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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 May 30 2025
Journal Name
Iraqi Journal Of Science
Association of Superoxide Dismutase with Ticagrelor Treatment in Patients with Peripheral Arterial Disease
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Peripheral artery disease (PAD) is associated with increased oxidative stress and impaired endothelial function. Ticagrelor treatment improves antioxidant properties in addition to its antiplatelet effects. This study investigated the impact of Ticagrelor treatment on serum superoxide dismutase (SOD) levels and other biochemical parameters in PAD patients. It also evaluated the potential diagnostic accuracy and clinical utility of specific biomarkers based on receiver operating characteristic (ROC) analysis. Seventy individuals were categorized into healthy control (n=40), baseline PAD patients not on Ticagrelor (B-PAD, n=30), and same PAD patients after treated with Ticagrelor (A-PAD, n=30). Parameters measured included SOD concent

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Publication Date
Mon Mar 02 2015
Journal Name
Chemistry And Materials Research
Synthesis and Characterization of 3,5-Dimethyl-2- (4-nitrophenyl azo)-PhenolComplexes with Co(II) and Ni(II) and Study Its Effect on the Activity of AchEnzyme(invitro)
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Transition metal complexes of Co(II) and Ni(II) with azo dye 3,5-dimethyl-2-(4-nitrophenylazo)-phenol derived from 4-nitoaniline and3,5-dimethylphenol were synthesized. Characterization of these compounds has been done on the basis of elemental analysis,electronic data, FT-IR,UV-Vis and 1 HNMR, as well as magnetic susceptibility and conductivity measurements. The nature of thecomplexes formed were studies following the mole ratio and continuous variation methods, Beer ' s law obeyed over a concentrationrange (1x10 -4 - 3x10 -4 M). High molar absorbtivity of the complex solutions were observed. From the analytical data, thestoichiomerty of the complexes has been found to be 1:2 (Metal:ligand). On the basis of physicochemical data tetrahedral

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Publication Date
Sat Jul 01 2017
Journal Name
Journal Of Biological Chemistry
Functional and phylogenetic evidence of a bacterial origin for the first enzyme in sphingolipid biosynthesis in a phylum of eukaryotic protozoan parasites
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Publication Date
Tue Apr 18 2023
Journal Name
Al–bahith Al–a'alami
Public relations programs and its role to enhance the morale of employees in the Ministry of Transportation: A survey study on the State land Transport Company
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This research aims to learn about public relations programs and their role to enhance the morale of the State land Transport Company employees.The researcher relied on the survey method and use a questionnaire and scale tools to collect information from workers in the Department of Relations and Media and employees in all departments.
The research reached several conclusions, including:
1- Public relations seek to increase workers’ confidence in senior management and motivate them to improve their production, as well as their relentless endeavor to bring workers closer by following multiple and varied forms of communication with them.
2- The results of the study showed that there was a negative i

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
RAPID SPECTROPHOTOMETRIC ESTIMATION OF TRACE AMOUNTS OF MEFENAMIC ACID BASED DISPERSIVE LIQUID-LIQUID MICROEXTRACTION OF IN PHARMACEUTICAL PREPARATIONS.
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A dispersive liquid-liquid microextraction combines with UV-V is spectrophotometry for the preconcentration and determination of Mefenamic acid in pharmaceutical preparation was developed and introduced. The proposed method is based on the formation of charge transfer complexation between mefenamic acid and chloranil as an n-electron donor and a p-acceptor, respectively to form a violet chromogen complex measured at 542 nm. The important parameters affecting the efficiency of DLLME were evaluated and optimized. Under the optimum conditions, the calibration graphs of standard and drug, were ranged 0.03-10 µg mL-1. The limits of detection, quantification and Sandell's sensitivity were calculated. Good recoveries of MAF Std. and drug at 0.05,

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Publication Date
Tue Jul 21 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An in vitro evaluation of fit of the crowns fabricated by zirconium oxide-based ceramic CAD/CAM systems, before and after porcelain firing cycles and after glaze cycles
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Background: The objective of this in vitro study was to evaluate the vertical marginal fit of crowns fabricated with ZrO2 CAD/CAM, before and after porcelain firing cycles and after glaze cycles. Materials and Methods: An acrylic resin model of a left maxillary first molar was prepared and duplicated to have Nickel-Chromium master die. Ten die stone dies were sent to the CAD/CAM (Amann Girrbach) for crowns fabrication. Marginal gaps along vertical planes were measured at four indentations at the (mid mesial, mid distal, mid buccal, mid palatal) before (Time 0) and after porcelain firing cycles (Time 1) and after glaze cycles (Time 2) using a light microscope at a magnification of ×100. One way ANOVA LSD tests were performed to determine wh

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Publication Date
Fri Mar 24 2017
Journal Name
Journal Of Engineering
Composite Techniques Based Color Image Compression
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Compression for color image is now necessary for transmission and storage in the data bases since the color gives a pleasing nature and natural for any object, so three composite techniques based color image compression is implemented to achieve image with high compression, no loss in original image, better performance and good image quality. These techniques are composite stationary wavelet technique (S), composite wavelet technique (W) and composite multi-wavelet technique (M). For the high energy sub-band of the 3 rd level of each composite transform in each composite technique, the compression parameters are calculated. The best composite transform among the 27 types is the three levels of multi-wavelet transform (MMM) in M technique wh

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Publication Date
Tue Feb 28 2017
Journal Name
Journal Of Engineering
Composite Techniques Based Color Image Compression
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     Compression for color image is now necessary for transmission and storage in the data bases since the color gives a pleasing nature and natural for any object, so three composite techniques based color image compression is implemented to achieve image with high compression, no loss in original image, better performance and good image quality. These techniques are composite stationary wavelet technique (S), composite wavelet technique (W) and composite multi-wavelet technique (M). For the high energy sub-band of the 3rd  level of each composite transform in each composite technique, the compression parameters are calculated. The best composite transform among the 27 types is the three levels of multi-wavelet

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Publication Date
Mon Jan 09 2023
Journal Name
2023 15th International Conference On Developments In Esystems Engineering (dese)
Deep Learning-Based Skin Cancer Identification
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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Physics: Conference Series
Graphical password based mouse behavior technique
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Abstract<p>This paper proposes a new password generation technique on the basis of mouse motion and a special case location recognized by the number of clicks to protect sensitive data for different companies. Two, three special locations click points for the users has been proposed to increase password complexity. Unlike other currently available random password generators, the path and number of clicks will be added by admin, and authorized users have to be training on it.</p><p>This method aims to increase combinations for the graphical password generation using mouse motion for a limited number of users. A mathematical model is developed to calculate the performance</p> ... Show More
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