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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 Dec 01 2016
Journal Name
Journal Of Engineering
Experimental Investigation of Natural Convection into a Horizontal Annular Tube with Porous Medium Effects
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In this work, an experimental investigation has been done for heat transfer by natural-convection through a horizontal concentric annulus with porous media effects. The porous structure in gap spacing consists of a glass balls and replaced by plastic (PVC) balls with different sizes. The outer surface of outer tube is isothermally cooled while the outer surface of inner tube is heated with constant heat flux condition. The inner tube is heated with different supplied electrical power levels. Four different radius ratios of annulus are used. The effects of porous media material, particles size and annulus radius ratio on heat dissipation in terms of average Nusselt number have been analyzed.

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Publication Date
Thu Jan 25 2024
Journal Name
Iraqi Journal Of Agricultural Sciences
SPRAYING NANO CHITOSAN LOADED WITH NPK, NETTEL AND GREEN TEA EXTRACTS AS A TOOL FOR IMPROVEMENT POTATO PRODUCTIVITY
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This study was aimed to evaluate the effect of spraying nano chitosan loaded with NPK fertilizer and nettle leaf and green tea extracts on the growth and productivity of potato for the spring and fall seasons of 2021.It was conducted at private farm in Wasit Governorate, Iraq, as a factorial experiment (5 × 5) within randomized complete block design using three replicates. The first factor included spraying with four concentrations of chitosan nanoparticles loaded with NPK fertilizer 0, 10. 15 and 20% in addition to chemical fertilization treatment, the second factor was spraying nettle leaf extract 25 and 35 gL-1 and green tea extract with 2 and 4 g.L-1, in addition to the control treatment, spraying with distilled water only. The

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Publication Date
Sun Jun 05 2011
Journal Name
Baghdad Science Journal
Top soil layer equi-electrical conductivity and pollution with salts mapping for a region located within Baghdad city
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This research deals with the study of top soil electrical conductive regions located within Baghdad City. The research included measuring the dissolved soil material extraction Electrical Conductivity (EC) with an aqueous solution for the top (0-30 cm) soil layer of the study area. As the electrical conductivity values increase by increasing the amount of dissolved salts in principle, we can consider that the aim of this research is to predict the amount and distribution of (soil contamination with salts) which is represented by the (Salt Index), this factor calculated for each soil representative sample taken from the region with a depth of (30 cm). Laboratory (EC) test values measured by the use of solutions (EC) digital meter for the ex

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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
The Effect of a Mediator on Scaffolding EFL Student Teachers’ Teaching Competencies, Self- Efficacy and Self–Awareness
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This study aims to find out the effect of the mediator on scaffolding fourth yearstudent- teachers' teaching competencies and their self-efficacy. The present study combines scaffolding and self-efficacy by using a mediator on scaffolding students affects teaching competencies and selfefficacy and from the results of which the existence of student-teachers’ selfawareness was ensured as an effect of the same independent variable. The model affects their teaching competencies and led them to be aware of the needs of their pupils and themselves. 

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Publication Date
Tue Sep 01 2020
Journal Name
Baghdad Science Journal
A Comparative Study on the Active Constituents, Antioxidant Capacity and Anti-Cancer Activity of Cruciferous Vegetable Residues
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This study is pointed out to estimate the effectiveness of two solvents in the extraction and evaluating the active ingredients and their antioxidant activity as well as anti-cancer efficiency. Therefore, residues from four different Brassica vegetables viz. broccoli, Brussels sprout, cauliflower, and red cherry radish were extracted using two procedures methods: methanolic and water crude extracts. Methanol extracts showed the highest content of total phenolic (TP), total flavonoids (TF), and total tannins (TT) for broccoli and Brussels sprouts residues. Methanolic extract of broccoli and Brussels sprouts residues showed the highest DPPH· scavenging activity (IC50 = 15.39 and 18.64 µg/ml). The methanol and water ex

