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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
Thu Jan 01 1970
Journal Name
Journal Of Biotechnology Research Center
Diagnostic values of serum IL-17A and IL-18 in Rheumatoid arthritis and Correlation with treatment
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Background: Rheumatoid arthritis (RA) is an autoimmune disorder that involves autoantibodies attacking and weakening joints. RA is characterized by leukocyte (Monocyte, Lymphocyte mast cell .etc) infiltrations into the synovial compartment leading to inflammation in the synovial membrane.   Synovitis leads to the release of pro-inflammatory cytokines, matrix metalloproteinases, chemokines, complement proteins, and growth factors. Objective: The current study pointed to verify the diagnostic values of interleukin -17 A and interleukin -18 in Rheumatoid arthritis (RA) patients and the effect of treatment thereon. Study subjects and methods: A total of 88 samples with RA were selected from the health clinics of AL-Yarmouk

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Synthesis and Characterization of Some Metal Complexes with their Sulfamethoxazoleand 4,4'-dimethyl-2,2'-bipyridyl and study Cytotoxic Effect on Hep-2 Cell Line
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The ligand 4-amino-N-(5-methylisoxazole-3-yl)-benzene-sulfonamide(L1) (as a chelating ligand) was treated with Pd(II),Pt (IV) and Au(III) ions in alcoholic medium in order to prepare a series of new metal complexes. Mixed ligand complexes of this primary ligand were prepared in alcoholic medium in presence of the co-ligand 4,4'-dimethyl-2,2'-bipyridyl(L2) with Cu(II) ,Pd(II) and Au(III) ions. The complexes were characterized in solid state using flame atomic absorption, elemental analysis C.H.N.S, FT-IR, UV-Vis Spectroscopy, conductivity and magnetic susceptibility measurements. The nature of some complexes formed in ethanolic solution has been studied following the molar ratio method, also stability constant was studied and the complexes f

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Co-digestion of Shumblan with Different Wastes as a Source for the Biogas Production
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Shumblan (SH) is one of the most undesirable aquatic plants widespread in the irrigation channels and water bodies. This work focuses on boosting the biogas potential of shumblan by co-digesting it with other types of wastes without employing any chemical or thermal pretreatments as done in previous studies. A maximum biogas recovery of 378 ml/g VS was reached using shumblan with cow manure as inoculum in a ratio of 1:1. The methane content of the biogas was 55%. Based on volatile solid (VS) and C/N ratios, biogas productions of 518, 434, and 580 ml/g VS were obtained when the shumblan was co-digested with food wastes (SH:F), paper wastes (SH:P), and green wastes (SH:G) respectively. No significant changes of methane contents were observ

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Publication Date
Sat Sep 02 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Desulphurization of Simulated Oil Using SAPO-11 with CNT's as Adsorbent: A Kinetic Study
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In this study, sulfur was removed from imitation oil using oxidative desulfurization process. Silicoaluminophosphate (SAPO-11) was prepared using the hydrothermal method with a concentration of carbon nanotubes (CNT) of 0% and 7.5% at 190 °C crystallization temperature. The final molar composition of the as-prepared SAPO-11 was Al2O3: 0.93P2O5: 0.414SiO2. 4% MO/SAPO-11 was prepared using impregnation methods. The produced SAPO-11 was described using X-ray diffraction (XRD) and Brunauer-Emmet-Teller (N2 adsorption–desorption isotherms). It was found that the addition of CNT increased the crystallinity of SAPO-11. The results showed that the surface area of SAPO-11 containing 7.5% CNT was 179.54 m2/g, and the pore volume was 0.31

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Publication Date
Wed Jan 14 2026
Journal Name
Journal Of Robotics And Control (jrc)
Intelligent Semi-Active Vibration Control of Automobiles: A Half-Car Model with Smart Dampers
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Semi-active suspension systems have emerged as an attractive alternative to fully active suspensions because they offer a superior capacity to improve vehicle ride comfort and handling performance with significantly lower energy consumption. Conventional semi-active control strategies, however, such as skyhook damping, often cannot accommodate the nonlinear and time-varying dynamics of vehicles in operation under impulse or severe road disturbances. In this context, an intelligent smart-damper controller is proposed in this paper by incorporating a Modified Fuzzy Adaptive Fuzzy Logic Control framework in a half-car suspension model. In the developed controller, the effective damping force is adaptively tuned using real-time measurements of

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
An Analysis of a Partial Temporary Immunity SIR Epidemic Model with Nonlinear Treatment Rate
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     A partial temporary immunity SIR epidemic model involv nonlinear treatment rate is proposed and studied. The basic reproduction number  is determined. The local and global stability of all equilibria of the model are analyzed. The conditions for occurrence of local bifurcation in the proposed epidemic model are established. Finally, numerical simulation is used to confirm our obtained analytical results and specify the control set of parameters that affect the dynamics of the model.

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Publication Date
Sun Jul 24 2022
Journal Name
Healthcare
Incidence of Gingival Black Triangles following Treatment with Fixed Orthodontic Appliance: A Systematic Review
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This systematic review aimed to investigate the relation between orthodontic treatment (OT) and the incidence of the gingival black triangle (GBT) after completing treatment with a fixed orthodontic appliance, as well as the associated risk factors and the level of alveolar bone. Electronic and hand searches were conducted in three electronic databases for relevant articles published up to March 2022. Retrieved articles went through a two-step screening procedure, and the risk of bias (RoB) was assessed by the Joanna Briggs Institute checklists. The incidence of GBT after OT was set as the primary outcome, while the secondary outcomes were the risk factors associated with GBT and alveolar bone loss following OT. Out of 421 papers, 5

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Publication Date
Wed Oct 25 2023
Journal Name
College Of Islamic Sciences
Provisions for a Muslim to be naturalized with the citizenship of non-Muslim countries
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Praise to Allah, Lord of the Worlds. Thank you very much. Blessed. As his face should be majestic and great. His authority, and may peace and blessings be upon our master Muhammad, a perpetual blessing until the Day of Judgment

And upon the God of purity, His righteous companions, and those who follow them in righteousness until the Day of Judgment. But after:-

Anyone who looks into the history of nations, peoples, and the conditions of human beings will see that naturalization as a person’s affiliation to a particular state is something that happened only in recent centuries. In ancient times, a person’s loyalty was to the tribe to which the person belonged, and he was integrated into it and attributed to it, and in

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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Science
A Class of Harmonic Multivalent Functions for Higher Derivatives Associated with General Linear Operator
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    The main goal of this paper is to introduce the higher derivatives multivalent harmonic function class, which is defined by the general linear operator. As a result, geometric properties such as coefficient estimation, convex combination, extreme point, distortion theorem and convolution property are obtained. Finally, we show that this class is invariant under the Bernandi-Libera-Livingston integral for harmonic functions.

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Desulphurization of Simulated Oil Using SAPO-11 with CNT's as Adsorbent: A Kinetic Study
...Show More Authors

In this study, sulfur was removed from imitation oil using oxidative desulfurization process. Silicoaluminophosphate (SAPO-11) was prepared using the hydrothermal method with a concentration of carbon nanotubes (CNT) of 0% and 7.5% at 190 °C crystallization temperature. The final molar composition of the as-prepared SAPO-11 was Al2O3: 0.93P2O5: 0.414SiO2. 4% MO/SAPO-11 was prepared using impregnation methods. The produced SAPO-11 was described using X-ray diffraction (XRD) and Brunauer-Emmet-Teller (N2 adsorption–desorption isotherms). It was found that the addition of CNT increased the crystallinity of SAPO-11. The results showed that the surface area of SAPO-11 cont

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