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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 Jul 23 2026
Journal Name
Egyptian Journal Of Aquatic Biology And Fisheries
Evaluation of the Yellow Mealworm (Tenebrio molitor) Meal as an Alternative Protein Source for Common Carp (Cyprinus carpio) Fingerlings
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This study evaluated yellow mealworm (Tenebrio molitor) larvae meal as an alternative animal-protein ingredient in diets for common carp (Cyprinus carpio) fingerlings. Two diets were compared for 60 days: a conventional fish-meal diet (T1; 32.09% crude protein) and a diet in which the animal-protein component was replaced weight-for-weight with T. molitor meal (T2; 23.88% crude protein). Each treatment was tested in duplicate tanks containing 28 fingerlings per tank, and growth was assessed over three consecutive 20-day phases. The initial mean body weight was 3.21 g. Weight gain differed significantly between treatments (p < 0.05), with the highest total value recorded in T2 (4.87 ± 0.47 g). The T2 diet produced a significantly higher fee

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Publication Date
Wed Jan 01 2014
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Reaction 32 70 70 33 Ge p n As (, ) γ Using a2-ratio Method.
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The δ-mixing of γ-transitions in 70As populated in the 32 70 70 33 Ge p n As (, ) γ reaction is calculated in the present work by using the a2-ratio methods. In one work we applied this method for two cases, the first one is for pure transition and the sacend one is for non pure transition, We take into account the experimental a2-coefficient for previous works and δ -values for one transition only.The results obtained are, in general, in a good agreement within associated errors, with those reported previously , the discrepancies that occur are due to inaccuracies existing in the experimental data of the previous works.

Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
Single Nucleotide Polymorphism of Interleukin-28β Subunit Genes Predict Host Susceptibility to Hepatitis C virus (HCV) Infection among Iraqi Patients
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Hepatitis C virus (HCV) is a liver disease that affects14 million people. Feasible research was conducted for identifying the genotypes and allele frequency of some single nucleotide polymorphisms (SNPs) of the IL-28β genes and their predictive role in disease incidence in Iraqi patients. The SNPs (rs28416813, rs4803219, rs11881222, and rs8103142) of IL-28β have been associated with susceptibility to several diseases. Ninety eight (98) HCV patients were included in this research; with average age ± SE (42.28 ± 3.44) years. Also, 80 healthy people (with average age ± SE (29.40 ± 2.84) years) were included as a control group. The SNPs were detected by allele-specific PCR (polymerase chain reaction) using specific primers. The re

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Skills of Intended Meaning behind the Context when Reading Poetry among Fifth Grade Students- Literary Branch from Teachers’ Perspectives
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        The current research aims to investigate the skills of the intended meaning beyond the context when reading poetry among fifth literary students. To achieve the aim of the research, the researcher has followed the descriptive approach and used two tools: an open questionnaire that includes an inquiry about the skills of the intended meaning beyond the poetic context, and a closed questionnaire that were examined by the juries, and modified accordingly. Besides, its validity and stability were examined by applying the study on an exploratory sample of (15) teachers to reach its final version and determine the time required to answer it. Then, the researcher applied it on the research sample of (9

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Choosing the best method for estimating the survival function of inverse Gompertz distribution by using Integral mean squares error (IMSE)
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In this research , we study the inverse Gompertz distribution (IG) and estimate the  survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes

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Publication Date
Sun Mar 06 2022
Journal Name
Nature Environment And Pollution Technology
Green Synthesis Of Bimetallic Iron/Copper Nanoparticles Using Ficus Leaves Extract For Removing Orange G(OG) Dye From Aqueous Medium
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This study shows that it is possible to fabricate and characterize green bimetallic nanoparticles using eco-friendly reduction and a capping agent, which is then used for removing the orange G dye (OG) from an aqueous solution. Characterization techniques such as scanning electron microscopy (SEM), Energy Dispersive Spectroscopy (EDAX), X-Ray diffraction (XRD), and Brunauer-Emmett-Teller (BET) were applied on the resultant bimetallic nanoparticles to ensure the size, and surface area of particles nanoparticles. The results found that the removal efficiency of OG depends on the G‑Fe/Cu‑NPs concentration (0.5-2.0 g.L-1), initial pH (2‑9), OG concentration (10-50 mg.L-1), and temperature (30-50 °C). The batch experiments showed

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Publication Date
Tue Mar 12 2024
Journal Name
مداد الآداب
“As if sky was blue”: An Eco-Marxist Reading of Caryl Churchill’s Play Not Not Not Not Not Enough Oxygen
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 Humanity is confronted with a growing array of environmental challenges that demand immediate attention and cannot be disregarded. One of the issues the world faces is air pollution, which presents a significant risk to both the environment and human well-being. The capitalist system has a great impact on the exacerbation of air pollution and environmental deterioration. This impact is reflected in Caryl Churchill’s post-apocalyptic play Not Not Not Not Not Enough Oxygen (1971). The play presents a futuristic scenario in which humanity faces grave consequences due to the polluting practices of capitalism and the unsustainable exploitation of natural resources. It depicts a future in which environmental degradation drives people

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Physics: Conference Series
Neural Network Model for Synthesis of Thermally Sprayed (AI/AI<sub>2</sub>O<sub>3</sub>) Composite Protective Coatings
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Abstract<p>Al<sub>2</sub>O<sub>3</sub> and Al<sub>2</sub>O<sub>3</sub>–Al composite coatings were deposited on steel specimens using Oxy-acetylene gas thermal spray gun. Alumina was mixed with Aluminum in six groups of concentrations (0, 5, 10,12,15 and 20% ) Al2O3, Specimens were tested for corrosion using Potentiodynamic polarization technique. Further tests were conducted for the effect of temperature on polarization curve and the hardness tests for the coated specimens. At first, Modelling was carried out using MINITAB-19, least square method, as a 2nd degree nonlinear model, bad results were achieved because of the high nonlinearity. Better result w</p> ... Show More
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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Japanese territorial dispute about the Soviet northern provinces )South Kuril Islands until the end of the Cold War( Historical Study
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The imposition of (state) policy on the South Kuril Islands.In the Pacific was a subject
of borders dispute between Japan and Soviet Union which appeared clearly afterthe second
Great War and during the cold war. Despite the end of the Cold War and the collapse of the
Soviet Union in 1991, this conflict has continued, thus both countries had to made a historic
and legitimate claims to demand the rights of sovereignty and ownership of four islands
occupied by the Soviet Union after World War II under the international conventions and
treaties, but these claims are proven failures through the continuation of the regional conflict.

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Choosing the best method for estimating the survival function of inverse Gompertz distribution by using Integral mean squares error (IMSE)
...Show More Authors

In this research , we study the inverse Gompertz distribution (IG) and estimate the  survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes

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