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Publication Date
Thu Sep 01 2016
Journal Name
Journal Of Engineering
The Effect of Vehicle Body Shapes on the Near Wake Region and Drag Coefficient: A Numerical Study
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The purpose of this paper is to gain a good understanding about wake region behind the car body due to the aerodynamic effect when the air flows over the road vehicle during its movement. The main goal of this study is to discuss the effect of the geometry on the wake region and the aerodynamic drag coefficient. Results will be achieved by using two different shapes, which are the fastback and the notchback. The study will be implemented by the Computational Fluid Dynamic (CFD) by using STAR-CCM+® software for the simulation. This study investigates the steady turbulent flow using k-epsilon turbulence model. The results obtained from the simulation show that the region of the air separation behind the vehicle

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Publication Date
Mon Jul 08 2024
Journal Name
Journal Of Microbiology, Biotechnology And Food Sciences
SYNERGISTIC EFFECTS OF NEEM OIL AND GENTAMICIN ON PSEUDOMONAS AERUGINOSA VIA PHZM GENE DOWNREGULATION: A COMPREHENSIVE REVIEW
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Exploring the antibacterial potential of neem oil (Azadirachta indica) in combination with gentamicin (GEN) against pathogenic molds, especially Pseudomonas aeruginosa, has drawn concern due to the quest for natural treatment options against incurable diseases. Prospective research directions include looking for natural cures for many of the currently incurable diseases available now. microbial identification system, were used to identify the isolates. The research utilized a range of methods, such as the diffusion agar well (AWD) assays, TEM (transmission electron microscopy) analysis, minimum inhibitory concentration (MIC) assays, and real-time PCR (RT-qPCR) to analyze bacterial expression and the antibacterial action of neem oil (Azadira

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Publication Date
Thu Jul 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Simulation and Analysis the Attenuation Effect of Atmospheric Layers on a Laser Beam Within the Visible Range
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Abstract: The power and the size of the final spot of the laser beam reaching the target are very important requirements in most of the laser applications and fields such as medical, military, and scientific, so studying laser propagation in the atmosphere is a very important topic. The propagation of the laser beam through the atmosphere is subject to several attenuation processes that deplete the power and expand the beam. Through the simulation results of the free electron laser within the visible region of the electromagnetic spectrum (400-700nm), it was found that the attenuation increases with decreasing wavelength. Laser propagation in the presence of rain and snow leads to a very large loss of power compared to propagation i

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Publication Date
Wed Apr 01 2020
Journal Name
Plant Archives
Germination and seedling growth in primed sorghum seed with gibberellic and salicylic acids
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A laboratory experiment was conducted in the labs of Seeds Testing and Certification Department, Ministry of Agriculture in 2017 to improve germination and seedling growth in primed sorghum seeds by different concentrations and soaking durations of acids of gibberellic (GA3)(distilled water, 75, 150 and 300 mg l-1), salicylic (SA)(distilled water, 40, 70 and 100 mg l-1) and soaking duration (SD)(12 and 24 h). Factorial experiment in completely randomized design was applied with four r replications. The results showed the superiority of the two soaking treatments with GA3 (300 mg l-1) and SA (70 mg l-1) at germination ratio, radicle and plumule lengths, seedling dry weight and seedling vigour index (81.3%, 2.7 cm, 8.9 cm, 0.081 mg and 984) a

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary vitamin E and uric acid in patients with OLP and healthy individuals
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Background: Oral Lichen planus (OLP) is a T-cell mediated chronic inflammatory oral mucosal disease of unknown etiology. Recent studies have reported an increased oxidative stress and lipid peroxidation in such patients. This suggests that reactive oxygen species may have a role in the pathogenesis of lichen planus. Oxidative stress in OLP release molecules consisting of granzymes resulting in local tissue damage in the effectors. Antioxidants that can defend against oxidative stress in the body cells include enzymes, as well as non- enzymatic antioxidants, such as melatonin, uric acid, vitamin A and E. Purpose: To study the level of salivary vitamin E and uric acid as antioxidant agents in patients with OLP and compared with healthy con

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