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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
Mon Dec 08 2025
Journal Name
Pigment &amp; Resin Technology
Sustainable automotive interior trim components based on SBR-expanded polystyrene composites reinforced with biomass fibers
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Purpose

The purpose of this paper is to apply styrene butadiene rubber (SBR) as virgin alongside expanded polystyrene (EPS) resin as a recycled polymer after consumption in the presence of bagasse fibers (BF) as biomass source derived from sugarcane in different concentrations to reinforce this polymeric matrix to form affordable composites that can be used in manufacturing low-cost and sustainable car interior-trim constituents.

Design/methodology/approach

SBR and EPS represent an example for thermoplastic elastomers (

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Engineering
Priority Based Transmission Rate Control with Neural Network Controller in WMSNs
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Wireless Multimedia Sensor Networks (WMSNs) are networks of wirelessly interconnected sensor nodes equipped with multimedia devices, such as cameras and microphones. Thus a WMSN will have the capability to transmit multimedia data, such as video and audio streams, still images, and scalar data from the environment. Most applications of WMSNs require the delivery of multimedia information with a certain level of Quality of Service (QoS). This is a challenging task because multimedia applications typically produce huge volumes of data requiring high transmission rates and extensive processing; the high data transmission rate of WMSNs usually leads to congestion, which in turn reduces the Quality of Service (QoS) of multimedia applications. To

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Priority Based Transmission Rate Control with Neural Network Controller in WMSNs
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Wireless Multimedia Sensor Networks (WMSNs) are networks of wirelessly interconnected sensor nodes equipped with multimedia devices, such as cameras and microphones. Thus a WMSN will have the capability to transmit multimedia data, such as video and audio streams, still images, and scalar data from the environment. Most applications of WMSNs require the delivery of multimedia information with a certain level of Quality of Service (QoS). This is a challenging task because multimedia applications typically produce huge volumes of data requiring high transmission rates and extensive processing; the high data transmission rate of WMSNs usually leads to congestion, which in turn reduces the Quality of Service (QoS) of multimedia appli

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Publication Date
Fri Nov 01 2019
Journal Name
International Journal On Interactive Design And Manufacturing (ijidem)
A real-time automated sorting of robotic vision system based on the interactive design approach
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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Analysis of Docetaxel Adverse Drug Reactions: A Retrospective Study Based on Iraqi Pharmacovigilance Center Database
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Docetaxel is an effective treatment approved for many types of cancers, but its effectiveness in clinical practice can be compromised by significant occurrence of adverse drug reactions. The aim of the current study was to measure the distribution of adverse drug reactions of docetaxel reported in Iraq and to assess the causality, severity, seriousness, preventability, expectedness and outcome of these adverse reactions. A retrospective study conducted on individual case safety reports from the Iraqi Pharmacovigilance Center / Ministry of Health. The study included 118 individual case safety report containing 236 adverse drug reactions.
Most of the adverse drug reactions were related to skin and subcutaneous tissue disorders(26.7%), f

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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
The Impact of Agile Methodologies and Cost Management Success Factors: An Empirical Study
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Software cost management is a significant feature of project management. As such, it needs to be employed in a project or line of work. Software cost management is integral to software development failures, which, in turn, cause software failure. Thus, it is imperative that software development professionals develop their cost management skills to deliver successful software projects. The aim of this study is to examine the impact of cost management success factors with project management factors and three agile methodologies – Extreme Programming (XP), Scrum and Kanban methodologies which are used in the Pakistani software industry. To determine the results, the researchers applied quantitative approach through an extensive survey on

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
Artificial Neural Network Models to Predict the Cost and Time of Wastewater Projects
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Infrastructure, especially wastewater projects, plays an important role in the life of residential communities. Due to the increasing population growth, there is also a significant increase in residential and commercial facilities. This research aims to develop two models for predicting the cost and time of wastewater projects according to independent variables affecting them. These variables have been determined through a questionnaire distributed to 20 projects under construction in Al-Kut City/ Wasit Governorate/Iraq. The researcher used artificial neural network technology to develop the models. The results showed that the coefficient of correlation R between actual and predicted values were 99.4% and 99 %, MAPE was

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Publication Date
Sat Jan 01 2022
Journal Name
Proceeding Of The 1st International Conference On Advanced Research In Pure And Applied Science (icarpas2021): Third Annual Conference Of Al-muthanna University/college Of Science
Dimensional analysis of predicting the removal of chemical oxygen demand from domestic wastewater using moving bed biofilm reactor
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Municipal wastewater sources are becoming increasingly important for reuse, for irrigation purposes, so they must be treated to meet environmentally friendly local or global standards. The aim of this study is to establish, calibrate, and validate a model for predicting chemical oxygen demand for the pilot plant of mobile biofilm reactors operating from municipal wastewater in Maaymyrh located in Hilla city Using the approach of dimensional analysis. The approach of Buckingham's theorem was used to derive a model of dimensional analysis design for the forecast of (COD) in the pilot plant. The effluent concentration (COD) It has been derived as a result of the influential concentration of (COD), dissolved oxygen (DO), volume of pilot plant

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Publication Date
Wed Oct 01 2008
Journal Name
Iraqi J Comm Med
Dermatofibrosarcoma Protuberans:&quot; Epidemiological and Clinical Study
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AA Al-Nuaimy, Iraqi J Comm Med, 2008 - Cited by 3

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Publication Date
Wed Feb 09 2011
Journal Name
Journal Of Engineering
Low cost automatic sun path tracking system
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Solar tracking systems used are to increase the efficiency of the solar cells have attracted the attention of researchers recently due to the fact that the attention has been directed to the renewable energy sources. Solar tracking systems are of two types, Maximum Power Point Tracking (MPPT) and sun path tracking. Both types are studied briefly in this paper and a simple low cost sun path tracking system is designed using simple commercially available component. Measurements have been made for comparison between fixed and tracking system. The results have shown that the trackin