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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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Sun Oct 01 2017
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Hourly yield prediction of a double-slope solar still hybrid with rubber scrapers in low-latitude areas based on the particle swarm optimization technique
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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering
Utilization of Iraqi Metakaolin in Special Types of Concrete: A Review Based on National Researches
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Publication Date
Wed Aug 24 2022
Journal Name
Journal Of Tikrit University For Humanities
A Training Program Based on Integrating Future Thinking Skills and Classroom Interaction Patterns for Mathematics Teachers and Providing Their Students with Creative Solution Skills
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The research aims to recognize the impact of the training program based on integrating future thinking skills and classroom interaction patterns for mathematics teachers and providing their students with creative solution skills. To achieve the goal of the research, the following hypothesis was formulated: There is no statistically significant difference at the level (0.05) between the mean scores of students of mathematics teachers whose teachers trained according to the proposed training program (the experimental group) and whose teachers were not trained according to the proposed training program (the control group) in Pre-post creative solution skills test. Research sample is consisted of (31) teachers and schools were distribut

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Publication Date
Wed Oct 29 2025
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Nursing Science Quarterly
Effectiveness of an Educational Program in Reducing Pressure Injuries in Patients With Spinal Cord Injury in Iraq
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Persons with spinal cord injury are at high risk of developing pressure injuries, and their caregivers are in a critical position to help prevent them. The objective of this study was to evaluate the effectiveness of an educational program for caregivers of persons with spinal cord injuries to prevent pressure injuries in Iraq. A pre- and post-test design was used and involved 25 caregivers of persons with spinal cord injury during the acute care phase in an SCI-specific unit of a hospital. A scale and questionnaire were used to gather the participants’ demographic information, pre- and post-educational program knowledge, and observations of their pre- and post-program performance of pressure injury preventive tasks. Descriptive s

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International Journal Of Advancements In Computing Technology
A proposed Technique for Information Hiding Based on DCT
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The aim of this work is to design an algorithm which combines between steganography andcryptography that can hide a text in an image in a way that prevents, as much as possible, anysuspicion of the hidden textThe proposed system depends upon preparing the image data for the next step (DCT Quantization)through steganographic process and using two levels of security: the RSA algorithm and the digitalsignature, then storing the image in a JPEG format. In this case, the secret message will be looked asplaintext with digital signature while the cover is a coloured image. Then, the results of the algorithmare submitted to many criteria in order to be evaluated that prove the sufficiency of the algorithm andits activity. Thus, the proposed algorit

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Fri Mar 31 2023
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Journal Of Al-qadisiyah For Computer Science And Mathematics
A Cryptosystem for Database Security Based on RC4 Algorithm
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Because of vulnerable threats and attacks against database during transmission from sender to receiver, which is one of the most global security concerns of network users, a lightweight cryptosystem using Rivest Cipher 4 (RC4) algorithm is proposed. This cryptosystem maintains data privacy by performing encryption of data in cipher form and transfers it over the network and again performing decryption to original data. Hens, ciphers represent encapsulating system for database tables

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A Multiple System Biometric System Based on ECG Data
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Publication Date
Wed Mar 20 2019
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Journal Of Legal Sciences
Sale Based on an Open Price – A Comparative Study
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The ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, the

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Mon May 11 2020
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A Cryptosystem for Database Security Based on TSFS Algorithm
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Implementation of TSFS (Transposition, Substitution, Folding, and Shifting) algorithm as an encryption algorithm in database security had limitations in character set and the number of keys used. The proposed cryptosystem is based on making some enhancements on the phases of TSFS encryption algorithm by computing the determinant of the keys matrices which affects the implementation of the algorithm phases. These changes showed high security to the database against different types of security attacks by achieving both goals of confusion and diffusion.

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Publication Date
Mon Sep 01 2025
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Steganography Based on Image Compression Using a Hybrid Technique
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Information security is a crucial factor when communicating sensitive information between two parties. Steganography is one of the most techniques used for this purpose. This paper aims to enhance the capacity and robustness of hiding information by compressing image data to a small size while maintaining high quality so that the secret information remains invisible and only the sender and recipient can recognize the transmission. Three techniques are employed to conceal color and gray images, the Wavelet Color Process Technique (WCPT), Wavelet Gray Process Technique (WGPT), and Hybrid Gray Process Technique (HGPT). A comparison between the first and second techniques according to quality metrics, Root-Mean-Square Error (RMSE), Compression-

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