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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
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Study the Effect of Face Sheets Material on Strength of Sandwich Plates with Circular Hole
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This study aims to investigate the effect of changing skins material on the strength of sandwich plates with circular hole when subjected to mechanical loads. Theoretical, numerical and experimental analyses are done for sandwich plates with hole and with two face sheet materials. Theoretical analysis is performed by using sandwich plate theory which depends on the first order shear deformation theory for plates subjected to tension and bending separately. Finite element method was used to analyse numerically all cases by ANSYS program.

The sandwich plates were investigated experimentally under bending and buckling load separately. The relationship between stresses and the ratio of hole diameter to plate width (d/b) are built, by

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Publication Date
Sat Apr 09 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Effect of Sustainable Glass Powder on the Properties of Reactive Powder Concrete with Polypropylene Fibers
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Global warming and environmental damage have become major problems. The production of Portland cement releases large quantities of gas, which cause pollution to the atmosphere. This problem can be solved via the use of sustainable materials, such as glass powder. This study investigates the effect of partial replacement of cement with sustainable glass powder at various percentages (0, 15, 20, and 25%) by weight of cement on some mechanical properties (compressive strength, flexural strength, absorption, and dry density) of Reactive Powder Concrete (RPC) containing a percentage of Polypropylene fibers (PRPC) of 1% by weight. Furthermore, steam curing was performed for 5 hours at 90oC after hardening the sample directly. The RPC was

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of fixed orthodontic appliance with antihypertensive drugs on the body weight of experimental rats
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Background: This study aims to investigate the effect of fixed orthodontic appliances and/or antihypertensive drugs on the weight of experimental rats. Materials and Methods: Thir-ty-six male Wistar albino rats were subjected to a split-mouth design study, in which an orthodontic appliance was inserted in one side to move the first molar mesially for 2 weeks while the other side acted as a control to tooth movement. The rats were allocated into three groups: group A (n = 12), without any pharmacological treatment; group B (n = 12), subcu-taneous injection of bisoprolol fumarate (5 mg/kg) daily; and group C (n = 12), subcutaneous injection of valsartan (10 mg/kg) daily. A fixed orthodontic appliance with a closing coil spring delivering 5

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Publication Date
Sun Jan 25 2015
Journal Name
Geomechanics And Engineering
Improvement of bearing capacity of footing on soft clay grouted with lime-silica fume mix
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Publication Date
Sun Oct 17 2021
Journal Name
Iraqi Journal Of Physics
The effect of inorganic pigment on the tensile properties of polycarbonate irradiated with UV – light
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The effect of UV-light on the tensile properties of pure PC has been studied. It was shown that irradiation of PC undergo a drop in the tensile properties of 30 hour of exposure. The results of irradiated samples shows that the addition of ZnO and TiO2 with different percentages (0.5, 1, 1.5 %) will reduce the Young modulus and ultimate stress of PC/ZnO ,PC/ TiO2 composites

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages
Free will between Slavery and Freedom: A Study of Linda Brent in Incidents in the Life of a Slave Girl by Harriet Jacobs
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Harriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong wille

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Publication Date
Thu Jul 23 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Nutritional Status among a Group of Preschool Children in Relation to Concentration of Selected Elements in Saliva and Caries Severity (A Comparative Study)
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Background: Nutritional status during childhood is very important for individual development and growth. Nutrition has local and systemic effect on the oral health by affecting dental health and salivary composition. This study was aimed to determine effect of iron, sodium and potassium ions in saliva on the nutritional status and to determine the effect of nutritional status on caries severity among preschool children. Material and Methods: The sample consists of 90 children aged 4 and 5 years of both genders, selected from 6 kindergartens in Al-Resafa aspect of Baghdad province. Children classified according to their nutritional status into three groups (normalweight, underweight and overweight). Nutritional status was determined by usi

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of The College Of Languages (jcl)
Free will between Slavery and Freedom: A Study of Linda Brent in Incidents in the Life of a Slave Girl by Harriet Jacobs
...Show More Authors

Harriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong w

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
On Solving Singular Multi Point Boundary Value Problems with Nonlocal Condition
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In this paper Hermite interpolation method is used for solving linear and non-linear second order singular multi point boundary value problems with nonlocal condition. The approximate solution is found in the form of a rapidly convergent polynomial. We discuss behavior of the solution in the neighborhood of the singularity point which appears to perform satisfactorily for singular problems. The examples to demonstrate the applicability and efficiency of the method have been given.

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Publication Date
Sun Dec 02 2012
Journal Name
Baghdad Science Journal
The Inhibitory Effect Zingiber Offlcinale Extracts on Microorganisms whichAssociated with Biscuit.
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The research aimed at studying the inhibitive effect of the hot watery dry and ethanolic ginger(85%) and fragrant oil which are added in concentrates of o.o25, o.o5o and 0.1g / 100g respectively in the growth of bacteria and molds. The results of the initial chemical diagnosis showed containment of ginger roots extract on. Alkaloids, Glycosides, Flavonoids and Suponins. The highest inhibitive effect of the bacteria reached the concentrate . 0.1% of the oil extract then the concentrate 0.050% of the ethanolic hot extract follows it. While 0.1% was the least inhibitive concentrate for the hot watery extract. But the inhibitive effect of the hot oily and alcoholic extracts in the numbers of molds colonies was 0.025%, when the concentrate 0.1%

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