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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
Fri Jul 14 2023
Journal Name
International Journal Of Information Technology &amp; Decision Making
A Decision Modeling Approach for Data Acquisition Systems of the Vehicle Industry Based on Interval-Valued Linear Diophantine Fuzzy Set
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Modeling data acquisition systems (DASs) can support the vehicle industry in the development and design of sophisticated driver assistance systems. Modeling DASs on the basis of multiple criteria is considered as a multicriteria decision-making (MCDM) problem. Although literature reviews have provided models for DASs, the issue of imprecise, unclear, and ambiguous information remains unresolved. Compared with existing MCDM methods, the robustness of the fuzzy decision by opinion score method II (FDOSM II) and fuzzy weighted with zero inconsistency II (FWZIC II) is demonstrated for modeling the DASs. However, these methods are implemented in an intuitionistic fuzzy set environment that restricts the ability of experts to provide mem

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Publication Date
Sun Feb 25 2018
Journal Name
Advances In Bioresearch
Survey of field crickets (Orthoptera, Grylidae) in different regions of Iraq
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Publication Date
Sun Feb 12 2017
Journal Name
World J Exp Biosc
Detection and sequencing of blaVEB-1 gene in clinical isolates of Proteus mirabilis Isolates from Baghdad City`s hospitals
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In Present study, 25 clinical isolates of Proteus spp. of clinical samples, urine, wounds and burns collected from different hospitals in Baghdad city, all isolates were identified as Proteus mirabilis using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifying as P. mirabilis. The susceptibility of P. mirabilis isolates to cefotaxime was 66.6 %, while to ceftazidime was 20%. Extended spectrum β-lactamses producing Proteus was 30.7 %. DNA of 5 isolates of P. mirabilis was extracted and detection for blaVEB-1 gene by using multiplex polymerase chain reaction (PCR). Results showed that the presence of this gene in all tested isolates, as an important indicator for increas

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Publication Date
Sat Sep 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
2D and 3D Modeling of Rock Mechanical Properties of Khasib Formation in East Baghdad Oil Field
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Knowing the distribution of the mechanical rock properties and the far field stresses for the field of interest is an important task for many applications concerning reservoir geomechanics, including wellbore instability analysis, hydraulic fracturing, sand production, reservoir compaction, and subsidence. A major challenge with determining the rock's mechanical properties is that they cannot be directly measured at the borehole. Furthermore, the recovered carbonate core samples for performing measurements are limited and they provide discrete data for specific depths.

   The purpose of this study is to build 2D and 3D geomechanical models of the Khasib reservoir in the East Baghdad oil field/ Central area. TECHLOG.2015.3 softwa

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Publication Date
Sun Dec 01 2002
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EFFICIENCY OF PARASITOIDS OF PEA LEAFMINER PHYTOMYZA HORTICOLA GOUREAU AND THEIR APPEARANCE TIME IN THE FIELD
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Eleven hymenopterous species: two braconids, seven eulophids and two pteromalids
parasitized the larvae of Phytomyza horticola Goureau. The activity of the parasites began at
the end of April and evidently increased during May. The female of the parasites fed and
parasitized mostly on the second and third larval instars of P. horticola . Diglyphus iseae
Walker and Cirrospilus vittatus Walker were dominant larval parasites. Chrysocharis
pentheus Walker and Pediobius acantha Walker were main pupal parasites.

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Publication Date
Thu Mar 06 2025
Journal Name
International Journal Of Applied Mechanics And Engineering
Comparison of The Mechanical Properties of Low-Cost Bio Fiber Reinforced Polymer Composites
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In this study, the physical, and mechanical properties of low-cost and biocomposites were evaluated. The walnut shell and date palm frond fibers were thermally treated in an oven at a temperature of 70°C and then chemically treated with NaOH and distilled water solution, after these treatments, the biocomposite materials will be thermally treated again at 50°C. This procedure was performed for three types of biocomposite; Walnut shell Fiber Reinforced Polymer (WFRP), Date palm Fiber Reinforced Polymer (DFRP), and Hybrid Fiber Reinforced Polymer (HFRP), whereas the biocomposite sheets consisting of 30% biofibers and 70% unsaturated polyester, the mechanical test specimens were cut by a CNC machine according to ASTM standards. The e

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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Design of Nonlinear PID Neural Controller for the Speed Control of a Permanent Magnet DC Motor Model based on Optimization Algorithm
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In this paper, the speed control of the real DC motor is experimentally investigated using nonlinear PID neural network controller. As a simple and fast tuning algorithm, two optimization techniques are used; trial and error method and particle swarm optimization PSO algorithm in order to tune the nonlinear PID neural controller's parameters and to find best speed response of the DC motor. To save time in the real system, a Matlab simulation package is used to carry out these algorithms to tune and find the best values of the nonlinear PID parameters. Then these parameters are used in the designed real time nonlinear PID controller system based on LabVIEW package. Simulation and experimental results are compared with each other and showe

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Publication Date
Wed Sep 21 2022
Journal Name
Biochemical And Cellular Archives
ANTIBIOTIC SUSCEPTIBILITY AND BIOFILM FORMATION OF PSEUDOMONAS AERUGINOSA ISOLATED FROM CLINICAL AND ENVIRONMENTAL HOSPITAL SAMPLES
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Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen and a model bacterium for studying virulence and bacterial social traits. While it can be isolated in low numbers from a wide variety of environments including soil and water, it can readily be found in almost any human/animal-impacted environment. It is a major cause of illness and death in humans with immunosuppressive and chronic conditions, and infections in these patients are difficult to treat due to a number of antibiotic resistance mechanisms and the organism’s propensity to form multicellular biofilms. One hundred twenty clinical samples and forty hospital environmental samples (various sources) were collected from hospitals in Baghdad city during the period from Oc

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Publication Date
Fri Dec 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Comparing the effectiveness of using three different re-mineralizing pastes on remineralisation of artificially induced white spot lesion
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Background: This study aimed to compare the surface microhardness (MH) and mineral content of white spot lesions(WSLs) after using bioactive glass (BAG)casein phosphopep-tides-amorphous calcium phosphate(CPP-ACP),and nanohydroxyapatite(Nano-HAP) under pHcycling. Material and method:18 sound maxillary first premolar were used for the study.10 were selected for the vickers microhardness test, For Energy-dispersive X-ray spectroscopy analysis (EDX), the remaining 8 premolar teeth were used, 40 sections of enamel blocks (Four from each tooth) were produced from the middle part of the buccal and palatal surfaces of teeth for MH test while 48 sections of enamel blocks (Six from each tooth) were produced for EDX analysis. Enamel slabs were divi

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning premarital screening of sexual transmitted disease on Student's Knowledge at Baghdad University
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Objectives: To identify the effectiveness of instructional program concerning premarital screening of sexual transmitted disease on student's knowledge at Baghdad University and examine the relationship between students' knowledge and certain studied variables. And hypothesis for this study; There is a difference in university student’s knowledge toward premarital screening between pre and posttests of instructional program. Methodology: A quasi-experimental design (pretest-posttest approach) was conducted at six colleges and its college of education ibn rushd, college of political science, college of law, college of literatur

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