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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
Thu Sep 01 2016
Journal Name
Physica Medica
Quantitative analysis of sentinel lymph node detection using a novel small field of view hybrid gamma camera (HGC)
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Introduction The Hybrid Gamma Camera (HGC) is being developed to enhance the localisation of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. Purpose To assess the capability of the HGC, a lymph-node-contrast (LNC) phantom was constructed for an evaluative study simulating medical scenarios of varying radioactivity concentration and SLN size. Materials and methods The phantom was constructed using two methyl methacrylate PMMA plates (8 mm thick). The SLNs were simulated by drilling circular wells of diameters ranging between 10 mm and 2.5 mm (16 wells in total) in one plate. These simulated SLNs were placed underneath scattering material with thicknesses ranging between 5 mm

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Publication Date
Fri Sep 15 2023
Journal Name
Al-academy
A new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting
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Art is a language in which the artist expresses himself, his society, and the events he lives in, so new artistic trends emerged, so the artist no longer practices his art as required by any previous artistic rules. And the thoughts wandering inside him, which led him to the abstract method in which the artist tries to employ the elements of the artwork in a plastic construction through which he achieves the relationships of the abstract form through the rhythms of lines, colors, spaces, shapes and textures without these plastic elements having any connection with the visual reality.
The research aims to find a new vision inspired by the school of geometric abstraction to enrich the field of Saudi plastic painting. And to take advan

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Publication Date
Sun Dec 01 2024
Journal Name
Energy Storage
Comprehensive Study of <scp>PAN</scp>‐<scp>NaBF<sub>4</sub></scp> Solid Polymer Electrolytes: Insights Into Optical, Structural, Thermal, Electrical, and Electrochemical Properties for Sodium‐Ion Batteries
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ABSTRACT<p>This research explores the use of solid polymer electrolytes (SPEs) as a conductive medium for sodium ions in sodium‐ion batteries, presenting a possible alternative to traditional lithium‐ion battery technology. The researchers prepare SPEs with varying molecular weight ratios of polyacrylonitrile (PAN) and sodium tetrafluoroborate (NaBF<sub>4</sub>) using a solution casting method with dimethyl formamide as the solvent. Through optical absorbance measurements, we identified the PAN:NaBF<sub>4</sub> (80:20) SPE composition as having the lowest energy band gap value (4.48 eV). This composition also exhibits high thermal stability based on thermogravimetric analysis results. </p> ... Show More
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Publication Date
Thu Dec 15 2022
Journal Name
Al-academy
Strategies of brain-based learning theory and its impact on the achievement of students of the Department of Art Education in Teaching Methods
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The aim of the current research is to reveal the effect of using brain-based learning theory strategies on the achievement of Art Education students in the subject of Teaching Methods. The experimental design with two equal experimental and control groups was used. The experimental design with two independent and equal groups was used, and the total of the research sample was (60) male and female students, (30) male and female students represented the experimental group, and (30) male and female students represented the control group. The researcher prepared the research tool represented by the cognitive achievement test consisting of (20) questions, and it was characterized by honesty and reliability, and the experiment lasted (6) weeks

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Publication Date
Wed Jun 24 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
PALEOBATHYMETRY ANALYSIS OF LIMESTONE IN BONGOMEME REGION BASED ON CONTENT OF BENTHIC FORAMINIFERA FOSSIL, GORONTALO DISTRICT, INDONESIA
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   The location of the study area is surging hills in Bongomene area, Gorontalo, Indonesia. In this study, a geological survey and sampling were taken, and then an analysis of the content of benthic foraminifera was performed in each sample. The study aims to discover the species of benthic foraminifera fossils and to determine the paleobathymetry to the studied regions. The results of the analysis contained seven fossils species, namely Ammomassilina alveoliniformis, Stelligerum astrononion, Haynesia germanica, Nonion fabum, Praeglobobulimina ovata, Rhabdammina discreata and Saccorhiza ramosa. Based on the content of benthic foraminifera fossils, paleobathymetry is determined as Middle Shelf to Outer

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Publication Date
Mon Oct 31 2022
Journal Name
Biodiversitas Journal Of Biological Diversity
Identification of new species record of Cyanophyceae in Diyala River, Iraq based on 16S rRNA sequence data
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Abstract. Hassan FM, Mahdi WM, Al-Haideri HH, Kamil DW. 2022. Identification of new species record of Cyanophyceae in Diyala River, Iraq based on 16S rRNA sequence data. Biodiversitas 23: 5239-5246. The biodiversity and water quality of the Diyala River require screening water in terms of biological contamination, because it is the only water source in Diyala City and is used for many purposes. This study aimed to identify a new species record of Cynaophyceae and emphasize the importance of using molecular methods beside classic morphological approaches, particularly in the water-shrinkage-aqua system. Five different sites along Diyala River were selected for Cyanophyceae identification. Morphological examination and 16S rRNA sequen

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Engineering
Pilot Based Channel Estimation and Synchronization in OFDM System
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Channel estimation and synchronization are considered the most challenging issues in Orthogonal Frequency Division Multiplexing (OFDM) system. OFDM is highly affected by synchronization errors that cause reduction in subcarriers orthogonality, leading to significant performance degradation. The synchronization errors cause two issues: Symbol Time Offset (STO), which produces inter symbol interference (ISI) and Carrier Frequency Offset (CFO), which results in inter carrier interference (ICI). The aim of the research is to simulate Comb type pilot based channel estimation for OFDM system showing the effect of pilot numbers on the channel estimation performance and propose a modified estimation method for STO with less numb

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Publication Date
Thu Nov 18 2021
Journal Name
Frontiers In Public Health
Dentists' Practices and Attitudes Toward Using Personal Protection Equipment and Associated Drawbacks and Cost Implications During the COVID-19 Pandemic
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Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic.

Methods: A questionnaire-based survey was used and was divided into five sections dedicated to collect demographic variables and to examine the dentists' practices, attitudes toward PPE, drawbacks, and cost of using PPE. Mann-Whitney U and Kruskal-Wallis tests were used to compare different sections of

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Publication Date
Wed Apr 01 2015
Journal Name
Al–bahith Al–a'alami
University Youth Attitudes towards Electronic Advertisements and their Relationship to the Behavior of the Consumer A Field Study of a Sample of Students of the College of Mass-Communication / University of Baghdad as a Model
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This research aims at identifying the communicative habits and content reflections on the communication process, especially the young audience which is one of the main group for whom the announcements are made. Because young people face life with passion and aspiration making them respond to each effect used by the media in the design of the advertising using all the effective techniques, attractive methods for young children like depending on drama, technical tricks, music and logos easily to be remembered and responded to the desires of the young in their entertainment. This research also aims at identifying the impact of the internet as a channel of commercial advertising on the purchasing behavior of young people at the universities

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Global Pharma Technology
Molecular Investigation of Curli Fimbriae Genes in Enterobacter cloacae Isolated from Various Clinical Sources in Baghdad, Iraq
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Thirteen isolates were collected from various clinical sources during the periodfrom 22/10/2017 to 22/12/2017. All the isolates were diagnosed based on the microscopic and biochemical propertiesby Vitek-2 Compact system. All isolates formed biofilm 100%, with 30% of isolatesbiofilm produced strongly and 70% on medium. The results of the present study have shown the presence of Curli fimbriae genes in E. cloacae bacteria from cases of urinary tract infections, infected patient with blood bacteremia and inflammation of wounds. Curli fimbriae is considered to be an important factor in the virulence of E.cloacae bacteria, which plays an important role in adhering and combining cells on solid surfaces to form the biofilmand helps in the adhesion

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