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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
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Quality of Life for Adult Clients with Hypermobility Syndrome Attending Private Clinics in Baghdad City: A Cross-Sectional Study
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Objective)s): To evaluate the quality of life for adult clients with hypermobility syndrome at private clinics in Baghdad City. Methodology: A cross-sectional study used a purposive ‘’non-probability’’ sample of (75) adult clients with Hypermobility Syndrome (HMS) male and female who age (25-64) years. The data were collected through the utilization of standard developed questionnaire of the world health organization (WHO). Data collected by interview with each client who is involved in the study. Each interview takes approximately (20) minutes. Results: The study revealed that there is an effect of hypermobility syndrome on the quality of life, which recorded fair level in general. The study also reported that there is an effect

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Publication Date
Mon Sep 25 2023
Journal Name
International Journal Of Energy Production And Management
Reducing Energy Consumption in Iraqi Campuses with Passive Building Strategies: A Case Study at Al-Khwarizmi College of Engineering
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University campuses in Iraq are substantial energy consumers, with consumption increasing significantly during periods of high temperatures, underscoring the necessity to enhance their energy performance. Energy simulation tools offer valuable insights into evaluating and improving the energy efficiency of buildings. This study focuses on simulating passive architectural design for three selected buildings at Al-Khwarizmi College of Engineering (AKCOE) to examine the effectiveness of their cooling systems. DesignBuilder software was employed, and climatic data for a year in Baghdad was collected to assess the influence of passive architectural strategies on the thermal performance of the targeted buildings. The simulations revealed that the

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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Insulin Like Growth Factor Binding Protein 7 as a Novel Diagnostic Marker in Sera of Iraqi Patients with Acromegaly
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The purpose of this study was to measure serum levels of insulin-like growth factor-binding protein (IGFBP7), Insulin-like Growth Factor 1 (IGF-1), Growth Hormone (GH), Interleukin 6 (IL-6) and insulin in acromegaly patients and healthy controls. The acromegaly group had 60 patients, while the population group had 30 people who had never had acromegaly before. The concentration of IGFBP7, IGF-1, GH, IL-6, and insulin were determined. The results of the present study indicate that IGFBP7 level in the acromegaly group was significantly lower (1.690.07 ng/mL vs. 2.740.12 ng/mL, respectively, p = 0.001). IGF-1, GH, IL-6, and insulin concentrations were also significantly higher in acromegaly patients. The diagnostic accuracy (2.194) was exce

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Publication Date
Fri Jun 18 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Quadtree partitioning scheme of color image based
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Publication Date
Fri May 01 2020
Journal Name
Journal Of Physics: Conference Series
Semi-group Ideals on prime and semiprime Γ-Near - Rings with Γ- (λ,δ) – derivations
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Abstract<p>Let h is Γ<sub>−(λ,δ) –</sub> derivation on prime Γ<sub>−</sub>near-ring G and K be a nonzero semi-group ideal of G and δ(K) = K, then the purpose of this paper is to prove the following :- (a) If λ is onto on G, λ(K) = K, λ(0) = 0 and h acts like Γ<sub>−</sub>hom. or acts like anti–Γ<sub>−</sub>hom. on K, then h(K) = {0}.(b) If h + h is an additive on K, then (G, +) is abelian.</p>
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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
On the Connection between the Dynamical System and the Ellis Compactification with Transitive Pointed System
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In this paper, some relations between the flows and the Enveloping Semi-group were studied. It allows to associate some properties on the topological compactification to any pointed flows. These relations enable us to study a number of the properties of the principles of flows corresponding with using algebric properties. Also in this paper proofs to some theorems of these relations are given.

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of Engineering
Experimental Study on Double-Pass Solar Air Heater with and without using Phase Change Material
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In this paper, an experimental study was conducted to enhance the thermal performance of a double-pass solar air heater (SAH) using phase change material (PCM) for thermal storage at climatic conditions of Baghdad city - Iraq. The double-pass solar air heater integrated with thermal storage system was manufactured and tested to ensure that the air heating reserved after the absence of the sun. The rectangular cavity filled with paraffin wax was used as a latent heat storage and incorporated into the lower channel of solar air heater. Experiments were carried out to evaluate the charging and discharging characteristics of two similar designed solar air collectors with and without using phase change material at a constant

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
A Comparative Study of Various Intelligent Algorithms Based Nonlinear PID Neural Trajectory Tracking Controller for the Differential Wheeled Mobile Robot Model
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This paper presents a comparative study of two learning algorithms for the nonlinear PID neural trajectory tracking controller for mobile robot in order to follow a pre-defined path. As simple and fast tuning technique, genetic and particle swarm optimization algorithms are used to tune the nonlinear PID neural controller's parameters to find the best velocities control actions of the right wheel and left wheel for the real mobile robot. Polywog wavelet activation function is used in the structure of the nonlinear PID neural controller. Simulation results (Matlab) and experimental work (LabVIEW) show that the proposed nonlinear PID controller with PSO
learning algorithm is more effective and robust than genetic learning algorithm; thi

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Publication Date
Tue Feb 04 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
A Comparative Study on the Probability of Diabetes and Psychosocial Deficiency of Badminton Players Youth Category
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Many people believe that diabetes appears after a psychological crisis, which is a misconception but it could be in them before having a crisis ore the crisis. But emotion increases the appearance of symptoms, and athletes are at risk of developing diabetes. Hypoglycemia is not unusual for athletes, and during physical activity the sugar level changes in the blood. Therefore, it is important to conduct tests for the measurement of sugar before and immediately after the activity, for the purpose of detecting the sharp drop in the sugar level and treating it, and the early detection is necessary to avoid the possibility of diabetes, the concept of psychological immunity in psychology is considered a positive concepts that maintain the balance

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Publication Date
Thu Apr 29 2021
Journal Name
International Journal Of Pavement Engineering
An assessment of lime-cement stabilisation on the elastic and resilient moduli of a clayey soil
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