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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
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Promoting Clinical Breast Examination as A screening Tool for Breast Cancer in Iraq
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Breast cancer constitutes about one fourth of the registered cancer cases among the Iraqi population (1)
and it is the leading cause of death among Iraqi women (2)
. Each year more women are exposed to the vicious
ramifications of this disease which include death if left unmanaged or the negative sequels that they would
experience, cosmetically and psychologically, after exposure to radical mastectomy.
The World Health Organization (WHO) documented that early detection and screening, when coped
with adequate therapy, could offer a reduction in breast cancer mortality; displaying that the low survival rates
in less developed countries, including Iraq, is mainly attributed to the lack of early detection programs couple

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Determine the Most Common Geotechnical Risks and Their Impacts on the Cost and Time Schedule for Implementing Water Treatment Plants in Iraq
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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
A Real-Time Fuzzy Load Flow and Contingency Analysis Based on Gaussian Distribution System
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Fuzzy logic is used to solve the load flow and contingency analysis problems, so decreasing computing time and its the best selection instead of the traditional methods. The proposed  method is very accurate with outstanding computation time, which made the fuzzy load flow (FLF) suitable for real time application for small- as well as large-scale power systems. In addition that, the FLF efficiently able to solve load flow problem of ill-conditioned power systems and contingency analysis. The FLF method using Gaussian membership function requires less number of iterations and less computing time than that required in the FLF method using triangular membership function. Using sparsity technique for the input Ybus sparse matrix data gi

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
Digital Data Encryption Using a Proposed W-Method Based on AES and DES Algorithms
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This paper proposes a new encryption method. It combines two cipher algorithms, i.e., DES and AES, to generate hybrid keys. This combination strengthens the proposed W-method by generating high randomized keys. Two points can represent the reliability of any encryption technique. Firstly, is the key generation; therefore, our approach merges 64 bits of DES with 64 bits of AES to produce 128 bits as a root key for all remaining keys that are 15. This complexity increases the level of the ciphering process. Moreover, it shifts the operation one bit only to the right. Secondly is the nature of the encryption process. It includes two keys and mixes one round of DES with one round of AES to reduce the performance time. The W-method deals with

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Publication Date
Wed Sep 03 2025
Journal Name
International Journal Of Pharmacy Practice
Appraising the cost of illness of diabetic retinopathy and diabetic macular edema over the last decade: a systematic review
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Abstract<sec> <title>Objective

The study objective was to summarize and evaluate the literature from the last decade about the cost of illness (COI) of diabetic retinopathy (DR) and diabetic macular edema (DME) through a systematic review.

Methods

Author conducted a search of the PubMed, and Google Scholar, electronic databases from January 2014 until July 2024, by identifying the following keywords ‘cost of illness,’ ‘economic burden,’ ‘diabetic retinopathy,’ and ‘diabetic m

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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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Publication Date
Wed Nov 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Responding to Environmental Changes through Resilient Urban Design: Insights from Iraq
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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
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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