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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 Mar 01 2009
Journal Name
Baghdad Science Journal
Some Results On Lie Ideals With (&#963;,&#964;)-derivationIn Prime Rings
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In this paper, we proved that if R is a prime ring, U be a nonzero Lie ideal of R , d be a nonzero (?,?)-derivation of R. Then if Ua?Z(R) (or aU?Z(R)) for a?R, then either or U is commutative Also, we assumed that Uis a ring to prove that: (i) If Ua?Z(R) (or aU?Z(R)) for a?R, then either a=0 or U is commutative. (ii) If ad(U)=0 (or d(U)a=0) for a?R, then either a=0 or U is commutative. (iii) If d is a homomorphism on U such that ad(U) ?Z(R)(or d(U)a?Z(R), then a=0 or U is commutative.

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Predicting changes on budget expenditures using Markov chains with practical application
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The researchers have a special interest in studying  Markov  chains as one of the probability samples which has many applications in different fields. This study comes to deal with the changes issue that happen on budget expenditures by using statistical methods, and Markov chains is the best expression about that as they are regarded reliable  samples in the prediction process. A transitional matrix is built for three expenditure cases (increase ,decrease ,stability) for one of budget expenditure items (base salary) for three directorates (Baghdad ,Nineveh , Diyala) of one  of the ministries. Results are analyzed by applying  Maximum likelihood estimation  and Ordinary least squares  methods resulting

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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 concentra

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Publication Date
Sun Dec 17 2017
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study Using the Passive Solar Chimney for Evaporative Cooling With PCM and CFM as a Thermal Energy Storage
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      In this work, a test room was built in Baghdad city, with (2*1.5*1.5) m3  in dimensions, while the solar chimneys (SC) were designed with aspect ratio (ar) bigger than 12. Test room was supplied by many solar collectors; vertical single side of air pass with ar equals 25, and tilted 45o double side of air passes with ar equals 50 for each pass, both collectors consist of flat thermal energy storage box collector (TESB) that covered by transparent clear acrylic sheet, third type of collector is array of evacuated tubular collectors with thermosyphon in 45o instelled  in the bottom of TESB of vertical SC. The TESB was

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Publication Date
Wed Oct 21 2015
Journal Name
Integrated Journal Of Engineering Research And Technology
A HYBRID CUCKOO SEARCH AND BACK-PROPAGATION ALGORITHMS WITH DYNAMIC LEARNING RATE TO SPEED UP THE CONVERGENCE (SUBPL) ALGORITHM
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BP algorithm is the most widely used supervised training algorithms for multi-layered feedforward neural net works. However, BP takes long time to converge and quite sensitive to the initial weights of a network. In this paper, a modified cuckoo search algorithm is used to get the optimal set of initial weights that will be used by BP algorithm. And changing the value of BP learning rate to improve the error convergence. The performance of the proposed hybrid algorithm is compared with the stan dard BP using simple data sets. The simulation result show that the proposed algorithm has improved the BP training in terms of quick convergence of the solution depending on the slope of the error graph.

Publication Date
Thu Apr 24 2025
Journal Name
Pertanika Journal Of Science And Technology
Enhancing Leachate Treatment with Electrocoagulation: A Computational Approach Using Response Surface Methodology
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Malaysia's growing population and industrialisation have increased solid waste accumulation in landfills, leading to a rise in leachate production. Leachate, a highly contaminated liquid from landfills, poses environmental risks and affects water quality. Conventional leachate treatments are costly and time-consuming due to the need for additional chemicals. Therefore, the Electrocoagulation process could be used as an alternative method. Electrocoagulation is an electrochemical method of treating water by eliminating impurities by applying an electric current. In the present study, the optimisation of contaminant removal was investigated using Response Surface Methodology. Three parameters were considered for optimisation: the curr

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Publication Date
Wed Feb 08 2023
Journal Name
Eneurologicalsci
Double encephalocele with an excellent outcome postoperatively: A case report from Iraq
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HTH Ali Tarik Abdulwahid , Ahmed Dheyaa Al-Obaidi , Mustafa Najah Al-Obaidi, eNeurologicalSci, 2023

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Serum CXCL 9 as a Potential Biomarker for Patients with Ulcerative Colitis
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Background: Ulcerative colitis (UC) is an inflammatory bowel disease restricted to the large intestine, characterized by superficial ulceration. It is a progressive and chronic disease requiring long-term treatment. Although its etiology remains unknown, it is suggested that environmental factors influence genetically susceptible individuals, leading to the onset of the disease. (C-X-C) ligand 9 is a chemokine that belongs to the CXC chemokine family, it plays a role in the differentiation of immune cells such as cytotoxic lymphocytes, natural killer T cells, and macrophages. Its interaction with its corresponding receptor CXCR3 which is expressed by a variety of cells such as effector T cells, CD8+ cytotoxic T cells, and macrophage

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Attitude The King Ghazi a Problem the Border with Kuwait 1933-1939
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King Ghazi (1933-1939) was of the Arabic characters that characterized national and
patriotic spirit and that faced the British policy in all its aspects.
King Ghazi distinguished as of Arab nationalist tendencies and called for the
liberalization of Arab lands which were under the rule of the Ottoman Empire. He called for
reunification under the one Arab country, Hence came the King invitations to liberate Kuwait
from the British protectorate and consolidated with Iraq.
King Ghazi established a private radio station in the royal palace (AL zzaahoor) palace
and provided special programs to return of Kuwait to Iraq, this radio station was The
prominent role in the revitalization of the Kuwaiti National Movement, an

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Publication Date
Sat Apr 02 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The structure of capital and its impact on the profitability of companies : is an analytical study of a sample of industrial companies listed on the Iraqi Stock Exchange
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This study aimed to know the impact of the capital structure measured by the ratio of financing to short-term capital and the ratio of financing to long-term capital on the profitability of companies, as measured by the rate of return on assets and the rate of return on equity. The study was applied to industrial sector companies listed in the Iraq Stock Exchange. The financial number of (14) companies, and (4) companies were selected that met the conditions for selecting the study sample. The study methodology relies on the analytical method as it is more appropriate to the nature, scope and objectives of the study, and the ready-made statistical program "SPSS" will be used to analyze the relationships and influence between the

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