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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
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Teaching Problems Faced by Female Teachers of Students with Intellectual Disability in Special Education Programs and the Proposed Solutions for that from their point of view - a qualitative study
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This study aims to identify the teaching problems that teachers of students with intellectual disabilities face, in addition to exploring the solutions suggested by them in order to overcome such problems or challenges. The researchers used a qualitative approach in order to understand the teachers' perceptions about these problems in a more in-depth way. The interview tools (in-depth and semi-structured interviews) were used to collect data from (3) female teachers from special education programs in the Asir region. The results revealed a number of themes including problems related to students, teachers and the teaching methods they use, curricula, school environment, and school administration. Moreover, the results indicated that famil

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Publication Date
Mon Jun 01 2015
Journal Name
Journal Of Engineering
Variation of Compression Index and Swelling Index with Degree of Saturation in Unsaturated Soils
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The variation of compression index Cc and swelling index Cs with the degree of saturation S was studied on unsaturated and fully saturated soils for different degrees of saturation (100%, 91%, 85%, 75%, 60%), several mathematical equations were found to describe these relationships, these equations can be used to predict settlement during the consolidation process in unsaturated and fully saturated soils.

 

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Publication Date
Fri Oct 01 2021
Journal Name
International Journal Of Mechanical Engineering And Robotics Research
Proportional-Derivative PD Vibration Control with Adaptive Approximation Compensator for a Nonlinear Smart Thin Beam Interacting with Fluid
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This work is concerned with the vibration attenuation of a smart beam interacting with fluid using proportional-derivative PD control and adaptive approximation compensator AAC. The role of the AAC is to improve the PD performance by compensating for unmodelled dynamics using the concept of function approximation technique FAT. The key idea is to represent the unknown parameters using the weighting coefficient and basis function matrices/vectors. The weighting coefficient vector is updated using Lyapunov theory. This controller is applied to a flexible beam provided with surface bonded piezo-patches while the vibrating beam system is submerged in a fluid. Two main effects are considered: 1) axial stretching of the vibrating beam that leads

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Publication Date
Wed Sep 30 2015
Journal Name
Iraqi National Journal Of Chemistry
Evaluation of copper and zinc in Sera of Iraqi male patients with prostate cancer in Baghdad city
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Prostate cancer is an important and potentially fatal disease in humans. Both genetic and environmental risk factors are associated with increased risk of prostate cancer among Asian pop

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Publication Date
Tue Nov 21 2023
Journal Name
Pharmacia
A comparative study of oral diacerein and transdermal diacerein as Novasomal gel in a model of MIA induced Osteoarthritis in rats
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Background: Osteoarthritis is a chronic pathology of the joints causing disability and morbidity. Diacerein is a disease-modifying agent indicated for osteoarthritis management with enhanced performance and have much lower side effects profile than conventional non-steroidal anti-inflammatory drugs. Oral administration of Diacerein is associated with a laxative effect, thus causing treatment discontinuation. Aim: This study aimed to evaluate the activity of Diacerein novasome-based transdermal gel compared with standard oral treatment in the management of induced osteoarthritis in a rat model. Materials and methods: A single intra-articular injection of monosodium iodoacetate was administered to the left knee joint, resulting in the develop

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Distribution of Municipal Services and Some Factors Affecting Them (A survey in a sample of districts from Rushed municipal in Baghdad)
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s The study aims to identify the fairness in the distribution of municipal services between  municipal districts and areas, from point of view  of municipal chamber staff and from the point of view of the citizen. It also aims to identify factors affecting the fairness of the distribution of municipal services. Municipal services were being studied : hygiene and waste, water supply, sewer, creating gardens,  and street paving .Factors which  examined its impact on municipal services are: resources available to municipal chamber, the managerial  process at municipal chamber,  and factors in the external environment surrounding  municipal chamber.The results of the study showed that level of the e

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Publication Date
Sat May 03 2025
Journal Name
Aip Conference Proceedings
On a graph associated to Ly group
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For the graph ⁠, the behavior associated with to the majority of the graphical properties of this graph is covered in this article. The reflection of the capabilities of on the Ly constructions is one of the key ideas addressed throughout this paper. For instance, by this technique we can comprehend the mechanism via which groups of relatively tiny structure are exist within Ly.

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Publication Date
Tue Sep 10 2013
Journal Name
Nature Communications
Carbon nanotubes on a spider silk scaffold
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Understanding the compatibility between spider silk and conducting materials is essential to advance the use of spider silk in electronic applications. Spider silk is tough, but becomes soft when exposed to water. Here we report a strong affinity of amine-functionalised multi-walled carbon nanotubes for spider silk, with coating assisted by a water and mechanical shear method. The nanotubes adhere uniformly and bond to the silk fibre surface to produce tough, custom-shaped, flexible and electrically conducting fibres after drying and contraction. The conductivity of coated silk fibres is reversibly sensitive to strain and humidity, leading to proof-of-concept sensor and actuator demonstrations.

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
Intertextuality with Prophetic Hadith in the Poetry of Safiyaddin Alhilliyy (Tools and Implications)
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 تحقق القراءةُ التَّناصيَّة قيمة موضوعيَّة للدرسِ النَّقديّ المعاصر؛ بمؤثراتها الثَّقافيَّة، والمعرفيَّة، لأنَّ الإبداعَ من سمات التُّراث الشِّعري في العصر الوسيط، وهو مسرحٌ لتداخلات نصِّيَّة مع مصادر متعددة دينيَّة، وأدبيَّة، وتاريخيَّة أداء ومضامين؛ يأتي اختيارُ (التَّناص مع الحديث النَّبوي في شعر صفيّ الدِّين الحلّي)؛ بوصفه امتدادًا شعريَّا أصيلًا لحضارة راقية معطاء

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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Evaluation of ELectrolytes in Adult Patients with Acute Leukemia before and after Chemotherapy
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Abstract:Leukemia is a cancer of early blood forming cells. Most of them are cancers of white blood cells , however some leukemias start in other blood cell types.Electrolytes have modulatory effects on several biological mechanisms in the body namely as stabilizers,element of structures, essential element for hormonal function and also co-factors for a number of enzymes.In this study serum electrolytes levels were measured in patients with acute leukemia (AL) disorders before and after chemotherapy(anthracycline, doxorubicin, cytarabine ,prednisone, vincristine and doxorubicin) during one month and compared with that of control group. Blood samples were obtained from (43) patients (28 males and 15 females) aged (15-55)years;juset before an

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