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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 Jan 01 2019
Journal Name
Biochemical And Cellular Archives
Effect of HPV infection on the expression of fibronectin in a group of Iraqi women with cervical carcinoma
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: Cervical malignancy positioned as the fourth most prevalent disease among women around the world. HPVs especially HPV16 are the causative agent of cervical cancer, responsible of about 5% of all human cancers worldwide. Some researchers found that the fibronectin is repressed by the papillomavirus (HPV) type 16 E7 oncoprotein in both HPV-positive nontumorigenic and tumorigenic cell lines, while others found that the HPV oncoprotein increase the levels of fibronectin. The aim is to study the effect of HPV infection on Fibronectin expression and their correlation onthe development of Cervicalcancinoma. The current retrospective study enrolled paraffinized blocks of two groups. The research included 30 cervical carcinomatous tissues as well

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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
DAMAGE DETECTION AND LOCATION FOR IN AND OUT-OFPLANE CURVED BEAMS USING FUZZY LOGIC BASED ON FREQUENCY DIFFERENCE
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In this study, structures damage identification method based on changes in the dynamic characteristics
(frequencies) of the structure are examined, stiffness as well as mass matrices of the curved
(in and out-of-plane vibration) beam elements is formulated using Hamilton's principle. Each node
of both of them possesses seven degrees of freedom including the warping degree of freedom. The
curved beam element had been derived based on the Kang and Yoo’s thin-walled curved beam theory
in 1994. A computer program was developing to carry out free vibration analyses of the curved
beam as well as straight beam. Comparing with the frequencies for other researchers using the general
purpose program MATLAB. Fuzzy logic syste

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
Determination of Phosphodiesterase Type 5 Enzyme (PDE-5) Inhibitors and Analogues as Adulterants in Selected Herbal Products using Gas Chromatography–Electron Impact-Mass Spectrometer (GC-EI-MS)
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       Sildenafil, tadalafil, and vardenafil are phosphodiesterase type 5 enzyme (PDE-5) inhibitors used for the treatment of male erectile dysfunction. This present study aims to investigate 55 herbal products indicated for men’s sexual health from the Malaysian market for adulteration of PDE-5 inhibitors and analogues. The screening and identification of 20 PDE-5 inhibitors and analogues in herbal products of various forms (powder, capsules, tablets, and pastels) were conducted using gas chromatography–electron impact-mass spectrometer (GC-EI-MS). The analysis has shown that 19 herbal products were adulterated with PDE-5 inhibitors and analogues. Unique ion fragmentations and the presence of molecular

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Determination of Doxycycline Hyclate by Batch and Reverse Flow Injection Analysis Based on the Oxidative Coupling Reaction with 3-Methyl-2-benzothiazolinone Hydrazone hydrochloride (MBTH)
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New, simple and sensitive batch and reverse FIA spectrophotometric methods for the determination of doxycycline hyclate in pure form and in pharmaceutical preparations were proposed. These methods based on oxidative coupling reaction between doxycycline hyclate and 3-methylbenzothiazolinone-2-hydrazone hydrochloride (MBTH) in the presence ammonium ceric sulfate in acidic medium, to form green water-soluble dye that is stable and has a maximum absorbance at 626 nm. A calibration graph shows that a Beer's law is obeyed over the concentration range of 1-80 and 0.5-110 ?g.mL-1 of DCH for the batch and rFIA respectively with detection limit of 0.325 ?g.mL-1 of DCH for r-FIA methods. All different chemicals and physical experimental paramete

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Publication Date
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Cost Management of construction industries according to the fast-track method
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Construction projects have become a changing dramatically in recent decades and that the goal of the beneficiaries of the implementation of structural project is to complete the work with less time and within the cost of the specific and the best possible quality may sometimes happen that highlights the importance of time on the rest of the items at the implementation of projects for various reasons, including the need to use the project as soon as possible possible change rapidly to customer's requests, but the high cost of the project represents the biggest obstacle for entrepreneurs with its effects on the quality and the time workers, and is a measure of those elements in monetary terms is the key to integration between them, so the

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of The American Pharmacists Association
Estimating the cost of unclaimed electronic prescriptions at an independent pharmacy
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Publication Date
Tue Jan 14 2025
Journal Name
South Eastern European Journal Of Public Health
Deep learning-based threat Intelligence system for IoT Network in Compliance With IEEE Standard
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The continuous advancement in the use of the IoT has greatly transformed industries, though at the same time it has made the IoT network vulnerable to highly advanced cybercrimes. There are several limitations with traditional security measures for IoT; the protection of distributed and adaptive IoT systems requires new approaches. This research presents novel threat intelligence for IoT networks based on deep learning, which maintains compliance with IEEE standards. Interweaving artificial intelligence with standardization frameworks is the goal of the study and, thus, improves the identification, protection, and reduction of cyber threats impacting IoT environments. The study is systematic and begins by examining IoT-specific thre

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Publication Date
Sun Jan 01 2017
Journal Name
Statistical Applications In Genetics And Molecular Biology
Mixture model-based association analysis with case-control data in genome wide association studies
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Abstract<p>Multilocus haplotype analysis of candidate variants with genome wide association studies (GWAS) data may provide evidence of association with disease, even when the individual loci themselves do not. Unfortunately, when a large number of candidate variants are investigated, identifying risk haplotypes can be very difficult. To meet the challenge, a number of approaches have been put forward in recent years. However, most of them are not directly linked to the disease-penetrances of haplotypes and thus may not be efficient. To fill this gap, we propose a mixture model-based approach for detecting risk haplotypes. Under the mixture model, haplotypes are clustered directly according to their estimated d</p> ... Show More
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Publication Date
Thu Sep 01 2016
Journal Name
Radiology Case Reports
Intralobar pulmonary sequestration in elderly woman: a rare case report with emphasis on imaging findings
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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Naturally occurring radioactive materials and related hazard indices in Ahdeb oil field
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In this work, measurements of activity concentration of naturally occurring radioactive materials (NORM) isotopes and their related hazard indices for several materials such as crude oil, sludge and water in Ahdeb oil fields in Waste governorate using high pure germanium coaxial detection technique. The average values for crude oil samples were174.72Bq/l, 43.46Bq/l, 355.07Bq/l, 264.21Bq/l, 122.52nGy/h, 0.7138, 1.1861, 0.601 mSv/y, 0.1503mSv/y and 1.8361 for Ra-226, Ac-228, K-40, Ra eq, D, H-external and H-internal respectively. According to the results; the ratio between 238U to 232Th was 4, which represents the natural ratio in the crust earth; therefore, one can be strongly suggested that the geo-stricture of the

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