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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 Oct 01 2025
Journal Name
Journal Of Economics And Administrative Sciences
A Modified Fama-MacBeth Model based on the Single-Index Model
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The aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth.  Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment.  Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Applying A* Path Planning Algorithm Based on Modified C-Space Analysis
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In this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Chemical sensor based on a solid-core photonic crystal fiber interferometer
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Photonic crystal fiber interferometers are used in many sensing applications. In this work, an in-reflection photonic crystal fiber (PCF) based on Mach-Zehnder (micro-holes collapsing) (MZ) interferometer, which exhibits high sensitivity to different volatile organic compounds (VOCs), without the needing of any permeable material. The interferometer is robust, compact, and consists of a stub photonic crystal fiber of large-mode area, photonic crystal fiber spliced to standard single mode fiber (SMF) (corning-28), this splicing occurs with optimized splice loss 0.19 dB In the splice regions the voids of the holey fiber are completely collapsed, which allows the excitation and recombination of core and cladding modes. The device reflection

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Publication Date
Sun Jan 01 2012
Journal Name
International Journal Of Reasoning-based Intelligent Systems
SLMS: a smart library management system based on an RFID technology
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Publication Date
Thu May 01 2025
Journal Name
Applied Data Science And Analysis
Strengthening cloud data protection based on a novel cyber security framework
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Cybersecurity involves protecting computer networks, systems, and data from unauthorized access and disruptions using advanced technologies. The purpose of this research is to establish a novel cyber security framework for strengthening cloud data protection. In this paper, we propose a novel Dung Beetle optimization-redefined Intelligent Random Forest (DB-IRF) for accurate detection of intrusions in a cloud environment. We obtained a dataset that includes cloud system logs and network traffic data, including normal and malicious activities, to train our proposed model. We utilized z-score normalization to pre-process the gathered raw data. Our suggested model enhances classification accuracy by integrating DB optimization with the

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Publication Date
Tue Feb 01 2022
Journal Name
Journal Of Engineering
Self-Repairing Technique Based on Microcapsules for Cementitious Composites- A Review
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Self-repairing technology based on micro-capsules is an efficient solution for repairing cracked cementitious composites. Self-repairing based on microcapsules begins with the occurrence of cracks and develops by releasing self-repairing factors in the cracks located in concrete. Based on previous comprehensive studies, this paper provides an overview of various repairing factors and investigative methodologies. There has recently been a lack of consensus on the most efficient criteria for assessing self-repairing based on microcapsules and the smart solutions for improving capsule survival ratios during mixing. The most commonly utilized self-repairing efficiency assessment indicators are mechanical resistance and durab

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Determining and Predicting the Water Demand Dynamic System Model Mapping Urban Crawling and Monitoring Using Remote Sensing Techniques and GIS
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The problem of rapid population growth is one of the main problems effecting countries of the world the reason for this the growth in different environment areas of life commercial, industrial, social, food and educational. Therefore, this study was conducted on the amount of potable water consumed using two models of the two satellite and aerial images of the Kadhimiya District-block 427 and Al-Shu,laa district-block 450 in Baghdad city for available years in the Secretariat of Baghdad (2005, 2011,2013,2015). Through the characteristics of geographic information systems, which revealed the spatial patterns of urban creep by determining the role and buildings to be created, which appear in the picture for the

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Determining and Predicting the Water Demand Dynamic System Model Mapping Urban Crawling and Monitoring Using Remote Sensing Techniques and GIS
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Publication Date
Tue Feb 28 2023
Journal Name
Iraqi Geological Journal
Development of 3D Geological Model and Analysis of the Uncertainty in a Tight Oil Reservoir in the Halfaya Oil Field
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A geological model was built for the Sadi reservoir, located at the Halfaya oil field. It is regarded as one of the most significant oilfields in Iraq. The study includes several steps, the most essential of which was importing well logs from six oil wells to the Interactive Petrophysics software for conducting interpretation and analysis to calculate the petrophysical properties such as permeability, porosity, shale volume, water saturation, and NTG and then importing maps and the well tops to the Petrel software to build the 3D-Geological model and to calculate the value of the original oil in place. Three geological surfaces were produced for all Sadi units based on well-top data and the top Sadi structural map. The reservoir has

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Publication Date
Fri Dec 22 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Clinical Characteristics and Therapeutic Management of Osteogenesis Imperfecta in Iraqi Children
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Background: Osteogenesis imperfecta (OI) is a rare congenital condition that results in bone fragility, recurrent fractures, and various extra-skeletal manifestations. Currently, intravenous bisphosphonate is the mainstay of medical treatment in OI. Objective: To identify the effect of current management strategies on Iraqi children diagnosed with OI. Methods: A retrospective study enrolled OI patients who were registered in Central Child Teaching Hospital, Baghdad, Iraq, from January 2015 to December 2022. We enrolled confirmed OI cases (either clinically and/or radiologically) who received cyclic pamidronate therapy for at least 3 cycles. They neither received other types of bisphosphonates nor underwent surgical intervention. Res

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