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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 Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Impact Of Means Of Support On The Intention Entrepreneurial Field Research On A Sample Of Algerian Students
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     The aim of this paper to study the effect of the implicit factors on the entrepreneurial spirit of the students of the Algerian university. Our structural model was proposed based on the model (Shapiro et Sokol, 1982) and the model (Ajzen, 1991). We tested it on a sample of 163 university students at the University of Algiers 3. The model consists of a set of variables (the intention of contracting as a dependent variable, structural and social educational support as independent variables). The results showed that educational and social support factors affect the entrepreneurial spirit of students more than structural support. The Applied Impacts are the enhancing of knowledge capacities of university stu

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Publication Date
Tue Jul 22 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Effectiveness of Intralesional Vitamin D and Bleomycin Injections in Treating Recalcitrant Plantar Wart: A Comparative Study
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Background: Intralesional injections of vitamin D and bleomycin have gained growing clinical interest in the treatment of recalcitrant plantar warts, with pain as a major limitation associated with their use. Objective: To assess the clinical outcomes of vitamin D and bleomycin in managing treatment-resistant plantar warts. Methods: An interventional comparative study conducted on patients diagnosed with recalcitrant plantar warts over 9 months and not treated for two months. Patients were divided randomly into two groups: group A (24 patients received intralesional vitamin D) and group B (24 patients received intralesional bleomycin). The clearance rate and pain score were estimated by visual analogue scale (VAS). Results: 48 patie

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Publication Date
Tue Feb 25 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Evaluation of Hepatocyte Growth Factor in Iraqi Patients with Acute Myeloid Leukemia: Its Correlation with Clinical Parameters and Response to Induction Therapy
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BACKGROUND: Hepatocyte growth factor (HGF) is a proangiogenic factor that exerts different effects over stem cell survival growth, apoptosis, and adhesion. Its impact on leukemogenesis has been established by many studies. AIM: This study aimed to determine the effect of plasma HGF activity on acute myeloid leukemia (AML) patients at presentation and after remission. PATIENTS AND METHODS: This was a cross-sectional prospective study of 30 newly-diagnosed, adult, and AML patients. All patients received the 7+3 treatment protocol. Patients’ clinical data were taken at presentation, and patients were followed up for 6 months to evaluate the clinical status. Plasma HGF levels were estimated by ELISA based methods in the pa

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Measuring the continuity of the demand for money and its impact on the Iraqi dinar exchange rate for the period 1991-2013 function
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 Research Summary

It highlights the importance of assessing the demand for money function in Iraq through the understanding of the relationship between him and affecting the variables by searching the stability of this function and the extent of their influence in the Iraqi dinar exchange rate in order to know the amount of their contribution to the monetary policies of the Iraqi economy fee, as well as through study behavior of the demand for money function in Iraq and analyze the determinants of the demand for money for the period 1991-2013 and the impact of these determinants in the demand for money in Iraq.

And that the problem that we face is how to estimate the total demand for money in

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
A Population-Based Study on Agreement between Actual and Perceived Body Image
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Background: Obesity tends to appear in modern societies and constitutes a significant public health problem with an increased risk of cardiovascular diseases.

Objective: This study aims to determine the agreement between actual and perceived body image in the general population.

Methods: A descriptive cross-sectional study design was conducted with a sample size of 300. The data were collected from eight major populated areas of Northern district of Karachi Sindh with a period of six months (10th January 2020 to 21st June 2020). The Figure rating questionnaire scale (FRS) was applied to collect the demographic data and perception about body weight. Body mass index (BMI) used for ass

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Publication Date
Fri Mar 15 2024
Journal Name
Iraqi Statisticians Journal
Estimate a nonparametric copula density function based on probit and wavelet transforms
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This study employs wavelet transforms to address the issue of boundary effects. Additionally, it utilizes probit transform techniques, which are based on probit functions, to estimate the copula density function. This estimation is dependent on the empirical distribution function of the variables. The density is estimated within a transformed domain. Recent research indicates that the early implementations of this strategy may have been more efficient. Nevertheless, in this work, we implemented two novel methodologies utilizing probit transform and wavelet transform. We then proceeded to evaluate and contrast these methodologies using three specific criteria: root mean square error (RMSE), Akaike information criterion (AIC), and log

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using Mehar method to change fuzzy cost of fuzzy linear model with practical application
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  Many production companies suffers from big losses because of  high production cost and low profits for several reasons, including raw materials high prices and no taxes impose on imported goods also consumer protection law deactivation and national product and customs law, so most of consumers buy imported goods because it is characterized by modern specifications and low prices.

  The production company also suffers from uncertainty in the cost, volume of production, sales, and availability of raw materials and workers number because they vary according to the seasons of the year.

  I had adopted in this research fuzzy linear program model with fuzzy figures

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Clinical use of Metformin or Pioglitazone in Combination with Meloxicam in Patients with Knee Osteoarthritis; using Knee Injury and Osteoarthritis outcome Score
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Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.

This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen

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Publication Date
Wed Apr 20 2022
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Text image secret sharing with hiding based on color feature
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Publication Date
Wed May 10 2023
Journal Name
Journal Of Engineering
A Proposal Algorithm to Solve Delay Constraint Least Cost Optimization Problem
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Traditionally, path selection within routing is formulated as a shortest path optimization problem. The objective function for optimization could be any one variety of parameters such as number of hops, delay, cost...etc. The problem of least cost delay constraint routing is studied in this paper since delay constraint is very common requirement of many multimedia applications and cost minimization captures the need to
distribute the network. So an iterative algorithm is proposed in this paper to solve this problem. It is appeared from the results of applying this algorithm that it gave the optimal path (optimal solution) from among multiple feasible paths (feasible solutions).

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