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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 Jun 30 2025
Journal Name
Acta Logistica
A business continuity-based framework for risk management in smart supply chains: a fuzzy multi-criteria decision-making approach
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The aim of this study is to develop a novel framework for managing risks in smart supply chains by enhancing business continuity and resilience against potential disruptions. This research addresses the growing uncertainty in supply chain environments, driven by both natural phenomena-such as pandemics and earthquakes—and human-induced events, including wars, political upheavals, and societal transformations. Recognizing that traditional risk management approaches are insufficient in such dynamic contexts, the study proposes an adaptive framework that integrates proactive and remedial measures for effective risk mitigation. A fuzzy risk matrix is employed to assess and analyze uncertainties, facilitating the identification of disr

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Publication Date
Mon Oct 01 2012
Journal Name
Applied Energy
Analysis of thermal and electrical performance of a hybrid (PV/T) air based solar collector for Iraq
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The electrical and thermal performance of a typical single pass hybrid photovoltaic/thermal (PV/T) air collector is modeled, simulated and analyzed for two selected case studies in Iraq. An improved mathematical thermo-electrical model is derived in terms of design, operating and climatic parameters of the hybrid solar collector to evaluate its important characteristics: collector flow and heat removal factors, PV maximum power point and its temperature coefficient, and overall power and efficiency. Unlike previous PV/T thermal models, the present model is obtained with some additions and corrections in radiation and convection heat coefficients for the top loss and for the air duct with more applicable sky temperature correlation. The well

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Publication Date
Mon Oct 01 2012
Journal Name
Applied Energy
Analysis of thermal and electrical performance of a hybrid (PV/T) air based solar collector for Iraq
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Publication Date
Tue Sep 06 2016
Journal Name
Al-qadisiyah Journal For Administrative And Economic Sciences
Awareness of the regulatory and administrative leadership and its role in achieving the effectiveness of the internal control system and achieve fair accountability
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The research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso

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Publication Date
Wed Feb 10 2016
Journal Name
Scientific Reports
Experimental demonstration on the deterministic quantum key distribution based on entangled photons
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As an important resource, entanglement light source has been used in developing quantum information technologies, such as quantum key distribution(QKD). There are few experiments implementing entanglement-based deterministic QKD protocols since the security of existing protocols may be compromised in lossy channels. In this work, we report on a loss-tolerant deterministic QKD experiment which follows a modified “Ping-Pong”(PP) protocol. The experiment results demonstrate for the first time that a secure deterministic QKD session can be fulfilled in a channel with an optical loss of 9 dB, based on a telecom-band entangled photon source. This exhibits a conceivable prospect of ultilizing entanglement light source in real-life fiber-based

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Publication Date
Fri Feb 04 2022
Journal Name
Neuroquantology
Detecting Damaged Buildings on Post-Hurricane Satellite Imagery based on Transfer Learning
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In this article, Convolution Neural Network (CNN) is used to detect damage and no damage images form satellite imagery using different classifiers. These classifiers are well-known models that are used with CNN to detect and classify images using a specific dataset. The dataset used belongs to the Huston hurricane that caused several damages in the nearby areas. In addition, a transfer learning property is used to store the knowledge (weights) and reuse it in the next task. Moreover, each applied classifier is used to detect the images from the dataset after it is split into training, testing and validation. Keras library is used to apply the CNN algorithm with each selected classifier to detect the images. Furthermore, the performa

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Publication Date
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Correlation Study of Retinol Binding Protein4, Vitamin A with Liver Function Enzymes in Iraqi Fracture Patients with and without DM2
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A fracture is a damage to bone tissue that causes damage to the tissue surrounding the bone and may penetrate the skin. Subjects and methods: the present study included (80) fractured Iraqi patients (and 40) patients with DM2 and (40) without DM2 and compared them with (40) healthy control. Patients and control are matched in age. This study showed a significant increase in retinol-binding protein 4 (RBP4) and a considerable decrease in Vit .A GPT and GOT in fracture patients with and without DM2. In addition, there was a significant negative correlation between RBP4 with (GPT and GOT) in fracture patients with DM2 and a significant positive correlation between RBP4 with (GPT and GOT) in fracture patients without DM2.       

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Publication Date
Tue Nov 01 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Correlation Study of Retinol Binding Protein4, Vitamin A with Liver Function Enzymes in Iraqi Fracture Patients with and without DM2
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Background: Recent research indicates that persistent inflammatory responses may contribute to the rise of diabetic nephropathy (DN) and diabetic cardiovascular disease (DCVD) in type 2 diabetes mellitus patients (DM2). Numerous molecules associated with inflammation and angiogenesis have been implicated in the development and progression of DN and DCVD, respectively. Methods: The subjects were separated into five groups: healthy controls (n= 25), type 2 diabetes mellitus patients (n= 30), type 2 diabetes mellitus patients with nephropathy DN (n= 30), and type 2 diabetes mellitus patients with cardiovascular disease DCVD (n= 30). The blood levels of irisin, IL-8, HbA1C, urea, and creatinine were determined. Results: In current study there w

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Publication Date
Thu Jun 24 2021
Journal Name
Ibero-american Journal Of Exercise And Sports Psychology
The effect of an educational curriculum based on metacognitive skills in teaching some offensive skills on the specialized school of basketball in Baghdad governorate
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The educational process depends on the means of conveying information from the teacher to the learner. Whenever appropriate, this means the learning process takes place better, faster, and with less effort, and the problem of research lies. The players lack learning in the meta-knowledge curriculum in basketball offensive skills than offensive skills. The aim of the research is to identify the effect of training exercises for educational numbers based on metacognitive skills in teaching some offensive skills with basketball. As for the research assignment, there are statistically significant differences between the results of the pre and post tests for the experimental group and in favor of the post tests. The experimental approach was used

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
Comparison between Open Mini-incision Thyroidectomy and Conventional Thyroidectomy: Clinical Experience and Literatures Review
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Background: Thyroid surgery is most common endocrine surgery in general surgical practice. Objectives: the aim of this work is to evaluate the feasibility, benefits and outcomes of open mini-incision thyroidectomy and compared the results with that of conventional thyroidectomy. The comparison between the two groups was in term of incision length, amount of blood loss, time of operation, postoperative pain, hospital stay and the cosmetic outcomes.Type of the study: this is a single-blinded randomized controlled studyMethods: This study compared the advantages and outcomes of 22 patients subjected to mini-incision thyroidectomy (Group A) with the equal numbers of patients subjected to conventional thyroidectomy (Group B).Results: the oper

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