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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 Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Geopolitical dimensions to build a dam on the downstream Renaissance (Egypt and Sudan)
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Varied uses of international rivers in the past few decades dramatically, resulting in this multiplicity of uses and all associated with it for the occurrence of freshwater scarcity activities, and thus an increase in conflicts and disputes around on the rights of each of the riparian countries to benefit from the waters of the river at various purposes, particularly the establishment of dams on some of them as is the case (Renaissance Ethiopian) big impact on downstream countries Dam (Egypt and Sudan), due to the Oukuahma at the end of the Nile Valley made them vulnerable to environmental fluctuations, political crises facing the Nile basin countries, and any reduction in the proportion of water is not only the Nile River, but for all r

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Publication Date
Wed May 26 2021
Journal Name
Energies
Rotational Piezoelectric Energy Harvesting: A Comprehensive Review on Excitation Elements, Designs, and Performances
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Rotational Piezoelectric Energy Harvesting (RPZTEH) is widely used due to mechanical rotational input power availability in industrial and natural environments. This paper reviews the recent studies and research in RPZTEH based on its excitation elements and design and their influence on performance. It presents different groups for comparison according to their mechanical inputs and applications, such as fluid (air or water) movement, human motion, rotational vehicle tires, and other rotational operational principal including gears. The work emphasises the discussion of different types of excitations elements, such as mass weight, magnetic force, gravity force, centrifugal force, gears teeth, and impact force, to show their effect

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Publication Date
Mon Oct 23 2023
Journal Name
Journal Of Optics
Single mode optical fiber sensor based on surface plasmon resonance for the detection of the oil aging for the electrical transformers
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This work presents a novel technique for the detection of oil aging in electrical transformers using a single mode optical fiber sensor based on surface plasmon resonance (SPR). The aging of insulating oil is a critical issue in the maintenance and performance of electrical transformers, as it can lead to reduce insulation properties, increase risk of electrical breakdown, and decrease operational lifespan. Many parameters are calculated in this study in order to examine the efficiency of this sensor like sensitivity (S), signal to noise ratio (SNR), resolution (refractive index unit) and figure of merit (FOM) and the values are for figure of merit is 11.05, the signal to noise ratio is 20.3, the sensitivity is 6.63, and the resolution is 3

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Publication Date
Sun Jun 30 2024
Journal Name
International Journal Of Intelligent Engineering And Systems
Enhancement of the Blood Glucose Level for Diabetic Patients Based on an Adaptive Auto-Tuned PID Controller via Meta-Heuristic Methods
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Publication Date
Mon Jul 09 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ESTIMATION OF WATER POLLUTION AND CULTIVATED PLANTS ON THE DIYALA RIVER WITH HEAVY ELEMENTS DURING THE SUMMER BY FLAME ATOMIC ABSORPTION: ESTIMATION OF WATER POLLUTION AND CULTIVATED PLANTS ON THE DIYALA RIVER WITH HEAVY ELEMENTS DURING THE SUMMER BY FLAME ATOMIC ABSORPTION
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This study was carried out to measure the percentage of heavy metals pollution in the water of the Diyala river and to measure the percentage of contamination of these elements in the leafy vegetables grown on both sides of the Diyala river, which are irrigated by the contaminated river water (celery, radish, lepidium, green onions, beta vulgaris subsp, and malva). Laboratory analysis was achieved to measure the ratio of heavy element contamination (Pb, Fe, Ni, Cd, Zn and Cr) using flame atomic absorption spectrophotometer during the summer months of July and August for the year 2017. The study showed that the elements of zinc, chromium, nickel and cadmium were high concentrations and exceeded. The maximum concentration of these

