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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
Thu Feb 01 2024
Journal Name
Computers In Biology And Medicine
Model based smooth super-twisting control of cancer chemotherapy treatment
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Chemotherapy is one of the most efficient methods for treating cancer patients. Chemotherapy aims to eliminate cancer cells as thoroughly as possible. Delivering medications to patients’ bodies through various methods, either oral or intravenous is part of the chemotherapy process. Different cell-kill hypotheses take into account the interactions of the expansion of the tumor volume, external drugs, and the rate of their eradication. For the control of drug usage and tumor volume, a model based smooth super-twisting control (MBSSTC) is proposed in this paper. Firstly, three nonlinear cell-kill mathematical models are considered in this work, including the log-kill, Norton-Simon, and hypotheses subject to parametric uncertainties and exo

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Publication Date
Mon Mar 31 2025
Journal Name
Romanian Medical Journal
Amylase and lipase roles as prognostic indicators in patients with diabetic foot
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Background. Diabetes mellitus (DM) is a prevalent disease that, if not appropriately managed, can lead to a variety of problems, including diabetic foot. Glycated hemoglobin A1c (HbA1c), FBS, amylase, and lipase are important diabetic management indicators now employed as diagnostic tests. Objective. This study aimed to evaluate the value of amylase and lipase as predictive markers in patients with diabetic foot. Patients and methods. This study included 50 patients who reported to Baghdad Hospital with diabetic feet between November 2023 and February 2025. All patients had their HbA1c, amylase, lipase, and FBS levels tested. Means, independent t-tests, and the F-test were used in the statistical analysis. Results. The study evaluat

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Publication Date
Sun Dec 31 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Heat Transfer and Hydrodynamic in Internal Jacket Airlift Bioreactor with Microbubble Technology
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   Integration of laminar bubbling flow with heat transfer equations in a novel internal jacket airlift bioreactor using microbubbles technology was examined in the present study. The investigation was accomplished via Multiphysics modelling to calculate the gas holdup, velocity of liquid recirculation, mixing time and volume dead zone for hydrodynamic aspect. The temperature and internal energy were determined for heat transfer aspect.

   The results showed that the concentration of microbubbles in the unsparged area is greater than the chance of large bubbles with no dead zones being observed in the proposed design.  In addition the pressure, due to the recirculation velocity of liquid around the draft

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Publication Date
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Lipid Profile and Insulin Resistance in Patients with Type-ΙΙ Diabetes Mellitus
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Objective: To investigate the relation between dyslipidemia and insulin resistance where it is one of the metabolic
disorders in patients with type-ΙΙ diabetes mellitus and compare the results with the control group.
Methodology: Blood samples were collected from (35) patients with type-ΙΙ diabetes mellitus, besides (35) healthy
individuals as a control group were enrolled in this study. The age of all subjects range from (20-50). Serum was
used in determination of glucose, insulin, lipid profile (cholesterol (Ch), triglyceride (TG), high-density lipoprotein
(HDL-Ch), low-density lipoprotein (LDL-Ch) and very low-density lipoprotein (VLDL), for patients and control
groups. Insulin resistance (IR) was calculated acco

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Natural and Mixed Convection in Square Vented Enclosure Filled with Metal Foam
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Steady natural and mixed convection flow in a square vented enclosure filled with water-saturated aluminum metal foam is numerically investigated. The left vertical wall is kept at constant temperature and the remaining walls are thermally insulated. Forced convection is imposed by providing an inlet at cavity bottom surface, and a vent at the top surface. Natural convection takes place due to the temperature difference inside the enclosure. Darcy-Brinkman-Forchheimer model for fluid flow and the two-equation of the local thermal non-equilibrium model for heat flow was adopted to describe the flow characteristics within the porous cavity. Numerical results are obtained for a wide range of width of the inlet as a fraction

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Publication Date
Tue Jun 17 2025
Journal Name
Baghdad Science Journal
ATPase level in Iraqi Diabetic Patients with and without Diabetic Kidney Disease
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Publication Date
Wed Dec 31 2025
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Arrestin Beta-2 in Prostate Cancer and its Relationship with Trace Elements
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Background: Prostate cancer (PCa) is the most prevalent non-cutaneous malignancy and the second-leading cause of cancer-relatedmortality among males. Cancer is just one of the several disorders that may be linked to variations in trace element concentrations.Objective: To evaluate serum arrestin β-2 as a prostate cancer tumor marker and its association with trace elements.Methods: This case- control study was carried out at the Department of Biochemistry, College of Medicine, University of Baghdad and at the Urology department, Ghazi Al-Hariri Hospital for Surgical Specialities during the period from March 2022 to May 2023. In this case-control study 120 males were enrolled: Sixty men with newly diagnosed primary prostate cancer (P

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Publication Date
Tue Jun 14 2016
Journal Name
Al-academy
Idealism and Realism in The Design: A Comparative Study
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At the beginning of the twentieth century distorting handling totalitarian phenomena of art, which can be called the stage of the test, transition from the theory of ideal theory and other realistic is not cushy, since it requires vision and reading and other concepts, and in light of this dialectic manifested research problem by asking the following Is affected by the design idealism and realism. Through the above mentioned questions, the researcher found rationale for addressing this problem, the study through his research, which is marked (idealism and realism in a comparative study design). And demonstrated the importance of research in the identification of the concept and the effectiveness of the two theories idealism and realism a

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Publication Date
Sat Jun 29 2019
Journal Name
Journal Of The College Of Education For Women
Parenthetical Constructions in English and Arabic: A Contrastive Study
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The present study attempts to give a detailed discussion and analysis of parenthetical constructions in English and Arabic, the aim being to pinpoint the points of similarity and difference between the two languages in this particular linguistic area.The study claims that various types of constructions in English and Arabic could be considered parenthetical; these include non-restrictive relative clauses, non-restrictive appositives, comment clauses, vocatives, interjections, among others. These are going to be identified, classified, and analyzed according to the Quirk grammar - the approach to grammatical description pioneered by Randolph Quirk and his associates, and published in a series of reference grammars during the 1970

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Southwest Jiaotong University
Integrity and Security in Cloud Computing Environment: A Review
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Cloud computing is a newly developed concept that aims to provide computing resources in the most effective and economical manner. The fundamental idea of cloud computing is to share computing resources among a user group. Cloud computing security is a collection of control-based techniques and strategies that intends to comply with regulatory compliance rules and protect cloud computing-related information, data apps, and infrastructure. On the other hand, data integrity is a guarantee that the digital data are not corrupted, and that only those authorized people can access or modify them (i.e., maintain data consistency, accuracy, and confidence). This review presents an overview of cloud computing concepts, its importance in many

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