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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
Fri Nov 10 2017
Journal Name
Iosr Journal Of Agriculture And Veterinary Science (iosr-javs)
Influence of adding ascorbic acid and yeast on growth and yield and Rhizobium of snap bean (Phaseolus vulgaris L.) under irrigation with saline water
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A field experiment was carried out in Horticulture Department / Collage of Agricultur e/University of Baghdad to study influence of adding ascorbic acid(asa) and bread yeast extract in snap bean cv.primel under irrigation with saline water using sodium chloride salt (NaCl) during spr ing season of 2016 .A factorial experiment using Randomized Complete Block Design( RCBD) with three replications wereconducted . The first factor includes three treatments of salinity which were tap water ( S0), 4ds.m-1(S1) and 8ds.m-1 (S2) . The second factor includes three treatments which were control treatment without any adding (C) ,ascorbic acid 0.3g.l-1( A ) and yeast extract 12g.l -1( Y ). Results showed significant and gradually decreases in all studie

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Publication Date
Mon Nov 01 2021
Journal Name
Review Of International Geographical Education
Thought and emotion with their role in interior design
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The current research deals with thought and emotion and their role in interior design, and in the firstchapter, the research problem was identified through contemplation and an extensive study of theextent of the possibility of representing thought and emotion and shedding light on them according towhat the research seeks to express, which theorizations in the field of interior design have not beenexposed to. The importance of the research was manifested in being a cognitive addition to researchersin the field of interior design in the College of Fine Arts and its corresponding colleges, to benefit from ascientific material that is unique in dealing with the terms of thought and emotion in designs for publicinterior spaces by studying the d

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
A Study of Some Physical Properties for Binary System of Cyclohexane with n-decane and 1-pentanol at Different Temperatures
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mixtures of cyclohexane + n-decane and cyclohexane + 1-pentanol have been measured at 298.15, 308.15, 318.15, and 328.15 K over the whole mole fraction range. From these results, excess molar volumes, VE , have been calculated and fitted to the Flory equations. The VE values are negative and positive over the whole mole fraction range and at all temperatures. The excess refractive indices nE and excess viscosities ?E have been calculated from experimental refractive indices and viscosity measurements at different temperature and fitted to the mixing rules equations and Heric – Coursey equation respectively to predict theoretical refractive indices, we found good agreement between them for binary mixtures in this study. The variation of th

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Publication Date
Fri Mar 01 2019
Journal Name
Archives Of Plastic Surgery
Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods
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Background Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle.

Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a mod

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Publication Date
Sat May 01 2021
Journal Name
Chemical Engineering Research And Design
Ternary glycerol-based deep eutectic solvents: Physicochemical properties and enzymatic activity
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The present study investigates deep eutectic solvents (DESs) as potential media for enzymatic hydrolysis. A series of ternary ammonium and phosphonium-based DESs were prepared at different molar ratios by mixing with aqueous glycerol (85%). The physicochemical properties including surface tension, conductivity, density, and viscosity were measured at a temperature range of 298.15 K – 363.15 K. The eutectic points were highly influenced by the variation of temperature. The eutectic point of the choline chloride: glycerol: water (ratio of 1: 2.55: 2.28) and methyltriphenylphosphonium bromide:glycerol:water (ratio of 1: 4.25: 3.75) is 213.4 K and 255.8 K, respectively. The stability of the lipase enzyme isolated from porcine pancreas (PPL) a

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Publication Date
Mon Dec 14 2020
Journal Name
2020 13th International Conference On Developments In Esystems Engineering (dese)
Anomaly Based Intrusion Detection System Using Hierarchical Classification and Clustering Techniques
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With the rapid development of computers and network technologies, the security of information in the internet becomes compromise and many threats may affect the integrity of such information. Many researches are focused theirs works on providing solution to this threat. Machine learning and data mining are widely used in anomaly-detection schemes to decide whether or not a malicious activity is taking place on a network. In this paper a hierarchical classification for anomaly based intrusion detection system is proposed. Two levels of features selection and classification are used. In the first level, the global feature vector for detection the basic attacks (DoS, U2R, R2L and Probe) is selected. In the second level, four local feature vect

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Publication Date
Sun Aug 06 2023
Journal Name
Journal Of Economics And Administrative Sciences
Probit and Improved Probit Transform-Based Kernel Estimator for Copula Density
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Copula modeling is widely used in modern statistics. The boundary bias problem is one of the problems faced when estimating by nonparametric methods, as kernel estimators are the most common in nonparametric estimation. In this paper, the copula density function was estimated using the probit transformation nonparametric method in order to get rid of the boundary bias problem that the kernel estimators suffer from. Using simulation for three nonparametric methods to estimate the copula density function and we proposed a new method that is better than the rest of the methods by five types of copulas with different sample sizes and different levels of correlation between the copula variables and the different parameters for the function. The

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Publication Date
Sun Jul 01 2018
Journal Name
2018 2nd International Conference On Imaging, Signal Processing And Communication (icispc)
Analogy-based Common-Sense Knowledge for Opinion-Target Identification and Aggregation
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The development of Web 2.0 has improved people's ability to share their opinions. These opinions serve as an important piece of knowledge for other reviewers. To figure out what the opinions is all about, an automatic system of analysis is needed. Aspect-based sentiment analysis is the most important research topic conducted to extract reviewers-opinions about certain attribute, for instance opinion-target (aspect). In aspect-based tasks, the identification of the implicit aspect such as aspects implicitly implied in a review, is the most challenging task to accomplish. However, this paper strives to identify the implicit aspects based on hierarchical algorithm incorporated with common-sense knowledge by means of dimensionality reduction.

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Publication Date
Mon May 01 2023
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Comparison hybrid techniques-based mixed transform using compression and quality metrics
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Image quality plays a vital role in improving and assessing image compression performance. Image compression represents big image data to a new image with a smaller size suitable for storage and transmission. This paper aims to evaluate the implementation of the hybrid techniques-based tensor product mixed transform. Compression and quality metrics such as compression-ratio (CR), rate-distortion (RD), peak signal-to-noise ratio (PSNR), and Structural Content (SC) are utilized for evaluating the hybrid techniques. Then, a comparison between techniques is achieved according to these metrics to estimate the best technique. The main contribution is to improve the hybrid techniques. The proposed hybrid techniques are consisting of discrete wavel

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Publication Date
Fri Apr 28 2023
Journal Name
Surgical Neurology International
Neurosurgery theater-based learning: Etiquette and preparation tips for medical students
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