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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
Sat Oct 01 2022
Journal Name
Baghdad Science Journal
The Role of Serum Chitinase-3-Like 1 Protein (YKL-40) Level and its Correlation with Proinflammatory Cytokine in Patients with Rheumatoid Arthritis
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Chitinase-3-like 1 protein (YKL-40) is a glycoprotein primarily produced in the arthritic joint and plays a crucial role in inflammatory processes. The aim of the study is to establish the role of YKL-40 as a biomarker for rheumatoid arthritis (RA) compared to proinflammatory biomarkers and disease activity. The study included 58 patients and 18 control. Diseases activity score (DAS-28) and clinical disease activity index (CDAI) were measured. Serum level of YKL-40, tumor necrosis factor-α (TNF-α), interleukin-1B (IL-1β), erythrocyte sedimentation (ESR), rheumatoid factor (RF), C-reactive protein (CRP), and anti-citrullinated protein antibody (ACPA) were assessed. The results showed that the median serum YKL-40 level which was 5.42 

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Publication Date
Mon Dec 25 2023
Journal Name
Optical Materials
Impact of a precise pH value change on the characteristics of deposited tin monosulphide films onto a flexible substrate
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The chemical bath deposition technique (CBD) is considered the cheapest and easiest compared with other deposition techniques. However, it is highly sensitive to effective parameter deposition values such as pH, temperature, and so on. The pH value of the reaction solution has a direct impact on both the nucleation and growth rate of the film. Consequently, this study presents a novel investigation into the effect of a precise change. in the pH reaction solution value on the structural, morphological, and photoresponse characteristics of tin monosulphide (SnS) films. The films were grown on a flexible polyester substrate with pH values of 7.1, 7.4, and 7.7. The X-ray diffraction patterns of the grown films at pH 7.1 and 7.4 confirmed

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Publication Date
Fri Jul 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of different staining materials on color stability of sapphire brackets bonded with different types of light cure orthodontic adhesives (An in vitro study)
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Background: The demand for better esthetic during orthodontic treatment has increased nowadays, so orthodontists starting using esthetic arch wires, brackets and ligatures.Tooth colored brackets were introduced in different types of materials. Sapphire ceramic brackets are one type of esthetic brackets and their color stability remains the main concern for the clinicians and patients at the same time. The present study design to evaluate the effect of three different staining materials (pepsi, black tea and cigarette smoke) on the stainability of sapphire ceramic brackets bonded with three types of light cure orthodontic adhesives which include: Resilience, Enlight and Transbond. Materials and Methods: The sample consisted of three hundre

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Publication Date
Sat Dec 04 2021
Journal Name
International Journal Of Drug Delivery Technology
Evaluation of the Anti-inflammatory and Anti-oxidant Activity of Crab Components and Crab Shell in Experimental Rats in Comparison with Dexamethasone and Diclofenac Sodium
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Crabs belong to the crustacean family (Decapods crustacean), and their shells contain natural ingredients from which the bioactive compounds are derived. It has been used as folklore medicine in cancer treatment. We investigate the possible anti-inflammatory and anti-oxidant effects for crab shells and whole crabs. Thirty-six rats (150–200 gm) from both sexes were used, divided into six groups, the anti-inflammatory and anti-oxidant activity measured using cotton pellet induce granuloma model. Detection of tumor necrosis factor alpha (TNF α), Interleukin 1 beta (IL-1β), superoxide (SOD), and malondialdehyde (MDA) levels using ELISA Kits. The data analysis by one-way ANOVA followed by the Tukey test. Values are significant at (p < 0.05).

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
What came as a language in the book to explain Ibn Aqeel on Alfiya Ibn malek
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It is found in the book "Ibn Aqeel: Alfiya Ibn Malek" that there are some linqustical aspected are related to the native tribal speakers like Tamim or Tie or some others. Sometimes in the book he said "some Arabian said without mentioning the name of the tribe.
As weel, he hasn’t mentioned the accent but he does mention the language. In the book, he has brought back the most important and the biqqest Arabian tribes suchas tribes of Hegaz, Tamim, Hatheyal, son of Anber, Tie, Rabia Bin Wael, Bani Katham, Au there, Bani AL Harth, Bani Kalb, Bani Hgim, Zabid, Hamedan, Alia Qais, Bani Ameer and many others. However, the most mentioned tribes were Hegaz and Tami.
Hence, the importance of the book expiain Ibn Aqeel by mentioning these A

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Publication Date
Fri Aug 05 2016
Journal Name
Wireless Communications And Mobile Computing
A comparison study on node clustering techniques used in target tracking WSNs for efficient data aggregation
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Wireless sensor applications are susceptible to energy constraints. Most of the energy is consumed in communication between wireless nodes. Clustering and data aggregation are the two widely used strategies for reducing energy usage and increasing the lifetime of wireless sensor networks. In target tracking applications, large amount of redundant data is produced regularly. Hence, deployment of effective data aggregation schemes is vital to eliminate data redundancy. This work aims to conduct a comparative study of various research approaches that employ clustering techniques for efficiently aggregating data in target tracking applications as selection of an appropriate clustering algorithm may reflect positive results in the data aggregati

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Publication Date
Sun May 23 2021
Journal Name
Egyptian Journal Of Chemistry
Thermodynamic study of adsorption of a mixture of Nolvadex and nanoparticle ferric oxide that prepared on the surface of activated charcoal
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Publication Date
Mon Sep 30 2019
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
A Comparative Study of the Influence of Different Types of Polymers on Viscosity Index and Pour Point of Iraqi Base Oils
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In this study, the effects of blending the un-branched acrylate polymer known as Poly (n-decyl acrylate), and the branched acrylate polymer known as Poly (iso-octyl acrylate), on the viscosity index (VI), and the pour point of the Iraqi base stocks 40, and 60 respectively, were investigated. Toluene was used as a carrier solvent for both polymer types. The improvement level of oils (VI, & pour point) gained by blending the oil with the acrylate derived polymers was compared with the values of (VI, and pour point) gained by blending the oil with a commercial viscosity index, and pour point improver. The commercial lubricant additive was purchased and used by Al-Daura Refineries. It consisted of an un-known olefin copolymer dissolved i

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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
An Ecological Observation on Inland water Ecosystem in Erbil –Iraq Kurdistan with particular reference to blue green algae Glaucospira
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Regular sampling for six months from January to July 2012 were taken in small, shallow, perennial, standing ponds near the Greater Zab River, Gwer district, Erbil. A variety of physicochemical parameters were determined. Air and water temperature were falling between 15.2 - 34.7 ? C and 15.5 and 26.5 ?C. The waters are neutral (pH 7.38-8.27), hard, alkaline, salty, high in TDS and EC (892-966?S/cm, and rich in nutrients (NO3: 2.1-4.1mg/l, PO4: 0.33-0.62 mg / l , SO4: 24.7-80.2 mg / l ). The attention fixed on a filamentous blue- green algae Glaucospira Lagerheim, 1982) which is new to Iraqi flora. It is a filament (trichome), solitary, pale or yellowish blue – green, without sheath, Screw like coiled, motile, some of them are activ

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Publication Date
Fri Jun 30 2023
Journal Name
Pakistan Heart Journal
Music Medicine Intervention--Based Program for Reducing Pain and Anxiety of Children Undergoing Bone Marrow Aspiration and Lumber Puncture Procedures
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