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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 Feb 29 2012
Journal Name
Al-khwarizmi Engineering Journal
A New Audio Steganography System Based on Auto-Key Generator
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Stenography is the art of hiding the very presence of communication by embedding secret message into innocuous looking cover document, such as digital image, videos, sound files, and other computer files that contain perceptually irrelevant or redundant information as covers or carriers to hide secret messages.

In this paper, a new Least Significant Bit (LSB) nonsequential embedding technique in wave audio files is introduced. To support the immunity of proposed hiding system, and in order to recover some weak aspect inherent with the pure implementation of stego-systems, some auxiliary processes were suggested and investigated including the use of hidden text jumping process and stream ciphering algorithm. Besides, the suggested

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Publication Date
Tue Oct 01 2019
Journal Name
2019 Ieee 9th International Conference On System Engineering And Technology (icset)
A Digital Signature System Based on Real Time Face Recognition
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This study proposed a biometric-based digital signature scheme proposed for facial recognition. The scheme is designed and built to verify the person’s identity during a registration process and retrieve their public and private keys stored in the database. The RSA algorithm has been used as asymmetric encryption method to encrypt hashes generated for digital documents. It uses the hash function (SHA-256) to generate digital signatures. In this study, local binary patterns histograms (LBPH) were used for facial recognition. The facial recognition method was evaluated on ORL faces retrieved from the database of Cambridge University. From the analysis, the LBPH algorithm achieved 97.5% accuracy; the real-time testing was done on thirty subj

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Publication Date
Sat Sep 30 2017
Journal Name
Al-khwarizmi Engineering Journal
Programming a Pneumatic Processes Sequence based on PLC by Demonstration
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Abstract

Pneumatic processes sequence (PPS) is used widely in industrial applications. It is common to do a predetermined PPS to achieve a specific larger task within the industrial application like the PPS achieved by the pick and place industrial robot arm. This sequence may require change depending on changing the required task and usually this requires the programmer intervention to change the sequence’ sprogram, which is costly and may take long time. In this research a PLC-based PPS control system is designed and implemented, in which the PPS is programmed by demonstration. The PPS could be changed by demonstrating the new required sequence via the user by following simple series of manual steps without h

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Publication Date
Sat Oct 29 2022
Journal Name
Computers
Intelligent Robotic Welding Based on a Computer Vision Technology Approach
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Robots have become an essential part of modern industries in welding departments to increase the accuracy and rate of production. The intelligent detection of welding line edges to start the weld in a proper position is very important. This work introduces a new approach using image processing to detect welding lines by tracking the edges of plates according to the required speed by three degrees of a freedom robotic arm. The two different algorithms achieved in the developed approach are the edge detection and top-hat transformation. An adaptive neuro-fuzzy inference system ANFIS was used to choose the best forward and inverse kinematics of the robot. MIG welding at the end-effector was applied as a tool in this system, and the wel

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Publication Date
Sat Oct 29 2022
Journal Name
Computers
Intelligent Robotic Welding Based on a Computer Vision Technology Approach
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Robots have become an essential part of modern industries in welding departments to increase the accuracy and rate of production. The intelligent detection of welding line edges to start the weld in a proper position is very important. This work introduces a new approach using image processing to detect welding lines by tracking the edges of plates according to the required speed by three degrees of a freedom robotic arm. The two different algorithms achieved in the developed approach are the edge detection and top-hat transformation. An adaptive neuro-fuzzy inference system ANFIS was used to choose the best forward and inverse kinematics of the robot. MIG welding at the end-effector was applied as a tool in this system, and the wel

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Epidemiological, Clinical, and immunological characteristics of Mycoplasma pneumonia infections among a group of hospitalized children in Suleimani city/Iraq
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Background: Mycoplasma pneumoniae (M. pneumoniae) is an important respiratory bacterial pathogen, especially among children. It causes acute upper and lower respiratory infections.Objective: This study was aimed to measure anti- M. pneumoniae antibodies among hospitalized children who were admitted to hospital diagnosed with acute respiratory tract infections.Method: Automated ELISA technique was performed to detect anti- M. pneumoniae antibodies (IgM and IgG antibodies) in serum from 108 children less than 5 years old. The children were admitted to the Pediatric Teaching Hospital in Suleimani city/Kurdistan Region/Iraq because of acute respiratory tract infections. A questionnaire was designed to collect demographic and clinical data fr

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Publication Date
Fri Oct 02 2015
Journal Name
American Journal Of Applied Sciences
Advances in Document Clustering with Evolutionary-Based Algorithms
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Document clustering is the process of organizing a particular electronic corpus of documents into subgroups of similar text features. Formerly, a number of conventional algorithms had been applied to perform document clustering. There are current endeavors to enhance clustering performance by employing evolutionary algorithms. Thus, such endeavors became an emerging topic gaining more attention in recent years. The aim of this paper is to present an up-to-date and self-contained review fully devoted to document clustering via evolutionary algorithms. It firstly provides a comprehensive inspection to the document clustering model revealing its various components with its related concepts. Then it shows and analyzes the principle research wor

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Reflection of Lean Management Approach on Human Resource Management Practices A field research in telecom companies in Iraq (Zain-Asia cell)
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Abstract

The current research is attempt to test the reflection of the lean management on the human resources management practices of two of the most important communication companies operating in Iraq (`Zain & Asia cell), The research aims to Determine the extent of adoption of the lean management approach in the two researched companies, as it improving human resource management practices. The research problem represented in the existence of lack of in some aspects of the application the lean management approach in service sector and neglecting the impact of its tools on the human resource management practices. For this purpose three principle research hypotheses has been formulated, first there is a correlation rel

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Publication Date
Thu Feb 01 2018
Journal Name
Research Journal Of Pharmaceutical,biological And Chemical Sciense
correlation of serum tumor necrosis factor alpha and high sensitive c-reactive protein with clinical periodontal parameters in osteoarthritis patients
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Publication Date
Tue Aug 24 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
A plan for transportation and distribution the products based on multi-objective travelling salesman problem in fuzzy environmental
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Transportation and distribution are the most important elements in the work system for any company, which are of great importance in the success of the chain work. Al-Rabee factory is one of the largest ice cream factories in Iraq and it is considered one of the most productive and diversified factories with products where its products cover most areas of the capital Baghdad, however, it lacks a distribution system based on scientific and mathematical methods to work in the transportation and distribution processes, moreover, these processes need a set of important data that cannot in any way be separated from the reality of fuzziness industrial environment in Iraq, which led to use the fuzzy sets theory to reduce the levels of uncertainty.

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