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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 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
Sun Mar 01 2026
Journal Name
Journal Of Information Hiding And Multimedia Signal Processing
Designing a New Text Encryption Approach Based on Genetic Algorithm
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Today, data security is a major problem concerning organizations and indi- viduals. The confidentiality of information is associated with using reliable and robust encryption algorithms in systems. Cyber-attacks on data and systems have become prevalent and sophisticated, and are increasing rapidly; hence, the need for developing robust encryption algorithms is crucial nowadays. This paper proposes a new encryption algorithm using dynamic symmetric key cryptography to encrypt text files. It utilizes a secret key for encryption and decryption processes, where the key’s length is varied depending on the text size. This presented approach gives a trade-off between speed and security, making it suitable for various applications, such as secur

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Publication Date
Sat Apr 30 2022
Journal Name
Al-kindy College Medical Journal
Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up
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Background Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the ute

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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
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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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
Wed Jan 01 2020
Journal Name
Journal Of Child Science
Clinical and Genetic Varieties of Gaucher Disease in Iraqi Children
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Abstract<p>Gaucher disease (GD), which is due to a deficiency in the lysosomal enzyme β-glucocerebrosidase, is a rare genetic disorder. It is characterized by a wide variety of clinical manifestations and severity of symptoms, making it difficult to manage. A cross-sectional hospital-based genetic study was undertaken with 32 pediatric patients. We recruited 21 males and 11 females diagnosed with GD, with a male-to-female ratio of 1.91:1. The mean age of the study population was 8.79 ± 4.37 years with an age range from 8 months to 17 years. We included patients on clinical evaluation from 2011 to 2019. An enzyme assay test was used to measure β-glucosidase enzyme activity in leukocytes and the GBA gene s</p> ... Show More
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Generating a Strong Key for a Stream Cipher Systems Based on Permutation Networks
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The choice of binary Pseudonoise (PN) sequences with specific properties, having long period high complexity, randomness, minimum cross and auto- correlation which are essential for some communication systems. In this research a nonlinear PN generator is introduced . It consists of a combination of basic components like Linear Feedback Shift Register (LFSR), ?-element which is a type of RxR crossbar switches. The period and complexity of a sequence which are generated by the proposed generator are computed and the randomness properties of these sequences are measured by well-known randomness tests.

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Publication Date
Thu Nov 19 2020
Journal Name
The Iraqi Journal For Information And Documentation Studies
The use of still and animated comics in providing user services in university information institutions: a field study
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Comics is a visual art (Still and motion pictures) it seeks to provide a Training courses are a series of intensive important educational and complementary programs, based on previous foundation experiences. Create to development the participants in aspects of specialization according to the requirements of the educational system to continue developing the previous scienti􀂡c and practical experiences. Personally, or adopted by the trainee institution, where the trainee gets a professional skill certi􀂡cate that contributes to the development his work.Development and Continuous Education Center (DCEC) at the University of Baghdad (UoBaghdad) is a center dedicated to continuing education courses in which the participant is awarded a cert

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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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