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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
Sun Jan 14 2018
Journal Name
Journal Of Engineering
Efficient Cost Management in the Housing Projects
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The cost management of cost indicators in housing projects, on the level of planning and design, is the most important quality indicators, for adoption of strategies of planning and design efficient in managing these indicators. So this research points out the need to highlight the most effective and influential cost indicators in housing projects, and to determine strategies in the management of these indicators in order to raise the efficiency of housing projects quality, to seemly the income level target group, taking into consideration the quality of housing standards, to achieve the basic requirements of housing. This paper highlights the importance of the cost  management, the types of housing cost, the method

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Publication Date
Wed Oct 01 2025
Journal Name
Central Asian Journal Of Medical And Natural Sciences
The Gastrointestinal Manifestations in Patients with COVID-19 and their Clinical Correlates in An Adult Iraqi Population Sample
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The gastrointestinal system is one of the many organs in the body that have been affected by the new viral illness known as coronavirus disease 2019 (COVID-19). To find out the GIT symptoms are into patients with Covid-19 and how they correspond with the severity of the illness. At the Al-Shifaa facility, 172 patients infected with COVID-19 participated in our study. A clinical examination, laboratory tests (CRP, D.Dimer, and serum ferritin), a chest CT scan, and a medical history were performed on each patient. The severity of the illness and other factors were taken into consideration while evaluating the gastrointestinal symptoms. Data collection from 172 patients, 91 patients infected with COVID-19 infection, 91 patients (52.9%) had GIT

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Publication Date
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
A Crime Data Analysis of Prediction Based on Classification Approaches
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Crime is considered as an unlawful activity of all kinds and it is punished by law. Crimes have an impact on a society's quality of life and economic development. With a large rise in crime globally, there is a necessity to analyze crime data to bring down the rate of crime. This encourages the police and people to occupy the required measures and more effectively restricting the crimes. The purpose of this research is to develop predictive models that can aid in crime pattern analysis and thus support the Boston department's crime prevention efforts. The geographical location factor has been adopted in our model, and this is due to its being an influential factor in several situations, whether it is traveling to a specific area or livin

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Publication Date
Fri Dec 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Place Identity and Urban Uniqueness: Insights from the AlRusafa Area, Old Baghdad, Iraq
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Publication Date
Tue Apr 02 2019
Journal Name
Artificial Intelligence Research
A three-stage learning algorithm for deep multilayer perceptron with effective weight initialisation based on sparse auto-encoder
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A three-stage learning algorithm for deep multilayer perceptron (DMLP) with effective weight initialisation based on sparse auto-encoder is proposed in this paper, which aims to overcome difficulties in training deep neural networks with limited training data in high-dimensional feature space. At the first stage, unsupervised learning is adopted using sparse auto-encoder to obtain the initial weights of the feature extraction layers of the DMLP. At the second stage, error back-propagation is used to train the DMLP by fixing the weights obtained at the first stage for its feature extraction layers. At the third stage, all the weights of the DMLP obtained at the second stage are refined by error back-propagation. Network structures an

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Publication Date
Fri Jul 26 2024
Journal Name
Surgical Neurology International
Orbital varices: Epidemiology, clinical presentation, and treatment outcomes – A scoping review
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Background:

Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy.

Methods:

Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and o

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Activity- Based Costing technology and its role in Cost Guidance: An Applied Study at the General Company for Textile and Leather Industries - Leather plant - Factory No. (7)
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Iraqi industrial units face strong competition due to many problems including1- high production costs2- weak interest in studying the market3- lack of government support for their products4- dumping the market with imported products with specifications and a competitive price as well as adopting the traditional cost system in calculating costs that do not provide appropriate information for pricing decisions Which requires studying and analyzing these problems and dealing with them by adopting modern technologies so that they can compete, so the research aims to show the knowledge bases of technology Activity- Based Costing, with an indication of the role of technology Activity- Based Costing in rationalizing the tax In, and the

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Publication Date
Thu Dec 25 2025
Journal Name
Sultan Qaboos University Medical Journal
Clinical and Molecular Analysis of ATP7B Variants Identified by Next-Generation Sequencing in Iraqi Adults With Wilson Disease
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Objectives: This study aimed to identify and analyse ATP7B variants in Iraqi adults with Wilson disease (WD) by long-read next-generation sequencing. Methods: This cross-sectional study was conducted at the Poisoning Consultation Center at Ghazy Al-Hariri Hospital for Surgical Specialties and the Gastroenterology Consultation Clinic at Baghdad Teaching Hospital, Medical City in Baghdad, Iraq. Unrelated patients with clinical and biochemical features suggestive of WD were recruited between October 2022 and October 2023. DNA was extracted from peripheral blood samples. Variants in the ATP7B gene were identified using long-read next-generation sequencing and then analysed by in-silico tools. Results: A total of 45 patients were recruited in

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Publication Date
Sat Sep 26 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of some salivary enzymes levels in type 2 diabetic patients with chronic periodontitis (Clinical and biochemical study)
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Background: Diabetic patients have been reported to be more susceptible to gingivitis and periodontitis than healthy subjects. Many intracellular enzymes like (alkaline phosphatase- (ALP), aspartate aminotransferase- (AST) and alanine aminotransferase- (ALT) that are released outside cells into the gingival crevicular fluid (GCF) and saliva after destruction of periodontal tissue during periodontitis. This study was conducted to determine the periodontal health status and the levels of salivary enzymes (ALP, AST and ALT) of the study and control groups and to correlate the levels of these enzymes with clinical periodontal parameters in each study group. Subjects, Materials and Methods: One hundred subjects were enrolled in the study, with a

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Publication Date
Fri Feb 01 2019
Journal Name
Iraqi Journal Of Information &amp; Communications Technology
Evaluation of DDoS attacks Detection in a New Intrusion Dataset Based on Classification Algorithms
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Intrusion detection system is an imperative role in increasing security and decreasing the harm of the computer security system and information system when using of network. It observes different events in a network or system to decide occurring an intrusion or not and it is used to make strategic decision, security purposes and analyzing directions. This paper describes host based intrusion detection system architecture for DDoS attack, which intelligently detects the intrusion periodically and dynamically by evaluating the intruder group respective to the present node with its neighbors. We analyze a dependable dataset named CICIDS 2017 that contains benign and DDoS attack network flows, which meets certifiable criteria and is ope

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