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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 Aug 30 2022
Journal Name
Research Journal Of Pharmacy And Technology
Status of HBeAg in association with other baseline tests in Iraqi patients with CHB
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Chronic Hepatitis B(CHB) is a serious sequel after Hepatitis B Virus infection, although the rate of chronicity is inverse with age but it may be associated with a significant proportion of deaths related to cirrhosis and liver cancer. HBV serology and measurement of hepatocytic enzymes with viral load can predict disease prognosis and response to treatment. HBeAg refers to a high viral replication and associated with more infectivity to others. This study aimed to determine the impact of HBeAg status in chronically infected patients on various baseline tests. A total of 90 patients with CHB infection who were included in this study. Several standardized measures used for liver function tests, viral load and hepatitis B serological

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Study on Co – odd (even) Sum Degree Edge Domination Number in Graphs
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 An edge dominating set    of a graph  is said to be an odd (even) sum degree edge dominating set (osded (esded) - set) of G if the sum of the degree of all edges in X is an odd (even) number. The odd (even) sum degree edge domination number  is the minimum cardinality taken over all odd (even) sum degree edge dominating sets of G and is defined as zero if no such odd (even) sum degree edge dominating set exists in G. In this paper, the odd (even) sum degree domination concept is extended on the co-dominating set E-T of a graph G, where T is an edge dominating set of G.  The corresponding parameters co-odd (even) sum degree edge dominating set, co-odd (even) sum degree edge domination number and co-odd (even) sum degree edge domin

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Publication Date
Thu Nov 30 2023
Journal Name
Iraqi Geological Journal
A Review on Pressure Transient Analysis in Multilayer Reservoir: South Iraq Case Study
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Multilayer reservoirs are currently modeled as a single zone system by averaging the reservoir parameters associated with each reservoir zone. However, this type of modeling is rarely accurate because a single zone system does not account for the fact that each zone's pressure decreases independently. Pressure drop for each zone has an effect on the total output and would result in inter-flow and the premature depletion of one of the zones. Understanding reservoir performance requires a precise estimation of each layer's permeability and skin factor. The Multilayer Transient Analysis is a well-testing technique designed to determine formation properties in more than one layer, and its effectiveness over the past two decades has been

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Publication Date
Mon Mar 15 2021
Journal Name
The Journal Of Legal And Social Sciences
The Limitations on the Judge’s Authority in Judicial Interpretation – France as a Model
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When exercising their authority in the jurisprudence, judges are subject to a set of restrictions that they must adhere to, as they do not want their jurisprudence to be accepted and welcomed by law practitioners in general, and legal scholars in particular, and in contrast to it, the arrows of criticism and defamation will extend to that jurisprudence, and then they will have to reverse them . Perhaps the most important of those restrictions imposed on judges is their observance of justice between the parties to the lawsuit through their lack of bias for one of the parties at the expense of the other, in addition to their observance of public order and public morals, as well as their observance of the legal texts that they work under its u

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Evaluating Educational Programs in Combating Indecent Behaviors Among University Students Using Structural Equation Modeling (Field study: Northern Border University)
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The study aimed to evaluate educational programs efficiency in applying the best educational practices to educate students from the dangers of indecent behaviors, in line with higher education policy and the appropriateness of educational program dimensions to spread awareness among students to not fall into the indecent behaviors clutches. The study adopted the inductive exploratory approach through structural equation modeling and the descriptive analysis of the collected data from randomly selected sample (n=385) from educational academics at Northern Border University in the Saudi Arabia using a specially designed survey tool to meet study purposes to evaluate dimensions of teaching methods, evaluation tools, training courses, course

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Publication Date
Thu May 11 2023
Journal Name
Engineering Applications Of Computational Fluid Mechanics
Photovoltaic-thermal system combined with wavy tubes, twisted tape inserts and a novel coolant fluid: energy and exergy analysis
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To create a highly efficient photovoltaic-thermal (PV-T) system and maximise the energy and exergy efficiency, this study aims to propose an innovative configuration of a PV-T system comprising wavy tubes with twisted-tape inserts. Following the validation of a numerical model, a parametric study has been conducted to assess the geometrical effects of twisted tape and wavy tubes, as well as the coolant fluid type and velocity, on the overall performance of a PV-T system, located in Shiraz, Iran. It is found that employing twisted tape improves the energy and exergy efficiency by approx. 6.3%. The best configuration yields 12.4% and 16.8% increase in energy and exergy efficiency compared to conventional PV systems. This is achieved at 15% vo

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Publication Date
Thu Sep 28 2023
Journal Name
Iraqi Journal Of Computer, Communication, Control And System Engineering
A Comparative Study Between the Fragile and Robust Watermarking Techniques and Proposing New Fragile Watermarking with Embedded Value Technique
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Since the Internet has been more widely used and more people have access to multimedia content, copyright hacking, and piracy have risen. By the use of watermarking techniques, security, asset protection, and authentication have all been made possible. In this paper, a comparison between fragile and robust watermarking techniques has been presented to benefit them in recent studies to increase the level of security of critical media. A new technique has been suggested when adding an embedded value (129) to each pixel of the cover image and representing it as a key to thwart the attacker, increase security, rise imperceptibility, and make the system faster in detecting the tamper from unauthorized users. Using the two watermarking ty

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Publication Date
Thu Aug 18 2022
Journal Name
Dental Hypotheses
Microleakage Evaluation of Glass Hybrid Restoration Following Usage of Papain-Based Gel and Ceramic Bur for Caries Removal: An in Vitro Study
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Publication Date
Fri Apr 28 2023
Journal Name
Mathematical Modelling Of Engineering Problems
Using Crushed Glass with Sand as a Single and Dual Filter Media for Removal of Turbidity from Drinking Water
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of The College Of Basic Education
Synthesis and Characterization of some biologically active transition metal complexes for a ligand derived from dimedone with mixed ligands.
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The aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 1H, 13C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(Π).Where M(Π) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a base. Complexes of the composition [M(L)(Q)] with (1

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