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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
Mon Dec 30 2024
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Reservoir permeability prediction based artificial intelligence techniques
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   Predicting permeability is a cornerstone of petroleum reservoir engineering, playing a vital role in optimizing hydrocarbon recovery strategies. This paper explores the application of neural networks to predict permeability in oil reservoirs, underscoring their growing importance in addressing traditional prediction challenges. Conventional techniques often struggle with the complexities of subsurface conditions, making innovative approaches essential. Neural networks, with their ability to uncover complicated patterns within large datasets, emerge as a powerful alternative. The Quanti-Elan model was used in this study to combine several well logs for mineral volumes, porosity and water saturation estimation. This model goes be

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Reinforcement Learning-Based Television White Space Database
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Television white spaces (TVWSs) refer to the unused part of the spectrum under the very high frequency (VHF) and ultra-high frequency (UHF) bands. TVWS are frequencies under licenced primary users (PUs) that are not being used and are available for secondary users (SUs). There are several ways of implementing TVWS in communications, one of which is the use of TVWS database (TVWSDB). The primary purpose of TVWSDB is to protect PUs from interference with SUs. There are several geolocation databases available for this purpose. However, it is unclear if those databases have the prediction feature that gives TVWSDB the capability of decreasing the number of inquiries from SUs. With this in mind, the authors present a reinforcement learning-ba

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Publication Date
Thu Jun 04 2020
Journal Name
Journal Of Discrete Mathematical Sciences And Cryptography
User authentication system based specified brain waves
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A security system can be defined as a method of providing a form of protection to any type of data. A sequential process must be performed in most of the security systems in order to achieve good protection. Authentication can be defined as a part of such sequential processes, which is utilized in order to verify the user permission to entree and utilize the system. There are several kinds of methods utilized, including knowledge, and biometric features. The electroencephalograph (EEG) signal is one of the most widely signal used in the bioinformatics field. EEG has five major wave patterns, which are Delta, Theta, Alpha, Beta and Gamma. Every wave has five features which are amplitude, wavelength, period, speed and frequency. The linear

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Publication Date
Fri Jan 01 2016
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Genetic--Based Face Retrieval Using Statistical Features
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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Assessment of Serum Levels of the WNT Pathway Antagonist (Dickkopf-1) in a Sample of Type 2 Diabetic Patients with Retinopathy using Two Groups of Antidiabetics
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Objectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and s

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Publication Date
Thu Dec 01 2022
Journal Name
Tropical Journal Of Natural Product Research
Alterations in Biochemical Parameters and Antioxidant Enzymes in Male Mice as Biomarkers of Exposure to Pollution with Cadmium
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There is currently a significantly larger concentration of toxins in our environment than there was in the past. This is mostly attributable to the expansion of modern industry. This investigation was conducted in order to investigate various haematological and biochemical changes in order to determine the effects of Cd on the liver and kidney. Because of its long biological half-life, it is considered hazardous to human health. The effect of sub-lethal doses (40, 80 and 120 mg\Kg) of Cadmium (Cd) on male mice were evaluated for 4 weeks, and analysis was done to estimate their biochemical parameters and antioxidant enzymes. The results showed that Cd-treated mice had considerably lower packed cell volume, red blood cells, and haemoglobin. W

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Publication Date
Sat Jul 25 2026
Journal Name
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An Impairment of Salivary Gland Function in Rheumatoid Arthritis: Association with Change in Salivary Biomarkers and Disease Activity
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Background: Rheumatoid arthritis is a chronic inflammatory autoimmune disease characterized by joint inflammation, involvement of exocrine salivary and lacrimal glands may occur as extra-articular mani¬festations in this disease. This study aimed to provide evidence of altered in function and composition of salivary gland in patients with rheumatoid arthritis by determine salivary flow rate and some biochemical parameters(total protein, amylase, peroxidase) and to investigate the relationship between disease activity and changes in function and composition of salivary gland. Materials and Methods: Fifty five patients with RA (7 males and 48 females) were enrolled in this study with age range (20-69) years. The patients were separated int

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Relationship between Emotional Intelligence and Decision Making Styles And their effect on Performance Excellence the university" An exploratory search for a sample of the administrative leaderships in the Mustansiriya University"
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Tue May 01 2018
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Publication Date
Tue Aug 30 2016
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The Effect of Different Furrow Depths and Speeds of Machinary Units Using A Locally Assembled Combine Implement on Planting Maize
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