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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
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
An Evaluation of Environmental Performance According to The International Standard (ISO14001: 2015) in a Field East of Baghdad / A Case Study in the Midline Oil Company
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EMS in accordance with ISO 14001: 2015 is considered an entry point to reduce environmental impacts, especially the effects resulting from the oil industry, which is the main source of environmental pollution and waste of natural resources, since the second revision of the standard took place in September 2015. The problem of the research was manifested in the weakness in understanding the correct guidelines that must be followed in order to obtain and maintain the standard. The purpose of this research was to give a general picture of what is behind ISO14001:2015 and how it is possible to create a comprehensive base for understanding its application by seeking the gap between the actually achieved reality, standards requirements

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Publication Date
Sat Jan 13 2018
Journal Name
Journal Of Engineering
Comparison Between ESP and Gas Lift in Buzurgan Oil field/Iraq
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Buzurgan oil Field which is located in south of Iraq has been producing oil for five decades that caused production to drop in many oil wells. This paper provides a technical and economical comparison between the ESP and gas lift in one oil well (Bu-16) to help enhancing production and maximize revenue. Prosper software was used to build, match and design the artificial lift method for the selected well, also to predict the well behavior at different water cut values and its effect on artificial lift method efficiency. The validity of software model was confirmed by matching, where the error difference value between actual and calculated data was (-1.77%).

The ESP results showed the durability of ESP regarding th

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Applied Pharmaceutical Science
The role of angiotensin converting enzyme (insertion)/(deletion) and angiotensin II type 1 receptor (A1166C) gene polymorphisms in antiproteinuric effect of ACE inhibitors in type 2 diabetic Iraqi patients
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The angiotensin converting enzyme (ACE) I\D gene polymorphism influences the blood ACE enzyme activity. Renoprotective effect of ACE inhibitors (ACEIs) varies among patients due to genetic variation, particularly in Renin-Angiotensin-Aldosterone System genes. This study investigates the genetic variations of ACE I\D and AGT1RA1166C gene polymorphisms in the antiproteinuric effect of ACEI therapy in type 2 diabetes mellitus (T2DM) patients. This is a cross-sectional study that included 76 T2DM patients who are ACEI users, divided into two groups: T2DM without diabetic kidney disease (DKD) included 31 patients, and T2DM with DKD included 45 patients. Urine samples were taken for measurement of urine albumin and creatinine, then calcul

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Publication Date
Mon May 01 2023
Journal Name
Rimak International Journal Of Humanities And Social Sciences
THE EFFECT OF ARRANGING WOMEN'S ISSUES IN THE IRAQI ELECTRONIC NEWSPAPERS' WEBSITES ON THE COGNITIVE LEVEL OF IRAQI UNIVERSITY FEMALE TEACHERS A FIELD STUDY OF A SAMPLE OF FEMALE TEACHERS AT THE UNIVERSITY OF BAGHDAD
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Women are considered the real power to build societies, as they are half of society, and it is their responsibility to raise generations، as human history testifies to the recording of great names with their giving and achievement in various scientific, social and humanitarian disciplines. Because of the importance of women in our lives, society must give them special care, whether at home or within the community structure to which they belong, so that they contribute to the image that brings about a transformation in the public scene, as well as providing them with support to take charge of bringing about change themselves, and this explains the interest of the press at all levels. Women's issues and topics through various journal

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Publication Date
Thu Dec 31 2020
Journal Name
Pollution Research Journal
ANALYSIS OF THE HYDRAULIC CHARACTERISTICS OF AL MAHAWIL STREAM USING HECRAS: A FIELD STUDY
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A water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte

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Publication Date
Thu Jan 01 2026
Journal Name
Malaysian Journal Of Nursing
Impact of Foot Reflexology on Neonates with Hyperbilirubinemia: A Systematic Review
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Background: Neonatal hyperbilirubinemia is a prevalent condition commonly treated with phototherapy. While effective, phototherapy can cause adverse effects such as dehydration and maternal separation, necessitating complementary care strategies. Objectives: This systematic review aims to evaluate the efficacy of foot reflexology and related tactile interventions on bilirubin levels and physiological parameters in neonates undergoing treatment for hyperbilirubinemia. Methods: A systematic search was conducted across five electronic databases (PubMed, Scopus, Web of Science, Google Scholar, and Cochrane Library) for studies published between 2019 and 2025. The review followed the PRISMA guidelines and PICOS framework. Twenty studies,

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Publication Date
Mon Jun 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
On Bayesian Estimation of System Reliability in Stress – Strength Model Based on Generalized Inverse Rayleigh Distribution
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Abstract<p>The parameter and system reliability in stress-strength model are estimated in this paper when the system contains several parallel components that have strengths subjects to common stress in case when the stress and strengths follow Generalized Inverse Rayleigh distribution by using different Bayesian estimation methods. Monte Carlo simulation introduced to compare among the proposal methods based on the Mean squared Error criteria.</p>
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Publication Date
Mon May 27 2019
Journal Name
Al-academy
The Arabic Calligraphy Effectiveness and Implications in Industrial Products Design: صلاح نوري محمود
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Arabic calligraphy has a special status as one of the most important oriental arts, which has been enhanced by the Islamic value. The Arabic fonts have been diverse in their classification into soft lines such as Diwani, thuluth and patch lines and others, and geometrical lines such as Kufic lines and their various types. The contemporary artist was also able to adapt the Arabic calligraphy of all kinds in the construction of the painting or line formations, especially after the development of the artistic digital techniques and computer software. Here comes the role of the industrial designer as being more in touch with the practical, technical and productive life, which requires great care in adapting the line formations of the Arabic

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Publication Date
Sat Nov 01 2008
Journal Name
Digital Signal Processing
A high performance parallel Radon based OFDM transceiver design and simulation
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major goal of the next-generation wireless communication systems is the development of a reliable high-speed wireless communication system that supports high user mobility. They must focus on increasing the link throughput and the network capacity. In this paper a novel, spectral efficient system is proposed for generating and transmitting twodimensional (2-D) orthogonal frequency division multiplexing (OFDM) symbols through 2- D inter-symbol interference (ISI) channel. Instead of conventional data mapping techniques, discrete finite Radon transform (FRAT) is used as a data mapping technique due to the increased orthogonality offered. As a result, the proposed structure gives a significant improvement in bit error rate (BER) performance. Th

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Publication Date
Thu May 05 2022
Journal Name
Karbala International Journal Of Modern Science
Heterogeneous catalytic degradation of dye by Fenton-like oxidation over a continuous system based on Box–Behnken design and traditional batch experiments
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In this study, iron was coupled with copper to form a bimetallic compound through a biosynthetic method, which was then used as a catalyst in the Fenton-like processes for removing direct Blue 15 dye (DB15) from aqueous solution. Characterization techniques were applied on the resultant nanoparticles such as SEM, BET, EDAX, FT-IR, XRD, and zeta potential. Specifically, the rounded and shaped as spherical nanoparticles were found for green synthesized iron/copper nanoparticles (G-Fe/Cu NPs) with the size ranging from 32-59 nm, and the surface area was 4.452 m2/g. The effect of different experimental factors was studied in both batch and continuous experiments. These factors were H2O2 concentration, G-Fe/CuNPs amount, pH, initial DB15

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