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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
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluations of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis
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Objective(s): To assess the adequacy of mediation program on medical attendants practice toward care of kids with diabetic's ketoacidosis. Methodology: A quasi-experimental design that applied at teaching hospitals for pediatric in AL Ramadi city to establish the Effectiveness of Intervention Program on Nurses` Practices about Care of Children with Diabetic Ketoacidosis from 3th of March 2022 till 20 of March 2023. Non-probability (purposive) sample of (50), likewise was alienated into the study (experimental) group. The study group included (50) nurses non-randomly selected from AL-Ramadi Teaching Hospital.

A preliminary study has conducted in AL-Ramadi Teaching Hospital The whole number of nurse

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Publication Date
Mon Jul 01 2019
Journal Name
Plant Archives
Effect of melatonin administration with different light colors on the production of local chickens
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This study aims to observe the effect of melatonin implantation and exposure to different light colors and their interaction on productive in local Iraqi chicken. This study was conducted at the poultry farm of the Department of Animal Production/College of Agriculture/University of Baghdad/Abu Ghraib, on 252 birds (180 females and 72 males). The birds were divided into three sections (white, red and green) each section contains two lines, one of which has been planted melatonin under the skin of the neck of birds and the other has not been planted hormone. The results of the study showed significant improvement in productive traits such as egg proportion rate, egg weight, cumulative eggs number, egg mass and feed conversion rate. That the

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
Effect of Milk Substitution with liquid whey on the quality properties of fatty cake
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This study exposed to use the liquid whey (which was produced from of soft cheese processed) partially or completely instead of milk in fatty cake, this whey residue is still not used, instead it is thrown in rivers which effect different environment and economic problems. Different concentrations was used (25% , 50% , 75% , and 100%) of whey in baked cake , Volume , height and other different properties ( panel taste ) was studied too . Sensory evaluation results showed that an improved in all the character of the baked cake was happen by the used of 25% and 50% of the whey in comparison with the control treatment, the 75% replacement showed a decrease in appearance , texture and tenderness , while the degrees of color and fla

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
The Effects of Soft Laser on Some Blood Parameters of Patients with Breast Cancer
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Background: Soft Laser has been advantageous in medical applications and is widely used in clinical practice. It is applied because it doesn’t cause the significant thermal effects or tissue hurt when irradiated. The blood response to low power laser radiation provides information about processes of laser radiation interaction with live creatures. Objective: The aim of the current work was to evaluate the laser-induced changes of in vitro erythrocyte sedimentation rate (ESR), mean corpuscular volume (MCV), and mean corpuscular hemoglobin concentration (MCHC) in patients with breast cancer by irradiating a human blood sample using a green laser and comparing its effects before and after irradiation with the same power density (100mW/c

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Publication Date
Sun Dec 01 2019
Journal Name
2019 Ieee Asia-pacific Conference On Computer Science And Data Engineering (csde)
Effect of Clay Content on Performance of a Crushed Rock Mix
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Publication Date
Sat Nov 24 2018
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Outcomes of Operative Management of 96 Cases with Traumatic Retroperitoneal Hematoma: A Single-Institution Experience
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AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of Biology, Agriculture And Healthcare
Histopathological Changes of Some Internal Organs of Mice Injected with Exotoxin a at Low Concentrations
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Abstract Exotoxin A is the most lethal virulence factor produced by Pseudomonas aeruginosa. It inhibits elongation factor-2 by ADP-ribosylation of EF2. This causes stop of the elongation of polypeptides. In recent study, the effect of low concentration of exotoxin A on some important internal organs of mice was studied. Four groups white mice were injected intraperitonialy with pure exotoxin A in the following manner 0.1, 0.2, 0.3, 0.4 ng\ animals. One mouse receives normal saline inrtaperitonialy as a control. After 72 hours the mice were killed and four organs were taken, liver, spleen, lung and heart from each killed mice. Histological sections were made from each organ and stained with hematoxylin and eosin stain then examined under mic

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Applied Mathematics
The Dynamics of a Tritrophic Leslie-Gower Food-Web System with the Effect of Fear
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The avoidance strategy of prey to predation and the predation strategy for predators are important topics in evolutionary biology. Both prey and predators adjust their behaviors in order to obtain the maximal benefits and to raise their biomass for each. Therefore, this paper is aimed at studying the impact of prey’s fear and group defense against predation on the dynamics of the food-web model. Consequently, in this paper, a mathematical model that describes a tritrophic Leslie-Gower food-web system is formulated. Sokol-Howell type of function response is adapted to describe the predation process due to the prey’s group defensive capability. The effects of fear due to the predation process are considered in the first two levels

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Publication Date
Sun Apr 02 2023
Journal Name
Narst 2023 Annual International Conference
Measuring Claim-Evidence-Reasoning Using Scenario-based Assessments Grounded in Real-world Issues
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Improving students’ use of argumentation is front and center in the increasing emphasis on scientific practice in K-12 Science and STEM programs. We explore the construct validity of scenario-based assessments of claim-evidence-reasoning (CER) and the structure of the CER construct with respect to a learning progression framework. We also seek to understand how middle school students progress. Establishing the purpose of an argument is a competency that a majority of middle school students meet, whereas quantitative reasoning is the most difficult, and the Rasch model indicates that the competencies form a unidimensional hierarchy of skills. We also find no evidence of differential item functioning between different scenarios, suggesting

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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
Phenol Content and Peroxidase Enzyme Activity in Soybean Infected with Xanthomonas axonopodis pv glycines with the Application of Bacillus subtilis JB12 and Bacillus velezensis ST32
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Xanthomonas axonopodis pv glycines (Xag) is a pathogen that causes pustule disease in soybeans. Many
techniques for controlling this disease have been widely developed, one of which is the use of biological agents.
Bacillus sp. from the soybean phyllosphere is a biological agent that has the potential to suppress the
development of pustule disease. One of the biological control mechanisms is through biochemical induction
of plant resistance which includes the accumulation of phenols, salicylic acid compounds, and peroxidase
enzymes. Bacillus subtilis JB12 and Bacillus velezensis ST32 are two bacteria isolated from the soybean
phyllosphere which have previously been known to suppress Xag through an anti

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