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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
Wed Jan 01 2020
Journal Name
Biochemical And Cellular Archives
Histological disturbance in liver and spleen of visceral leishmaniasis infected mice with the progression of infection
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Leishmania parasites reproduce wherever there are cells of the mononuclear phagocyte system, almost in macrophages. These are most copious in the liver and spleen;therefore, infection leads to an expansion of both of them. This study determined the burden of visceral leishmaniasis (VL) infection on liver and spleen. A total of 20 mice were infected peritoneally with 2x107promastigotes of Leishmania donovani / ml and other 12 mice left without infection as a healthy control. The weight of whole body, liver and spleen were measured and the histological development using hematoxylin and eosin stains were determined after 15, 30, 45-and 60-days post infection. The results represent that the mean weights of liver and spleen were increased in inf

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Publication Date
Sun Dec 01 2013
Journal Name
Baghdad Science Journal
Estimation of Testosterone, Estradiol and some Markers in Sera of Iraqi Patients with Benign Prostatic Hyperplasia.
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Benign prostatic hyperplasia (BPH) is one of the most common disease and major cause of morbidity in elderly men which may lead to bladder outflow obstruction and lower urinary tract symptoms (LUTS). Although sex steroid hormones play fundamental roles in prostate growth, their clinical significance is not completely clear. In the present study we assessed whether serum hormones levels as markers of prostate disease. This study includes (40) patients with benign prostatic hypertrophy and (40) control group with age rang (41-79) and (42-71) years respectively. The following biochemical investigations have been studied: Testosterone, Estradiol (E2), and Prostatic Specific Antigen (PSA) levels using ELISA method which correlated with t

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Publication Date
Thu Jul 11 2019
Journal Name
Journal Port Science Research
Evaluation Activity of Alanine Aminopeptidase (AAP) in Patients with Renal Dialysis, Purification and Isolation of Isoenzymes
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Publication Date
Thu Apr 01 2021
Journal Name
Biochemical And Cellular Archives
STUDY OF LYSYL OXIDASE-1 AND KIDNEY FUNCTION IN SERA OF IRAQI PATIENTS WITH DIABETIC NEPHROPATHY
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This study aimed to compare lysyl oxidase-1 level in diabetic patients with and without renal dysfunction, that LOX-1 may be an indicator for the early stage of diabetic nephropathy (DN). In addition to finding it is a relationship with kidney functions in Iraqi diabetic patients with and without renal dysfunction. Blood was obtained from 25 healthy individuals as a control group (G1), 25 diabetic patients with renal dysfunction, and 25 diabetic patients without renal dysfunction. Age range 40-60 years for all subjects. BMI (25-27) Kg/m2 . The serum was used for the analysis of LOX-1, FBG, urea, creatinine and uric acid. Whole blood is used for the determination of HbA1C. Results of FBG and HbA1C revealed a significant increase in G2 and G

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Publication Date
Tue Jan 29 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Financial contribution of taxes on Foreign oil companies in support of the state budget: The case of a foreign oil company in the Iraq Study
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Imposed on foreign oil companies from important sources in the financing of the general budget in most countries of the world income tax is considered as well as be used to achieve political, economic and social goals, and has developed the concept of the tax until it became play an important role in influencing the economic conditions of a country, and the aim of this research is to statement imposed on foreign oil companies operating in Iraq in the financing of the state budget income tax contribution, as well as clarify the contracts type contracts with these companies, which is in favor of Iraq, together with the Income Tax Law No. (19) for the year / 2010, and instructed No. (5) for the year / 2011, which organized the tax process s

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Theoretical And Applied Information Technology
Graph based text representation for document clustering
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Advances in digital technology and the World Wide Web has led to the increase of digital documents that are used for various purposes such as publishing and digital library. This phenomenon raises awareness for the requirement of effective techniques that can help during the search and retrieval of text. One of the most needed tasks is clustering, which categorizes documents automatically into meaningful groups. Clustering is an important task in data mining and machine learning. The accuracy of clustering depends tightly on the selection of the text representation method. Traditional methods of text representation model documents as bags of words using term-frequency index document frequency (TFIDF). This method ignores the relationship an

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Scopus (15)
Scopus
Publication Date
Tue Jan 29 2019
Journal Name
Journal Of The College Of Education For Women
Object Filling Using Table Based Boundary Tracking
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The feature extraction step plays major role for proper object classification and recognition, this step depends mainly on correct object detection in the given scene, the object detection algorithms may result with some noises that affect the final object shape, a novel approach is introduced in this paper for filling the holes in that object for better object detection and for correct feature extraction, this method is based on the hole definition which is the black pixel surrounded by a connected boundary region, and hence trying to find a connected contour region that surrounds the background pixel using roadmap racing algorithm, the method shows a good results in 2D space objects.
Keywords: object filling, object detection, objec

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Publication Date
Tue Jun 30 2015
Journal Name
International Journal Of Computer Techniques
Multifractal-Based Features for Medical Images Classification
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This paper presents a method to classify colored textural images of skin tissues. Since medical images havehighly heterogeneity, the development of reliable skin-cancer detection process is difficult, and a mono fractaldimension is not sufficient to classify images of this nature. A multifractal-based feature vectors are suggested hereas an alternative and more effective tool. At the same time multiple color channels are used to get more descriptivefeatures.Two multifractal based set of features are suggested here. The first set measures the local roughness property, whilethe second set measure the local contrast property.A combination of all the extracted features from the three colormodels gives a highest classification accuracy with 99.4

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Publication Date
Fri Jul 18 2014
Journal Name
International Journal Of Computer Applications
3-Level Techniques Comparison based Image Recognition
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Image recognition is one of the most important applications of information processing, in this paper; a comparison between 3-level techniques based image recognition has been achieved, using discrete wavelet (DWT) and stationary wavelet transforms (SWT), stationary-stationary-stationary (sss), stationary-stationary-wavelet (ssw), stationary-wavelet-stationary (sws), stationary-wavelet-wavelet (sww), wavelet-stationary- stationary (wss), wavelet-stationary-wavelet (wsw), wavelet-wavelet-stationary (wws) and wavelet-wavelet-wavelet (www). A comparison between these techniques has been implemented. according to the peak signal to noise ratio (PSNR), root mean square error (RMSE), compression ratio (CR) and the coding noise e (n) of each third

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Publication Date
Thu Oct 21 2021
Journal Name
The 3rd Al-noor International Conference Of Science And Technology 2021 Muscat-oman
Gama Platform Survey for Agent-Based Modelling
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The agent-based modeling is currently utilized extensively to analyze complex systems. It supported such growth, because it was able to convey distinct levels of interaction in a complex detailed environment. Meanwhile, agent-based models incline to be progressively complex. Thus, powerful modeling and simulation techniques are needed to address this rise in complexity. In recent years, a number of platforms for developing agent-based models have been developed. Actually, in most of the agents, often discrete representation of the environment, and one level of interaction are presented, where two or three are regarded hardly in various agent-based models. The key issue is that modellers work in these areas is not assisted by simulation plat

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