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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 Jun 04 2024
Journal Name
Computation
High-Performance Krawtchouk Polynomials of High Order Based on Multithreading
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Orthogonal polynomials and their moments serve as pivotal elements across various fields. Discrete Krawtchouk polynomials (DKraPs) are considered a versatile family of orthogonal polynomials and are widely used in different fields such as probability theory, signal processing, digital communications, and image processing. Various recurrence algorithms have been proposed so far to address the challenge of numerical instability for large values of orders and signal sizes. The computation of DKraP coefficients was typically computed using sequential algorithms, which are computationally extensive for large order values and polynomial sizes. To this end, this paper introduces a computationally efficient solution that utilizes the parall

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Pharmacy And Biological Sciences
Genetic Polymorphism of Iraqi Leishmania tropica Isolates Based on HSP70Gene
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Leishmaniasis is one of the important parasitic diseases, affecting mainly low social class people indeveloping countries, and is more prevalent and endemic in the tropical and subtropical regions of old worldand new world. Despite ofbroad distribution in Iraq,little known about the geneticcharacteristics of thecausative agents. So this study was aimed to evaluate the genetic varietyoftwo IraqiLeishmaniatropicaisolatesbased on heat shock protein gene sequence 70 (HSP70) in comparison with universal isolates recordedsequences data. After amplification and sequencing of HSP70 gene,the obtainedresults were alignment alongwith homologous Leishmania sequences retrieved from NCBI by using BLAST. The analysis results showedpresence of particular g

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Publication Date
Mon Aug 01 2022
Journal Name
Mathematics
Face Recognition Algorithm Based on Fast Computation of Orthogonal Moments
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Face recognition is required in various applications, and major progress has been witnessed in this area. Many face recognition algorithms have been proposed thus far; however, achieving high recognition accuracy and low execution time remains a challenge. In this work, a new scheme for face recognition is presented using hybrid orthogonal polynomials to extract features. The embedded image kernel technique is used to decrease the complexity of feature extraction, then a support vector machine is adopted to classify these features. Moreover, a fast-overlapping block processing algorithm for feature extraction is used to reduce the computation time. Extensive evaluation of the proposed method was carried out on two different face ima

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of Engineering
Development of Spatial Data Infrastructure based on Free Data Integration
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In recent years, the performance of Spatial Data Infrastructures for governments and companies is a task that has gained ample attention. Different categories of geospatial data such as digital maps, coordinates, web maps, aerial and satellite images, etc., are required to realize the geospatial data components of Spatial Data Infrastructures. In general, there are two distinct types of geospatial data sources exist over the Internet: formal and informal data sources. Despite the growth of informal geospatial data sources, the integration between different free sources is not being achieved effectively. The adoption of this task can be considered the main advantage of this research. This article addresses the research question of how the

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Publication Date
Tue Mar 12 2019
Journal Name
Al-khwarizmi Engineering Journal
Optimization Drilling Parameters of Aluminum Alloy Based on Taguchi Method
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This paper focuses on the optimization of drilling parameters by utilizing “Taguchi method” to obtain the minimum surface roughness. Nine drilling experiments were performed on Al 5050 alloy using high speed steel twist drills. Three drilling parameters (feed rates, cutting speeds, and cutting tools) were used as control factors, and L9 (33) “orthogonal array” was specified for the experimental trials. Signal to Noise (S/N) Ratio and “Analysis of Variance” (ANOVA) were utilized to set the optimum control factors which minimized the surface roughness. The results were tested with the aid of statistical software package MINITAB-17. After the experimental trails, the tool diameter was found as the most important facto

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Calculating Production Rate of each Branch of a Multilateral Well Using Multi-Segment Well Model: Field Example
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Multilateral wells require a sophisticated type of well model to be applied in reservoir simulators to represent them. The model must be able to determine the flow rate of each fluid and the pressure throughout the well. The production rate calculations are very important because they give an indication about some main issues associated with multi-lateral wells such as one branch may produce water or gas before others, no production rate from one branch, and selecting the best location of a new branch for development process easily.                                &nbsp

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Traumatic Stress Disorders &amp; Treatment
Randomised Controlled Study Comparing Two Psychological Therapies for Posttraumatic Stress Disorder (PTSD): Emotional Freedom Techniques (EFT) vs. Narrative Exposure Therapy (NET)
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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of a proposed program to solve the problem of mixing Arabic letters similar to the voice of students in the second grade primary
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The purpose of this research is to demonstrate the effectiveness of a program to address the problem of mixing similar letters in the Arabic language for students in the second grade of primary and to achieve the goal of the research. The researcher followed the experimental method to suit the nature of this research and found that there are statistically significant differences between the tribal and remote tests, The effectiveness of the proposed educational program. At the end of the research, the researcher recommends several recommendations, the most important of which are: 1 - Training students to correct pronunciation of the outlets, especially in the first three stages of primary education (primary) and the use of direct training

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Developing strategic leadership practices in the light of transparency and organizational citizenship behavior - A field study of a sample of the staff of the Office of the Inspector General at the Iraqi Ministry of Culture
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Diversity the terms and practice the organizational filed with different concepts and environment, which Iraqi environment part from them. Some organizational in Iraqi environment leave its basic oriented to agreement with the leader desire, their fore this research focus tow basic variable (organizational citizenship behavior & transparence), we supposition which is dependent to explanation the response variable (strategic leadership). The results justification in part and not justification in another part. For example the organizational citizenship behavior effect on some parte of the strategic leadership. The transparence have faraway to fly from the relation with organizational citizenship behavior and strategic leadershi

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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive Conflict Strategy in Comprehending Reading Among the Fifth Literary Students in the Subject of Literature and Texts
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The aim of the current study is to identify the effectiveness of cognitive conflict strategy in comprehending reading among literary fifth students in literature and literature texts. The researcher uses experimental method with partial control. The sample consisted of (80) students distributed into control and experimental groups. The scientific material, the behavioral goals, the teaching plans, and the instrument of the research have been prepared (reading comprehension test) by the researcher.

The instrument's validity and reliability have been calculated and then applied to the sample. After treating the data statistically by using SPSS, the results have revealed that there is a statistically significant difference at the si

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