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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
Sun Jun 21 2026
Journal Name
Journal Of Petroleum Research And Studies
Possibility to Apply Gas Lift Method for Low Production Wells with High Water Cut in (A) Oil Field
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Gas lift is one of the oldest methods used to produce hydrocarbon fluids from wells experiencing declining production. It works by aerating the mixture inside production tubing and forcing it to the surface. One of the reasons for declining production in oil wells is an increase in water cut or a drop in reservoir pressure, which requires one of the artificial lift methods to restore production. (A) oil field suffers from an increase in water cut, which has affected well productivity. The wells under study have a water cut of up to 66%, resulting in very low production rates. In this research, Pipesim software was used to build a physical and fluid model, then design an optimal gas lift system that achieves the highest possible prod

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Publication Date
Fri Jan 01 2016
Journal Name
Machine Learning And Data Mining In Pattern Recognition
A New Strategy for Case-Based Reasoning Retrieval Using Classification Based on Association
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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Solving Time-Cost Tradeoff Problem with Resource Constraint Using Fuzzy Mathematical Model
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Scheduling considered being one of the most fundamental and essential bases of the project management. Several methods are used for project scheduling such as CPM, PERT and GERT. Since too many uncertainties are involved in methods for estimating the duration and cost of activities, these methods lack the capability of modeling practical projects. Although schedules can be developed for construction projects at early stage, there is always a possibility for unexpected material or technical shortages during construction stage. The objective of this research is to build a fuzzy mathematical model including time cost tradeoff and resource constraints analysis to be applied concurrently. The proposed model has been formulated using fuzzy the

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Publication Date
Mon Mar 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
Speech Enhancement Algorithm Based on a Hybrid Estimator
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Abstract<p>Speech is the essential way to interact between humans or between human and machine. However, it is always contaminated with different types of environment noise. Therefore, speech enhancement algorithms (SEA) have appeared as a significant approach in speech processing filed to suppress background noise and return back the original speech signal. In this paper, a new efficient two-stage SEA with low distortion is proposed based on minimum mean square error sense. The estimation of clean signal is performed by taking the advantages of Laplacian speech and noise modeling based on orthogonal transform (Discrete Krawtchouk-Tchebichef transform) coefficients distribution. The Discrete Kra</p> ... Show More
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Publication Date
Sat Sep 26 2026
Journal Name
Journal Of Baghdad College Of Dentistry
A Clinical Method for Prediction of Alveolar Bone Mineral Density in the Area between the Second Premolar and First Molar in Iraqi Adults with Class I Occlusion
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Background: Orthodontic mini-implants are increasingly used in orthodontics and the bone density is a very important factor in stabilization and success of mini-implant. The aim of this study was to observe the relationship among maximum bite force (MBF); body mass index (BMI); face width, height and type; and bone density in an attempt to predict bone density from these variables to eliminate the need for CT scan which have a highly hazard on patient. Materials and Methods: Computed tomographic (CT) images were obtained for 70 patients (24 males and 46 females) with age range 18-30 years. The maxillary and mandibular buccal cortical and cancellous bone densities were measured between 2nd premolar and 1st molar at two levels from the alveol

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Office managers skills and it's impact on the effectiveness of time management A survey of a sample of departments managers in the institutes and faculties at the middle technical university
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The objective of this study is to highlight the skills of office managers and it's impact on the effectiveness of time management in the institutes and faculties of middle technical university and a group of cognitive and practical aims. The managers skills forms mthe modern trend and the main source to provide organizations with highly skilled managers with distinctive performance and because of the sharp changes in the environment which today's organizations works in it , business organizations generally and managers especially realise the importance of time management and it's role in achieving competitive advantage . The problem of this study raised from this point which reflect the extent of departments managers realisation

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Job satisfaction and its relation to the effectiveness of performance: Applied research on a sample of employees in the Federal board of supreme Audit
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The research aimed to study the job satisfaction of the staff of the Federal board of supreme Audit and its relation to the effectiveness of their performance, The questionnaire was adopted as a main tool in the collection of data and information from a random sample of (54) employees of the Federal board of supreme Audit. In light of this, the data were collected and analyzed and the hypotheses were tested using the statistical program (SPSS).

The researchers reached a number of conclusions, the most important of which were: (1) the respondents' response to the variables of job satisfaction and the effectiveness of the performance were medium; (2) there was a significant relationship between job satisfaction and performance effe

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Publication Date
Thu Aug 01 2013
Journal Name
Biochemistry
Mechanistic Insights from the Binding of Substrate and Carbocation Intermediate Analogues to Aristolochene Synthase
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Publication Date
Wed Jul 15 2026
Journal Name
European Journal Of Dentistry
Airway-centric Orthodontics: A Narrative Review of Current Evidence and Clinical Implications
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Abstract<p>Airway-centric orthodontics has been proposed as a conceptual framework that extends the traditional understanding of craniofacial development, functional disturbances, and orthodontic treatment outcomes beyond a purely dental perspective. This approach focuses on the potential interplay among upper airway characteristics, breathing patterns, and orofacial muscle function in influencing facial growth and occlusal relationships. This narrative review aims to outline the theoretical foundations of airway-centric orthodontics and to synthesize current evidence regarding the associations among upper airway characteristics, craniofacial morphology, and orthodontic interventions. A compr</p> ... Show More
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Publication Date
Sun Aug 10 2025
Journal Name
Central Asian Journal Of Medical And Natural Science
Microbial Load Comparison Between Clinical and Non-Clinical Student Environments in Al-Kindy College of Medicine
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The environmental surfaces hygiene of college premises like classrooms play role in spreading different pathogenic bacteria, furthermore a Medical students are often potential vectors for resistant bacteria to their entourage. This study aimed to assess bacterial contamination and their susceptibility to various antimicrobial agents in the educational classroom of Al-Kindy College of medicine in two classrooms: one occupied by clinical visitor and non-clinical visitor students to evaluate and determine its health risk. In this cross-sectional study, different sites of the educational classroom of Al-Kindy College of medicine were studied.&nbsp; Ninety-sex Different swab samples were collected from 8 different sites of college across bot

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