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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
Tue Sep 29 2026
Journal Name
Journal Of The College Of Basic Education
Fuzzy Nonparametric Regression Model Estimation Based on some Smoothing Techniques With Practical Application
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In this research, we use fuzzy nonparametric methods based on some smoothing techniques, were applied to real data on the Iraqi stock market especially the data about Baghdad company for soft drinks for the year (2016) for the period (1/1/2016-31/12/2016) .A sample of (148) observations was obtained in order to construct a model of the relationship between the stock prices (Low, high, modal) and the traded value by comparing the results of the criterion (G.O.F.) for three techniques , we note that the lowest value for this criterion was for the K-Nearest Neighbor at Gaussian function .

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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Gas Lift Optimization for Zubair Oil Field Using Genetic Algorithm-Based Numerical Simulation: Feasibility Study
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The gas-lift method is crucial for maintaining oil production, particularly from an established field when the natural energy of the reservoirs is depleted. To maximize oil production, a major field's gas injection rate must be distributed as efficiently as possible across its gas-lift network system. Common gas-lift optimization techniques may lose their effectiveness and become unable to replicate the gas-lift optimum in a large network system due to problems with multi-objective, multi-constrained & restricted gas injection rate distribution. The main objective of the research is to determine the possibility of using the genetic algorithm (GA) technique to achieve the optimum distribution for the continuous gas-lift injectio

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Publication Date
Thu Aug 08 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Novel Technique for Alveolar Ridge Expansion: A Comparative Clinical Study
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Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who

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Publication Date
Tue May 08 2018
Journal Name
Journal Of Dental Research
Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial
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A single-blind randomized controlled clinical trial in patients with deep caries and symptoms of reversible pulpitis compared outcomes from a self-limiting excavation protocol using chemomechanical Carisolv gel/operating microscope (self-limiting) versus selective removal to leathery dentin using rotary burs (control). This was followed by pulp protection with mineral trioxide aggregate (MTA) and restoration with glass ionomer cement and resin composite, all in a single visit. The pulp sensibility and periapical health of teeth were assessed after 12 mo, in addition to the differences in bacterial tissue concentration postexcavation. Apical radiolucencies were assessed using cone beam computed tomography/periapical radiographs (CBC

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Publication Date
Tue Sep 29 2026
Journal Name
Iraqi Journal Of Science
Synthesis and characterization of some 2-sulphanyl benzimidazole derivatives and study of effect as corrosion inhibitors for carbon steel in sulfuric acid solution
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This research involves the synthesis of some sulphanyl benzimidazole derivatives (Ia-c), which were prepared from reaction of 2-mercaptobenzimidazole substituted benzyl halide, and structures were identified by spectral methods[FTIR, 1H-NMR and 13C-NMR].These compounds were investigated as corrosion inhibitors for carbon steel in 1M H2SO4 solution using weight loss, potentiostatic polarization methods; obtained results showed that the sulphanyl benzimidazole derivatives retard both cathodic and anodic reactions in acidic media, by virtue of adsorption on the carbon steel surface. This adsorption obeyed Langmuir’s adsorption isotherm. The inhibition efficiency of (Ia-c) ranging between (65-92) %. By using different Ib derivative conc

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Publication Date
Tue Jul 28 2026
Journal Name
Aip Conference Proceedings
Synthesis and identification of some AzO dyes derived from metoclopramide and study of effect as corrosion inhibitors for carbon steel in HCl solution
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In this present research, new derivatives were designed from metoclopramide skeleton and after studying the effect of these materials as corrosion inhibitors for the carbon steel 45 in HCl solution. Metoclopramide as the starting compound was diazotized with sodium nitrate and concentrated HCl in below 5 oC to afford diazonium salt that coupled in a basic medium with active compounds like 1-Nitrose-2-naphthol and 2-Nitrose-1-naphthol to afforded azo compounds M1 and M2 respectively. The newly designed compounds identify their structure by distinct spectral techniques involving FTIR and 1H-NMR. Also several of its physical properties were determined. These compounds were studied as corrosion inhibitors in an acidic medium at different t

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Publication Date
Mon Jan 25 2021
Journal Name
Engineering And Technology Journal
Performance evaluation of Photovoltaic Panels by a Proposed Automated System Based on Microcontrollers
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Publication Date
Mon Dec 01 2014
Journal Name
2014 Ieee Symposium On Differential Evolution (sde)
Comparative analysis of a modified differential evolution algorithm based on bacterial mutation scheme
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A new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
A Software Defined Network of Video Surveillance System Based on Enhanced Routing Algorithms
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Software Defined Network (SDN) is a new technology that separate the ‎control plane from the data plane. SDN provides a choice in automation and ‎programmability faster than traditional network. It supports the ‎Quality of Service (QoS) for video surveillance application. One of most ‎significant issues in video surveillance is how to find the best path for routing the packets ‎between the source (IP cameras) and destination (monitoring center). The ‎video surveillance system requires fast transmission and reliable delivery ‎and high QoS. To improve the QoS and to achieve the optimal path, the ‎SDN architecture is used in this paper. In addition, different routing algorithms are ‎used with different steps. First, we eva

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Publication Date
Tue Feb 01 2022
Journal Name
Civil Engineering Journal
Calibration of a New Concrete Damage Plasticity Theoretical Model Based on Experimental Parameters
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The introduction of concrete damage plasticity material models has significantly improved the accuracy with which the concrete structural elements can be predicted in terms of their structural response. Research into this method's accuracy in analyzing complex concrete forms has been limited. A damage model combined with a plasticity model, based on continuum damage mechanics, is recommended for effectively predicting and simulating concrete behaviour. The damage parameters, such as compressive and tensile damages, can be defined to simulate concrete behavior in a damaged-plasticity model accurately. This research aims to propose an analytical model for assessing concrete compressive damage based on stiffness deterioration. The prop

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