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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
Sat Jan 28 2012
Journal Name
Rafidain Journal Of Science
Photodynamic Effect on Photosensitized Candida albicans with Hematoporphyrin Derivative Using Low Power Diode Laser In Vitro
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Publication Date
Thu Mar 20 2025
Journal Name
Tikrit Journal Of Engineering Sciences
Effect of Different Compressor Speeds on the Energy and Exergy of an Automobile Air-Conditioner Using R134a in the Absence and Presence of a Liquid-Suction Heat Exchanger
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Refrigerant R134a has been widely utilized in automotive air conditioning systems (AACSs); R134a has a high global warming potential (GWP) of 1430 despite having zero ozone depletion potential (ODP). Coming refrigeration systems must include refrigerants with low GWP and zero ODP. The aim of this experimental study is to evaluate the thermal performance of an (AAC) with different values of compressor speeds, i.e., (1000, 1700, and 2400 rpm) and two thermal loads, i.e., (500 and 1000 Watt) with the absence and presence of liquid suction heat exchanger (LSHX) using R134a. The results showed that adding LSHX enhanced the COP cycle by 7.18%, 10.7%, and 3.09% for the first, second, and third speed, respectively, at 500 Watt, while the en

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Sliding mode control based on high-order extended state observer for flexible joint robot under time-varying disturbance
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Abstract. In this paper, a high order extended state observer (HOESO) based a sliding mode control (SMC) is proposed for a flexible joint robot (FJR) system in the presence of time varying external disturbance. A composite controller is integrated the merits of both HOESO and SMC to enhance the tracking performance of FJR system under the time varying and fast lumped disturbance. First, the HOESO estimator is constructed based on only one measured state to precisely estimate unknown system states and lumped disturbance with its high order derivatives in the FJR system. Second, the SMC scheme is designed based on such accurate estimations to govern the nominal FJR system by well compensating the estimation errors in the states and the lumped

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Publication Date
Tue Sep 01 2020
Journal Name
Journal Of Engineering
An Adaptive Digital Neural Network-Like-PID Control Law Design for Fuel Cell System Based on FPGA Technique
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This paper proposes an on-line adaptive digital Proportional Integral Derivative (PID) control algorithm based on Field Programmable Gate Array (FPGA) for Proton Exchange Membrane Fuel Cell (PEMFC) Model. This research aims to design and implement Neural Network like a digital PID using FPGA in order to generate the best value of the hydrogen partial pressure action (PH2) to control the stack terminal output voltage of the (PEMFC) model during a variable load current applied. The on-line Particle Swarm Optimization (PSO) algorithm is used for finding and tuning the optimal value of the digital PID-NN controller (kp, ki, and kd) parameters that improve the dynamic behavior of the closed-loop digital control fue

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Publication Date
Tue Jan 01 2019
Wide-range tunable subwavelength band-stop filter for the far-infrared wavelengths based on single-layer graphene sheet
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Publication Date
Thu Oct 01 2020
Journal Name
Bulletin Of Electrical Engineering And Informatics
Lightweight hamming product code based multiple bit error correction coding scheme using shared resources for on chip interconnects
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In this paper, we present multiple bit error correction coding scheme based on extended Hamming product code combined with type II HARQ using shared resources for on chip interconnect. The shared resources reduce the hardware complexity of the encoder and decoder compared to the existing three stages iterative decoding method for on chip interconnects. The proposed method of decoding achieves 20% and 28% reduction in area and power consumption respectively, with only small increase in decoder delay compared to the existing three stage iterative decoding scheme for multiple bit error correction. The proposed code also achieves excellent improvement in residual flit error rate and up to 58% of total power consumption compared to the other err

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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
On Skew Left n-Derivations with Lie Ideal Structure
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In this paper the centralizing and commuting concerning skew left -derivations and skew left -derivations associated with antiautomorphism on prime and semiprime rings were studied and  the commutativity of Lie ideal under certain conditions were proved.

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Publication Date
Tue Jun 30 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Using the Artificial Gas Lift to Increase the Productivity of Noor Oil Field / Mishrif Formation
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Noor Oil Field is one of Iraqi oil fields located in Missan province / Amarah city. This field is not subjected to licensing rounds, but depends on the national effort of  Missan Oil Company. The first two wells in the field were drilled in seventies and were  not opened to production until 2009. The aim of this study is to study the possibility of using the method of gas lift to increase the productivity of this field . PROSPER software was used to design the continuous  gas lift by using maximum production rate in the design.

   The design was made after comparing  the measured pressure with the calculated pressure, this comparison  show  that the method of Beggs-Brill and Petroleum Exper

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Publication Date
Sat Sep 30 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Spatial Data Analysis for Geostatistical Modeling of Petrophysical Properties for Mishrif Formaiton, Nasiriya Oil Field
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Spatial data analysis is performed in order to remove the skewness, a measure of the asymmetry of the probablitiy distribution. It also improve the normality, a key concept of statistics from the concept of normal distribution “bell shape”, of the properties like improving the normality porosity, permeability and saturation which can be are visualized by using histograms. Three steps of spatial analysis are involved here; exploratory data analysis, variogram analysis and finally distributing the properties by using geostatistical algorithms for the properties. Mishrif Formation (unit MB1) in Nasiriya Oil Field was chosen to analyze and model the data for the first eight wells. The field is an anticline structure with northwest- south

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Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
In Silico Characterization of a Cyclin Dependent Kinase -A (CDKA) and its Coding Gene in some Oryza Species
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Rice (Oryza sativa) is a fundamental food for the majority of world population. Cyclin Dependent Kinase -A (CDKA) accelerates transition through different stages of cell cycle and contributes in gametes formation. In the present investigation, a CDKA encoding gene along with the corresponding protein were characterized in O. sativa Indica Group, O. glaberrimaO. barthii, O. brachyantha, O. glumipatula, O. longistaminata, O. meridionalis, O. nivara, O. punctata and O. rufipogon using in silico analyses. The results reflected little variation in most species except O. longistaminata and O. brachyantha. Compared with the remaining species, O. longistaminata

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