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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
Sun Dec 01 2013
Journal Name
Diyala Journal Of Engineering Sciences
Design and Simulation of parallel CDMA System Based on 3D-Hadamard Transform
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Future wireless systems aim to provide higher transmission data rates, improved spectral efficiency and greater capacity. In this paper a spectral efficient two dimensional (2-D) parallel code division multiple access (CDMA) system is proposed for generating and transmitting (2-D CDMA) symbols through 2-D Inter-Symbol Interference (ISI) channel to increase the transmission speed. The 3D-Hadamard matrix is used to generate the 2-D spreading codes required to spread the two-dimensional data for each user row wise and column wise. The quadrature amplitude modulation (QAM) is used as a data mapping technique due to the increased spectral efficiency offered. The new structure simulated using MATLAB and a comparison of performance for ser

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Proposed Hybrid Cryptosystems Based on Modifications of Playfair Cipher and RSA Cryptosystem
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Cipher security is becoming an important step when transmitting important information through networks. The algorithms of cryptography play major roles in providing security and avoiding hacker attacks. In this work two hybrid cryptosystems have been proposed, that combine a modification of the symmetric cryptosystem Playfair cipher called the modified Playfair cipher and two modifications of the asymmetric cryptosystem RSA called the square of RSA technique and the square RSA with Chinese remainder theorem technique. The proposed hybrid cryptosystems have two layers of encryption and decryption. In the first layer the plaintext is encrypted using modified Playfair to get the cipher text, this cipher text will be encrypted using squared

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Synthesis and Characterization of New phenolic Schiff bases Derivatives Based on Terephthaladehyde
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A variety of new phenolic Schiff bases derivatives have been synthesized starting from Terephthaladehyde compound, all proposed structures were supported by FTIR, 1H-NMR, 13C-NMR, Elemental analysis, some derivatives evaluated by Thermal analysis (TGA).

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Publication Date
Thu Mar 01 2018
Journal Name
Journal Of Engineering
Implementation of Power System Stabilizer Based on Conventional and Fuzzy Logic Controllers
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To damp the low-frequency oscillations which occurred due to the disturbances in the electrical power system, the generators are equipped with Power System Stabilizer (PSS) that provide supplementary feedback stabilizing signals. The low-frequency oscillations in power system are classified as local mode oscillations, intra-area mode oscillation, and interarea mode oscillations. A suitable PSS model was selected considering the low frequencies oscillation in the inter-area mode based on conventional PSS and Fuzzy Logic Controller. Two types of (FIS) Mamdani and suggeno were considered in this paper. The software of the methods was executed using MATLAB R2015a package.

 

 

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Publication Date
Wed Sep 30 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Correlation of Penetration Rate with Drilling Parameters For an Iraqi Field Using Mud Logging Data
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This paper provides an attempt for modeling rate of penetration (ROP) for an Iraqi oil field with aid of mud logging data. Data of Umm Radhuma formation was selected for this modeling. These data include weight on bit, rotary speed, flow rate and mud density. A statistical approach was applied on these data for improving rate of penetration modeling. As result, an empirical linear ROP model has been developed with good fitness when compared with actual data. Also, a nonlinear regression analysis of different forms was attempted, and the results showed that the power model has good predicting capability with respect to other forms.

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Publication Date
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
Detection of CTX-M-type ESBLs from Escherichia coli Clinical Isolates from a Tertiary Hospital, Malaysia
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The present study aims to detect CTX-M-type ESBL from Escherichia coli clinical isolates and to analyze their antibotic susceptibility patterns. One hundred of E. coli isolates were collected from different clinical samples from a tertiary hospital. ESBL positivity was determined by the disk diffusion method. PCR used for amplification of CTX-M-type ESBL produced by E. coli. Out of 100 E. coli isolates, twenty-four isolates (24%) were ESBL-producers. E. coli isolated from pus was the most frequent clinical specimen that produced ESBL (41.66%) followed by urine (34.21%), respiratory (22.23%), and blood (19.05%).  After PCR amplification of these 24 isolates, 10 (41.66%) isolates were found to possess CTX-M genes. The CTX-M type ESBL

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Publication Date
Wed Apr 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Using Resource Consumption Accounting to determine Customer Cost of Banks
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The Purpose of this Research show gap between a Normal Cost System and Resource consumption Accounting Applied in AL-Rafidin Bank.

The Research explores that, how the idle capacity can be determined under resource consumption accounting, discuss the possibility of employing these energies. Research also viewed how costs can be separated into Committee and Attribute. Resource Consumption Accounting assists managers in pricing services or products based on what these services or products use from each Source.

This Research has been proven

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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Educational And Psychological Researches
A comparative study between the emotional responses in patients with blood pressure on a scale of music types characteristics compared with responses to some Healthy patients
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The problem of the study and its significance:

           Due to the increasing pressures of life continually, and constant quest behind materialism necessary and frustrations that confront us daily in general, the greater the emergence of a number of cases of disease organic roots psychological causing them because of severity of a lack of response to conventional treatments (drugs), and this is creating in patients a number of emotional disorders resulting from concern the risk of disease

 

     That is interested psychologists and doctors searchin

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Publication Date
Mon Jun 01 2015
Journal Name
. International Journal Of Computer Science And Mobile Computing
A Hybrid Lossy Image Compression based on Wavelet Transform, Polynomial Approximation Model, Bit Plane Slicing and Absolute Moment Block Truncation
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Publication Date
Thu Dec 09 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
An Overview of Some Plant Based Products With Hepatoprotective Activity
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In folk medicine there are various medicinal amalgamation possessing hepatoprotective activity. This activity is of significance because several toxins cause liver injury. Hence, many pharmaceutical companies are targeting herbal medicines for the treatment of liver abnormalities and towards evolving a safe and effective formulation with desired route of administration. In current review we have focused on the studies showing hepatoprotective effect using marine compounds and plant derived compounds. Liver disorder, a global health problem, usually include acute or chronic hepatitis, heptoses, and cirrhosis. It may be due to toxic chemicals and certain antibiotics. Uncontrolled consumption of alcohol also affects liver in an unhealthy wa

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