container. Besides the interaction effect between students and teacher, this algorithm also observes the learning process between students in the classroom which does not need any control parameters. Thus, TLBO provides the teachers phase and students phase as its main updating process to find the best solution. More precisely, to validate the algorithm effectiveness, it was implemented in three sample cases. There was small data which had 5 size-types of items with 12 units, medium data which had 10 size-types of items w

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Publication Date
Mon Nov 09 2020
Journal Name
Construction Research Congress 2020
Alternative Risk Models for Optimal Investment in Portfolio-Based Community Solar
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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Optimal UAV Deployment for Data Collection in Deadline-based IoT Applications
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The deployment of UAVs is one of the key challenges in UAV-based communications while using UAVs for IoT applications. In this article, a new scheme for energy efficient data collection with a deadline time for the Internet of things (IoT) using the Unmanned Aerial Vehicles (UAV) is presented. We provided a new data collection method, which was set to collect IoT node data by providing an efficient deployment and mobility of multiple UAV, used to collect data from ground internet of things devices in a given deadline time. In the proposed method, data collection was done with minimum energy consumption of IoTs as well as UAVs. In order to find an optimal solution to this problem, we will first provide a mixed integer linear programming m

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Publication Date
Mon Mar 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Bionics-Based Approach for Object Tracking to Implement in Robot Applications
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In this paper, an approach for object tracking that is inspired from human oculomotor system is proposed and verified experimentally. The developed approach divided into two phases, fast tracking or saccadic phase and smooth pursuit phase. In the first phase, the field of the view is segmented into four regions that are analogue to retinal periphery in the oculomotor system. When the object of interest is entering these regions, the developed vision system responds by changing the values of the pan and tilt angles to allow the object lies in the fovea area and then the second phase will activate. A fuzzy logic method is implemented in the saccadic phase as an intelligent decision maker to select the values of the pan and tilt angle based

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Publication Date
Sun Apr 01 2018
Journal Name
2018 9th International Conference On Information And Communication Systems (icics)
An intersection-based segment aware algorithm for geographic routing in VANETs
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In networking communication systems like vehicular ad hoc networks, the high vehicular mobility leads to rapid shifts in vehicle densities, incoherence in inter-vehicle communications, and challenges for routing algorithms. It is necessary that the routing algorithm avoids transmitting the pockets via segments where the network density is low and the scale of network disconnections is high as this could lead to packet loss, interruptions and increased communication overhead in route recovery. Hence, attention needs to be paid to both segment status and traffic. The aim of this paper is to present an intersection-based segment aware algorithm for geographic routing in vehicular ad hoc networks. This algorithm makes available the best route f

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Publication Date
Wed Jul 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of orthodontic relapse on the proliferation of fibroblast and epithelial rests of Malassez in periodontal ligament of rat molars (A histopathological study)
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Background: Relapse of previously moved teeth, is major clinical problem in orthodontics with respect to the goals of successful treatment. This study investigated the effect of orthodontic relapse on the proliferation of fibroblast and epithelial rests of Malassez cells in periodontal ligament of rat molars. Materials and Methods: Sixteen ten-week- old male Wister rats were randomly divided into four groups composed of four animals each: Group I received no orthodontic force (control). In both Group II and Group III, uniform standardized expansive springs were used for moving the maxillary first molars buccally for periods of one and three weeks respectively. The spring initially generated an average expansive force of 20 g on each side.

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