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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 Feb 01 2025
Journal Name
Advanced Journal Of Chemistry, Section A
Synthesis and Characterization of Heterocyclic Derivatives to Evaluate their Efficiency as Corrosion Inhibitors for Carbon Steel in Saline Medium
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This work includes preparation of Az, Qz, and Tz derivatives from the reaction of Schiff base (Sb) derivative with anthranilic acid, chloroacetyl chloride, and sodium azide, as well as, the characterization via FT-IR, 1H-NMR, and 13CNMR. The anticorrosion inhibition of these compounds was studied and the measurements of carbon steel (CS) corrosion in sodium chloride solution 3.5% (blank) and inhibitor in solutions were calculated at a temperature range of 293-323 K by the technique of electrochemical polarization. In addition, some thermodynamic and kinetic activation parameters for inhibitor and blank solutions (Ea⋇, ΔH⋇, ΔS⋇, and ΔG⋇) were determined. The results showed high inhibition efficacy for all the prepared compounds,

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Scopus
Publication Date
Thu Jun 25 2020
Journal Name
International Journal Of Drug Delivery Technology
The Effects of Salvia officinalis Gel as an Adjunct to Scaling and Root Planning in Patients with Periodontitis (Clinical and Immunological Study)
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Background: Phytotherapy is the usage of herbal species with medicinal properties for the management of various diseases. Gingivitis and periodontitis are diseases that involve the role of both the bacteria and the host immune response. Over the years, various researches have shown the importance of herbal products in the management of periodontal diseases. Aims of the study: To evaluate the efficacy of locally applied Salvia officinalis gel as adjunctive in the treatment of chronic periodontitis. Subjects and methods: Fourteen patients (10 males and 4 females) with chronic periodontitis were enrolled in the present study with total number of twenty-eight periodontal pockets utilizing a split mouth design, the pockets were divided i

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Publication Date
Fri Jan 01 2021
Journal Name
Chemical Industry And Chemical Engineering Quarterly
Electrochemical harvesting of microalgae꞉ Parametric and cost-effectivity comparative investigation
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The cost of microalgae harvesting constitutes a heavy burden on the commercialization of biofuel production. The present study addressed this problem through economic and parametric comparison of electrochemical harvesting using a sacrificial electrode (aluminum) and a nonsacrificial electrode (graphite). The harvesting efficiency, power consumption, and operation cost were collected as objective variables as a function of applied current and initial pH of the solution. The results indicated that high harvesting efficiency obtained by using aluminum anode is achieved in short electrolysis time. That harvesting efficiency can be enhanced by increasing the applied current or the electrolysis time for both electrode materials, where 98

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Publication Date
Tue Oct 08 2002
Journal Name
Iraqi Journal Of Laser
Design Considerations of Laser Source in a Ring Network Based on Fiber Distributed Data Interface (FDDI)
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This work presents the use of laser diode in the fiber distributed data interface FDDI networks. FDDI uses optical fiber as a transmission media. This solves the problems resulted from the EMI, and noise. In addition it increases the security of transmission. A network with a ring topology consists of three computers was designed and implemented. The timed token protocol was used to achieve and control the process of communication over the ring. Nonreturn to zero inversion (NRZI) modulation was carried out as a part of the physical (PHY) sublayer. The optical system consists of a laser diode with wavelength of 820 nm and 2.5 mW maximum output power as a source, optical fiber as a channel, and positive intrinsic negative (PIN) photodiode

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
The effectiveness of change and transformation of formal displacement in the internal space (historical passenger stations as a model)
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Intellectual and material displacement is one of the design strategies through many mechanisms and means, and depends on the idea of changing the shape within the internal spaces at times and has concepts related to the transformation at other times. And represented by the boxes for travelers, the research problem emerged through the following question: (What is the effectiveness of displacement in the formal structures in the interior design of historical sites), and the aim of the study is to reveal the reality of the use of historical internal spaces and to determine the formal displacement that occurs as a result of change and transformation, and it included two topics, the first topic Transformation and the effectiveness of formal d

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Crossref
Publication Date
Sun Mar 28 2021
Journal Name
Journal Of The College Of Education For Women
Social Protection and its Impact on the Cohesion of Vulnerable Groups: A Field Study of a Sample Social Protection Network Beneficiaries: دينا داود محمد المولى
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Social protection meets different aspects of the needs of vulnerable groups, such as the economic, health, education, and family relations and ties in the Iraqi society. This is because vulnerable groups have suffered from social and economic influences that have negative implications on the social reality as a whole. Poverty is a case in point, which paved the way to frequent setbacks that have led to social structure instability. Accordingly, the present study aims to examine the role and effect of the Net of Social Protection Program in equally distributing social protection to curb or mitigate any negative consequnces that might happen to the poor segments and vulnerable people, who are succeptible to shocks, such as: the orphans, un

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Effectiveness and safety of non-fixation method in cochlear implantation
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ABSTRACTBackground: cochlear implants are electronic devices that convert sound energy into electrical signals to stimulate ganglion cells and cochlear nerve fibers. These devices are indicated for patients with severe to profound sensorineural hearing losses who receive little or no benefit from hearing aids. The implant basically takes over the function of the cochlear hair cells. The implant consists of external components (microphone, speech processor and transmitting coil) and internal components (receiver stimulator and electrode array). The implant is inserted via a trans mastoid facial recess approach to the round window and scala tympani.Objectives: to determine the effectiveness and safety of non fixation method in cochlear imp

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Scenography and the effectiveness of meaning in the theatrical space
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The elements of theater formation that fall within the spatial experience of the scenography of the show, which the directors work in in the imaginary theater, are important and have an aesthetic, intellectual and cognitive dimension, working to highlight reality in an aesthetic image surrounding space and space. And its relationship to the distinct, multiple and variable spaces above the stage, to produce theatrical signals and endless meanings through the possibility of infinite reconfiguration of the theater's space and its public and private space through the distribution of a group of blocks within the scenic image.
I dealt with in the first chapter (the methodological framework), which includes the research problem identified

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of artificial intelligence in achieving Customer satisfaction and its reflection on cost accounting: An applied research in the Iraqi electronic industries company
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Based economic units to technology to add innovations that lead to contribute to customer satisfaction, under intense competition and rapid development in customer taste, the economic units tend to apply the concepts that contribute to customer satisfaction led by the introduction of artificial intelligence techniques. In the production prominent role in the contributing and responding to the rapid changes in customer tastes, and consequent impact this in achieving customer satisfaction. Search gained importance of relying on artificial intelligence techniques to achieve customer satisfaction through speed of response to changes in the tastes of customers and thus be able to increase its market share، and sales growth، and to achieve a

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Crossref
Publication Date
Sat Mar 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The theory of convergent between standard and optimal cost supporting actual cost in an Enterprise: بحث تطبيقي في معمل الألبسة الرجالية في النجف للفترة من 2007-2020
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The research aims to achieve proof of convergence between optimal costs and standard costs in calculating costs for the economic unit, support efforts aimed at adopting optimal costs in cost accounts and accounting thought in general, and achieve benefit from the theory of convergence between optimal costs and standard costs in the field of achieving actual costs in The economic unit in order to reduce and converge, and this came to address the possibility of adopting the concept of optimal costs in the production costs calculations for the purposes of rationalizing administrative decisions, and rationalizing the preparation of financial statements within management accounting.

The research concluded that

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