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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 01 2023
Journal Name
Iraqi Journal Of Hematology
Evaluation of angiopoietin-2 level in patients with multiple myeloma at presentation and in remission state
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The study aimed to assess the level of ANG‑2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin‑6 (IL‑6) and beta‑2 microglobulin (B2M) levels. Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG‑2, B2M, and IL‑6 were tested by enzyme‑lin ked immunosorbent assay. There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG‑2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG‑2 showed signifi

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Silibinin in Lowering the Intraocular Pressure in Normotensive Rabbits: Interaction with Pilocarpine and Cyclopentolate
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Previous data indicated the effectiveness of silibinin as intraocular pressure (IOP) - lowering agent.  The present study was performed to evaluate the interaction of silibinin with pilocarpine or cyclopentolate in lowering IOP in normotensive rabbits. The effects of topically instilled silibinin hemisuccinate solution (0.75%) alone or adjunctly combined with 2% pilocarpine or 1% cyclopentolate on the IOP of normotensive rabbits were evaluated using indentation tonometry. The results showed that 0.75% solution of silibinin was found more potent than pilocarpine (2% drops) in lowering IOP of normotensive rabbits, while their combination results in longer duration of action. Moreover, the elevated IOP values produced by cyclopentolate

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
The Effect of MHD on a Longitudinal Flow of a Fractional Maxwell Fluid between Two Coaxial Cylinders
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      In this paper fractional Maxwell fluid equation has been solved. The solution is in the Mettag-Leffler form. For  the corresponding solutions for ordinary Maxwell fluid are obtained as limiting case of general solutions. Finally, the effects of different parameters on the velocity and shear stress profile are analyzed through plotting the velocity and shear stress profile.

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Publication Date
Sun Dec 31 2023
Journal Name
International Journal Of Intelligent Engineering And Systems
A Ranked-Aware GA with HoG Features for Infant Cry Classification
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Publication Date
Wed Mar 16 2022
Journal Name
2022 Muthanna International Conference On Engineering Science And Technology (micest)
A hybrid feature selection technique using chi-square with genetic algorithm
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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
A multivariate Bayesian model using Gibbs sampler with real data application
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In many scientific fields, Bayesian models are commonly used in recent research. This research presents a new Bayesian model for estimating parameters and forecasting using the Gibbs sampler algorithm. Posterior distributions are generated using the inverse gamma distribution and the multivariate normal distribution as prior distributions. The new method was used to investigate and summaries Bayesian statistics' posterior distribution. The theory and derivation of the posterior distribution are explained in detail in this paper. The proposed approach is applied to three simulation datasets of 100, 300, and 500 sample sizes. Also, the procedure was extended to the real dataset called the rock intensity dataset. The actual dataset is collecte

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Publication Date
Fri Jan 01 2016
Journal Name
Applied Numerical Mathematics
Multiple time-dependent coefficient identification thermal problems with a free boundary
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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Teen-Computer Interaction: Building a Conceptual Model with Thoughts- Emotion-Behaviour
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Teen-Computer Interaction (TeenCI) stands in an infant phase and emerging in positive path. Compared to Human-Computer Interaction (generally dedicated to adult) and Child-Computer Interaction, TeenCI gets less interest in terms of research efforts and publications. This has revealed extensive prospects for researchers to explore and contribute in the region of computer design and evaluation for teen, in specific. As a subclass of HCI and a complementary for CCI, TeenCI that tolerates teen group, should be taken significant concern in the sense of its context, nature, development, characteristics and architecture. This paper tends to discover teen’s emotion contribution as the first attempt towards building a conceptual model for TeenC

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Publication Date
Tue Oct 29 2019
Journal Name
5th International Turkic World Conference On Chemical Sciences And Technologies
New Functionalized MWCNT- Functionalized GO Nanocomposite with a High Dielectric Constant
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In this study, we introduce new a nanocomposite of functionalize graphene oxide FGO and functionalize multi wall carbon nanotube (F-MWCNT-FGO).The formation of nanocomposite was confirmed by FT-IR ,XRD and SEM. The magnitude of the dielectric permittivity of the (F-MWCNT-FGO) nanocomposite appears to be very high in the low frequency range and show a unique negative permittivity at frequencies range from 400 Hz to 4000Hz. The ac conductivity of nanocomposite reaches 23.8 S.m-1 at 100Hz.

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Publication Date
Thu Jul 28 2016
Journal Name
Journal Of Advanced Nursing
Cardiovascular medication adherence among patients with cardiac disease: a systematic review
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Abstract<sec><title>Aims

The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications.

Background

Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal.

Design

A systematic quantitative review of intervention effects.

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