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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
Mon Oct 14 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Short Term Effectiveness of Gamma Knife Radiosurgery in the Management of Brain Arteriovenous Malformation
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AIM: To evaluate the short-term effectiveness of Gamma knife radiosurgery as a modality of treatment of brain arteriovenous malformation. METHODS: Sixty-three patients with arteriovenous brain malformations underwent Gamma knife radiosurgery included in this prospective study between April 2017 and September 2018 with clinical and radiological with MRI follow up was done at three months and six months post-Gamma knife radiosurgery. By the end of the 12th-month post-Gamma knife radiosurgery, the patients were re-evaluated using digital subtraction angiography co-registered with M.R.I. During the 12 months follow up, CT scan or MRI was done at any time if any one of the patients᾽ condition deteriorated or developed signs and s

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Publication Date
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The effectiveness of the organization in the philosophy of the most prominent theoreticianAdministrative thought
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This paper discuses the mindset contribution of the organization Science in organizational effectiveness (OE), and the most valuable thoughts they introduced in this subject, starting from the pre- classical era, through classical era to present time. This paper has identified the main contribution in OE. The concept of OE didn’t arise until what had been introduced by Chester Barnard, although Max Weber mentioned this concept in his bureaucratic theory, but he didn’t explain it as Barnard does. After that no clear focus was pointed to this subject until Peter Drucker did so, which considered as the main participant in OE after Barnard. After that many researchers be interested in OE and they start studying this subject like

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Publication Date
Thu Jun 06 2019
Journal Name
Indian Journal Of Public Health, Research And Development
Clinical Manifestation of Singleton Pregnancy Complicated by Diabetes Mellitus
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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Risk-Based Inspection Due to Corrosion Consequences for Oil and Gas Flowline: A Review
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   The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli

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Publication Date
Fri Dec 25 2009
Journal Name
Wireless Personal Communications
A N-Radon Based OFDM Trasceivers Design and Performance Simulation Over Different Channel Models
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In this paper a new method is proposed to perform the N-Radon orthogonal frequency division multiplexing (OFDM), which are equivalent to 4-quadrature amplitude modulation (QAM), 16-QAM, 64-QAM, 256-QAM, ... etc. in spectral efficiency. This non conventional method is proposed in order to reduce the constellation energy and increase spectral efficiency. The proposed method gives a significant improvement in Bit Error Rate performance, and keeps bandwidth efficiency and spectrum shape as good as conventional Fast Fourier Transform based OFDM. The new structure was tested and compared with conventional OFDM for Additive White Gaussian Noise, flat, and multi-path selective fading channels. Simulation tests were generated for different channels

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Publication Date
Sun Jan 04 2015
Journal Name
Journal Of Educational And Psychological Researches
Effectiveness of the self-questioning strategy in the achievement of the third stage Institutes of teacher preparation and decision - making in Chemistry
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This research aims to find out "the effectiveness of the self-questioning strategy in the achievement of students Phase III institutes of teacher preparation and decision-making in chemistry." The researcher follows approach quasi-experimental with a post-test, and the sample consisted of (27) from " Teachers Training Institute-AL-Byaa "in Directorate of Education Baghdad Karkh / 2 students divided into two unequal groups: experimental its number (14) students studied using reciprocal teaching strategy and control its number (13) students have studied in the usual way.The two groups were equivalent extraneous variables.

The researcher was prepare achievement test consist of 40 items was the adoption of a measure of decision-makin

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Publication Date
Mon Apr 03 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Concept Maps in Academic Achievement among Family Education Students in the Subject of the Art of Elegance and Fashion
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Abstract

The current research aims to identify the effectiveness of concept maps in the academic achievement of the art of elegance and fashion for third vocational students. The current research is a quasi-experimental one. The research sample consisted of (74) female students in Al-Saydiyah secondary school for girls, they were divided into two groups: the experimental group and the control group. The following hypothesis was developed: There are no statistically significant differences at the level (0.05) between the average scores of the students who studied the subject using concept maps and the average scores of the students who studied the subject in the traditional method in the post-achievement test. The

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Publication Date
Thu Nov 27 2025
Journal Name
Frontiers In Robotics And Ai
Design of modified fractional-order PID controller for lower limb rehabilitation exoskeleton robot based on an improved elk herd hybridized with grey wolf and multi-verse optimization algorithms
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Rehabilitation robots are widely recognized as vital for restoring motor function in patients with lower-limb impairments. A Modified Fractional-Order Proportional-Integral-Derivative (MFOPID) controller is proposed to improve trajectory tracking of a 2-DoF Lower Limb Rehabilitation Exoskeleton Robot (LLRER). The classical FOPID is augmented with a modified control formulation by which steady-state error is reduced and the transient response is sharpened. Controller gains and fractional orders were tuned offline using a hybrid metaheuristic Improved Elk Herd Optimization hybridized with Grey Wolf and Multi-Verse Optimization algorithms (IElk-GM) so that exploration and exploitation are balanced. Superiority over the classical FOPID

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Publication Date
Fri Jul 01 2016
Journal Name
Colloids And Surfaces A: Physicochemical And Engineering Aspects
Stability and thermophysical properties of water-based nanofluids containing triethanolamine-treated graphene nanoplatelets with different specific surface areas
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tA novel synthesis procedure is presented for preparing triethanolamine-treated graphene nanoplatelets(TEA-GNPs) with different specific areas (SSAs). Using ultrasonication, the covalently functionalizedTEA-GNPs with different weight concentrations and SSAs were dispersed in distilled water to prepareTEA-GNPs nanofluids. A simple direct coupling of GNPs with TEA molecules is implemented to synthesizestable water-based nanofluids. The effectiveness of the functionalization procedure was validated by thecharacterization and morphology tests, i.e., FTIR, Raman spectroscopy, EDS, and TEM. Thermal conduc-tivity, dispersion stability, and rheological properties were investigated. Using UV–vis spectrometer, ahighest dispersion stability of 0.876

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical & Cellular Archives
THE STUDY ON ABILITY OF ESCHERICHIA COLI ISOLATED FROM DIFFERENT CLINICAL CASES TO BIOFILM FORMATION AND DETECTION OF CSGD GENE RESPONSIBLE FOR PRODUCE CURLI (FIMBRIAE)
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A total of 165 clinical sample included Urine, Swab wounds and Burns were collected from Baghdad Governorate. Results showed that rate all isolates of E. coli was 50(30.3%) and rate of urine infection was 46(92%) and rate of swab wounds infection 4(8%). Where was diagnostic based on streaked on MacConkey agar, then single colony was transferred to Eosin Methylene Blue (EMB). Identification some of the biochemical test included: Catalase test, Oxidase test, Indole test, Methyl red, Vogues - Proskauer test and Citrate Utilization test. Then confirmed by the Vitek - 2 Compact System. The ability of E.coli isolate to biofilm formation to be studied it is considered one of the most important factors of virulence and has role in causing injury an

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