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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 Jun 30 2013
Journal Name
Al-khwarizmi Engineering Journal
Estimated Outlet Temperatures in Shell-and-Tube Heat Exchanger Using Artificial Neural Network Approach Based on Practical Data
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The objective of this study is to apply Artificial Neural Network for heat transfer analysis of shell-and-tube heat exchangers widely used in power plants and refineries. Practical data was obtained by using industrial heat exchanger operating in power generation department of Dura refinery. The commonly used Back Propagation (BP) algorithm was used to train and test networks by divided the data to three samples (training, validation and testing data) to give more approach data with actual case. Inputs of the neural network include inlet water temperature, inlet air temperature and mass flow rate of air. Two outputs (exit water temperature to cooling tower and exit air temperature to second stage of air compressor) were taken in ANN.

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Efficient Task Scheduling Approach in Edge-Cloud Continuum based on Flower Pollination and Improved Shuffled Frog Leaping Algorithm
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The rise of edge-cloud continuum computing is a result of the growing significance of edge computing, which has become a complementary or substitute option for traditional cloud services. The convergence of networking and computers presents a notable challenge due to their distinct historical development. Task scheduling is a major challenge in the context of edge-cloud continuum computing. The selection of the execution location of tasks, is crucial in meeting the quality-of-service (QoS) requirements of applications. An efficient scheduling strategy for distributing workloads among virtual machines in the edge-cloud continuum data center is mandatory to ensure the fulfilment of QoS requirements for both customer and service provider. E

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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Effect of strategic thinking in human resource management strategies “Analytical field study of the views of a sample of managers in the Iraqi Ministry of Health”
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The researcher attempts to diagnose the level of the effect  of strategic thinking skills (intuition, meditation, creativity) of the managers in the Ministry of Health in Iraq and some of its institutions in the formulation of human resources management: (selection, training, incentivence , performance appraisal (Recognizing the importance of the subjects studied, and because of the importance of the expected results of th

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Publication Date
Thu Jan 01 2015
Journal Name
Iraqi Journal Of Science
Keystroke Dynamics Authentication based on Naïve Bayes Classifier
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Authentication is the process of determining whether someone or something is, in fact, who or what it is declared to be. As the dependence upon computers and computer networks grows, the need for user authentication has increased. User’s claimed identity can be verified by one of several methods. One of the most popular of these methods is represented by (something user know), such as password or Personal Identification Number (PIN). Biometrics is the science and technology of authentication by identifying the living individual’s physiological or behavioral attributes. Keystroke authentication is a new behavioral access control system to identify legitimate users via their typing behavior. The objective of this paper is to provide user

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Publication Date
Mon Apr 15 2019
Journal Name
Proceedings Of The International Conference On Information And Communication Technology
Hybrid LDPC-STBC communications system based on chaos
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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Engineering
GNSS Baseline Configuration Based on First Order Design
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The quality of Global Navigation Satellite Systems (GNSS) networks are considerably influenced by the configuration of the observed baselines. Where, this study aims to find an optimal configuration for GNSS baselines in terms of the number and distribution  of baselines to improve the quality criteria of the GNSS networks. First order design problem (FOD) was applied in this research to optimize GNSS network baselines configuration, and based on sequential adjustment method to solve its objective functions.

FOD for optimum precision (FOD-p) was the proposed model which based on the design criteria of A-optimality and E-optimality. These design criteria were selected as objective functions of precision, whic

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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
Optimum Median Filter Based on Crow Optimization Algorithm
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          A novel median filter based on crow optimization algorithms (OMF) is suggested to reduce the random salt and pepper noise and improve the quality of the RGB-colored and gray images. The fundamental idea of the approach is that first, the crow optimization algorithm detects noise pixels, and that replacing them with an optimum median value depending on a criterion of maximization fitness function. Finally, the standard measure peak signal-to-noise ratio (PSNR), Structural Similarity, absolute square error and mean square error have been used to test the performance of suggested filters (original and improved median filter) used to removed noise from images. It achieves the simulation based on MATLAB R2019b and the resul

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Publication Date
Thu Aug 01 2019
Journal Name
2019 2nd International Conference On Engineering Technology And Its Applications (iiceta)
Human Gait Identification System Based on Average Silhouette
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Publication Date
Mon May 15 2017
Journal Name
International Journal Of Image And Data Fusion
Image edge detection operators based on orthogonal polynomials
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Publication Date
Sun Sep 24 2023
Journal Name
Journal Of Al-qadisiyah For Computer Science And Mathematics
Iris Data Compression Based on Hexa-Data Coding
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Iris research is focused on developing techniques for identifying and locating relevant biometric features, accurate segmentation and efficient computation while lending themselves to compression methods. Most iris segmentation methods are based on complex modelling of traits and characteristics which, in turn, reduce the effectiveness of the system being used as a real time system. This paper introduces a novel parameterized technique for iris segmentation. The method is based on a number of steps starting from converting grayscale eye image to a bit plane representation, selection of the most significant bit planes followed by a parameterization of the iris location resulting in an accurate segmentation of the iris from the origin

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