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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 Feb 08 2024
Journal Name
Engineering, Technology &amp; Applied Science Research
Mitigating Reflection Cracking in Asphalt Concrete Overlays with ECC and Geotextile
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The rehabilitation of deteriorated pavements using Asphalt Concrete (AC) overlays consistently confronts the reflection cracking challenge, where inherent cracks and joints from an existing pavement layer are mirrored in the new overlay. To address this issue, the current study evaluates the effectiveness of Engineered Cementitious Composite (ECC) and geotextile fabric as mitigation strategies. ECC, characterized by its tensile ductility, fracture resistance, and high deformation capacity, was examined in interlayer thicknesses of 7, 12, and 17 mm. Additionally, the impact of geotextile fabric positioning at the base and at 1/3 depth of the AC specimen was explored. Utilizing the Overlay Testing Machine (OTM) for evaluations, the research d

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Obesity in kindergarten children and its relation with some variables Family
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Obesity is a common disease that resulted from over-nutrition in adults and children. It rarely causes damage to the centers of food in the brain. Obesity is defined as an increased body weight from its natural limit which is resulted from the accumulation of excessive amounts of fatty tissue incredibly up to 20% in males, 30 % in females unless this increase is not due to an increase in muscles as in athletes or accumulation of water in the body which is resulted from Mesothelioma or the magnitude of the skeleton.Obesity is the increase of the total average of fat in the body compared to other tissues, which causes an increasing body weight, thereby increasing body mass. The fatty child has an increase in the stored fatty layer under th

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Public sector in Iraq Transition and partnership with the private sector
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  The role of the public sector- Investment customizations-  economic embargo -  The role of the private sector - Coexistence between the public and private sectors -   Ratio of growth

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Publication Date
Wed Jun 01 2022
Journal Name
Resmilitaris
Evaluation mucin 1 polymorphism and expression with infertility in Iraqi females
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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
Correlation between malondialdehyde and metanephrine in patients with acute lymphoblastic leukemia
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Acute lymphoblastic leukemia (ALL) is one of the most common diseases , so in this study the serum level of malondialdehyde and its relationship with metanephrine was investigated in acute lymphoblastic leukemia patients over one month of treatment. Some biochemical parameters (serum glucose , total serum protein , malondialdehyde ,vitamin C, and metanephrine) changed as well as white blood cell count and blood hemoglobinlevelswere analyzed in sixty patients diagnosed with acute lymphoblastic leukemia over one month of treatment compared to healthy control group.Statistically significant increases (p<0.01) in white blood cell (WBC) count, mean concentrations of malondialdehyde (MDA) (p< 0.05) and metanephrine (p< 0.001) were observed in

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Psychological Pollution in Iraqi Society and its Relationship With some Variables
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The research aims to identify the level of psychological pollution in Iraqi society and the significant differences in psychological pollution in the Iraqi society according to variables. A sample of (600) individuals randomly selected from all governorates of Iraq, with (285) males and (315) females was used in the current study. The researcher adopted the scale of (Muhammad, 2004) psychological pollution consisting of (118) items, which limited (46) items after modification distributed into four areas: denial and abuse of the civilized identity, attachment to foreign formal aspects, effeminacy, and anarchism. The results of the research showed that there is no statistical significance among the individuals of the research sample. They

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Coloproctology
Obesity and helicobacter pylori infection in adults with non specific colitis
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Abstract<p> Background Non specific colitis is defined as inflammatory condition of the colon that when examined microscopically lacks any characteristic features of any specific form of colitis and is commonly seen in reports of colonoscopy biopsies. There are many factors that cause it like obesity and H pylori.</p><p> Aim of the study To determine the association of obesity and H pylori as contributory factors to this disease.</p><p> Patients and methods This is a case-controlled study was carried out in Al-Kindy College of Medicine from January 2017 to June 2018. Sixty individuals were included; forty of them had non specific colitis. The rest were hea</p> ... Show More
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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of insider trading in accounting information on the investors decisions: An Applied Study In a sample of corporation listed in Iraq Securities Exchange
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This research aims to discuss an important issue because of its role in increasing the efficiency of financial markets and boost investor confidence by a insider trading, which arises as a result of leaking secret information to some investors and reliable in the process of trading shares in the Iraq Stock Exchange And thus obtain abnormal profits at the expense of other investors. Research was based on the assumption that " Where shortcomings in local regulations relating to disclosure and insider trading in accounting information leads to the activate the phenomenon of insider trading in accounting information in the Iraq Stock Exchange and including a negative impact on investors' decisions ". and Because of the difficulty the discove

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Publication Date
Tue Aug 28 2018
Journal Name
Mechanical Sciences
Mechatronic design and genetic-algorithm-based MIMO fuzzy control of adjustable-stiffness tendon-driven robot finger
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Abstract. This work presents a detailed design of a three-jointed tendon-driven robot finger with a cam/pulleys transmission and joint Variable Stiffness Actuator (VSA). The finger motion configuration is obtained by deriving the cam/pulleys transmission profile as a mathematical solution that is then implemented to achieve contact force isotropy on the phalanges. A VSA is proposed, in which three VSAs are designed to act as a muscle in joint space to provide firm grasping. As a mechatronic approach, a suitable type and number of force sensors and actuators are designed to sense the touch, actuate the finger, and tune the VSAs. The torque of the VSAs is controlled utilizing a designed Multi Input Multi Output (MIMO) fuzzy controll

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Publication Date
Sat Jul 01 2023
Journal Name
Electric Power Systems Research
Analytical and measurement-based wideband two-port modeling of DC-DC converters for electromagnetic transient studies
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Power-electronic converters are essential elements for the effective interconnection of renewable energy sources to the power grid, as well as to include energy storage units, vehicle charging stations, microgrids, etc. Converter models that provide an accurate representation of their wideband operation and interconnection with other active and passive grid components and systems are necessary for reliable steady state and transient analyses during normal or abnormal grid operating conditions. This paper introduces two Laplace domain-based approaches to model buck and boost DC-DC converters for electromagnetic transient studies. The first approach is an analytical one, where the converter is represented by a two-port admittance model via mo

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