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Publication Date
Sun Sep 04 2011
Journal Name
Baghdad Science Journal
Synthesis, characterization and spectroscopic studies on Schiff base complexes of 1-phenyl-2, 3-dimethyl-4-amino-5-oxo-pyrazole with salicylaldehyde with some divalent transition metals
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In this research, the preparation of bidentate Schiff base was carried out via the condensation reaction of both the salicylaldehyde with 1-phenyl-2,3-dimethyl-4-amino-5-oxo-pyrazole to form the ligand (L). The mentioned ligand was used to prepare complexes with transition metal ions Mn(II), Co(II), Ni(II), Cu(II) and Zn(II). The resulting complexes were separated and characterized by FTIR and UV-Vis spectroscopic technique. Elemental analysis for Carbon, Hydrogen and Nitrogen elements, electronic spectra of the ligand and complexes were obtained, and the magnetic susceptibility tests were also achieved to measure the dipole moments. The molar conductivities were also measured and determination of chlorine content in the complexes and

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Publication Date
Thu Jul 16 2026
Journal Name
Modern Sport
The impact of diet program myself with some medicinal herbs in some physiological variables Empirical research on badminton players
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To develop a new basis to reduce the phenomenon of stress, one researcher used relaxation techniques is the use of medicinal herbs sedative which is emphasized by some specialists and researchers because of its direct impact on some of the functions of the body as members have a significant impact on the player from the mental and physical Came the importance of research in the use of medicinal herbs sedative and in particular (Lafracin Black, Plantago Sinani great, Alternen) within the program to soothe the psychological players badminton to get rid of the tension felt by sports by athletic competition through the use of a program to ease the psychological with a range of herbs and both means of calming influence of the nervous system. The

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Publication Date
Sun Dec 05 2010
Journal Name
Baghdad Science Journal
Effect of Granulocyte-colony stimulating factor with or without Moxifloxcacin therapy on capsulated Staphylococcus aureus infection in neutropenic mice
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Twenty bacterial isolates were identified as Staphylococcus aureus collected from wounds and catheters related infections. A capsulated S. aureus isolate was chosen after performing serum soft agar test, for this study Neutropenic mice were challenged with capsulated S. aureus ,and the effect of G-CSF with or without moxifloxacin was studied. The results indicated that the addition of G-CSF to moxifloxacin therapy have a synergistic effect in the killing of the bacteria, while when each G-CSF and moxifloxacin were used seperately have a similar effect on bacterial killing. It was found that the moxifloxacin has the same activity as G_CSF but is less costly than the latter one.

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Publication Date
Mon Apr 17 2023
Journal Name
Day 2 Tue, April 18, 2023
Development of a Multi-Completion Gas and Downhole Water Sink-Assisted Gravity Drainage (MC-DWS-AGD) to Improve Oil Recovery and Reduce Water Cut in Reservoirs with Strong Water Aquifers
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Abstract<p>Gas and downhole water sink assisted gravity drainage (GDWS-AGD) is a promising gas-based enhanced oil recovery (EOR) process applicable for reservoirs associated with infinite aquifers. However, it can be costly to implement because it typically involves the drilling of multiple vertical gas-injection wells. The drilling and well-completion costs can be substantially reduced by using additional completions for gas injection in the oil production wells through the annulus positioned at the top of the reservoir. Multi-completion-GDWS-AGD (MC-GDWS-AGD) can be configured to include separate completions for gas injection, oil, and water production in individual wells. This study simulates</p> ... Show More
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Publication Date
Thu Aug 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Analysis of the relationship of public budget deficit on external debt in lraq with in the framework of joint integration of the period (1990 – 2016 )
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Abstract

The term public budget defects became nowadays a chronic, economical phenomenon, almost all the countries weather advanced or development country suffered from it, despite the different visions to economic schools of a thought to accept or reject the deficit in public budget but the prevailed opinion that is needed to rule the role of the state by reducing the public spending which led to continuous deficits in public budget and the consequent upon increase in government borrowing, increase taxes on income and wealth, thus weakening the in contrive for private investment which contributed to the increase of in flationary stagnation, it became a duty to state covered by the lack of financial sources

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