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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 Apr 03 2022
Journal Name
Iraqi Journal Of Laser
On the use of Aluminium as a plasmonic material in polarization rotators based on a hybrid plasmonic waveguide
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: The Aluminium (Al) material emerged as a plasmonic material in the wavelength ranges from the ultraviolet to the visible bands in different on-chip plasmonic applications. In this paper, we demonstrate the effect of using Al on the electromagnetic (EM) field distribution of a compact hybrid plasmonic waveguide (HPW) acting as a polarization rotator. We compare the performance of Al with other familiar metals that are widely used as plasmonic materials, which are Silver (Ag) and Gold (Au). Furthermore, we study the effect of reducing the geometrical dimensions of the used materials on the EM field distributions inside the HPW and, consequently, on the efficiency of the polarization rotation. We perform the study based o

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Publication Date
Wed May 22 2024
Journal Name
Clinics And Practice
Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial
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Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control site

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Publication Date
Thu Oct 31 2019
Journal Name
Al-kindy College Medical Journal
Using Zinc in Management of Subfertile Male Patients: a Clinical Trial
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Background: The use of minerals in treatment of different diseases is as old as man himself. zinc is the most famous trace mineral related to male sexual function. Oligoasthenozoospermic subfertile patients were treated with zinc sulphate for three months.

Objectives: Aim of the research is to investigate the role of Zinc and if it affects the abnormalities of some semen parameters and to study the possible role of pharmaceutical preperations of zinc in amelioration of male subfertility as well as to assess the ability of Zinc to induce changes in the serum and semen zinc levels in addition to the levels of reproductive hormones (FSH and Testosterone).

Type of the study:

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Estimation of the demand function of ration card items in the light of IMF reforms
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The ration card system is a kind of support provided by the state to individuals through the provision of essential goods at subsidized prices during the period of war or crisis. For many years, the ration card was an essential source of food supplies to Iraqis, especially under the economic siege of the nineties, But after the events of 2003 and the passage of Iraq's political and economic changes required radical reforms in the ration card system according to the recipes of the International Monetary Fund. It was evident from the estimation of the demand function that the price did not have the greatest impact on this type of goods because the ration card items are subsidized by the government. There is also a

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Publication Date
Wed Sep 27 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessing the reliability of serum macrophage migration inhibitory factor as a marker for diabetic nephropathy prediction in type 2 diabetes patients and the effect of ACE inhibitors on its level
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Abstract Diabetic nephropathy (DN) is a prevalent chronic microvascular diabetic complication. As inflammation plays a vital role in the development and progress of DN the macrophages migration inhibitory factor (MIF), a proinflammatory multifunctional cytokine approved to play a critical function in inflammatory responses in various pathologic situations like DN. This study aimed To assess serum levels of MIF in a sample of Iraqi diabetic patients with nephropathy supporting its validity as a marker for predicting nephropathy in T2DM patients. In addition, to evaluate the nephroprotective effect of angiotensin-converting enzyme (ACE) inhibitors in terms of their influence on MIF levels. This is a case-control study involving ninety

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Publication Date
Mon Dec 31 2018
Journal Name
Journal Of Theoretical And Applied Information Technology
Fingerprints Identification and Verification Based on Local Density Distribution with Rotation Compensation
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The fingerprints are the more utilized biometric feature for person identification and verification. The fingerprint is easy to understand compare to another existing biometric type such as voice, face. It is capable to create a very high recognition rate for human recognition. In this paper the geometric rotation transform is applied on fingerprint image to obtain a new level of features to represent the finger characteristics and to use for personal identification; the local features are used for their ability to reflect the statistical behavior of fingerprint variation at fingerprint image. The proposed fingerprint system contains three main stages, they are: (i) preprocessing, (ii) feature extraction, and (iii) matching. The preprocessi

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Publication Date
Thu Apr 01 2021
Journal Name
Annals Of The Romanian Society For
Relation Study between Chromogranin a and Other Clinical Biomarker in Iraqi Children with Growth Hormone Deficiency Undergo Treated Via Recombinant Growth Hormone
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Growth hormone deficiency is a condition that occurs when a limited volume of growth hormone is released by the pituitary gland since growth hormone deficiency causes growth delays, short stature, and overall physical development delays. symptoms differ based on the age at which they occur .Aim of this study Estimating the level of growth hormone serotonin ,IGF-1 and Chromogranin A before and after with treatment recombinant growth hormone and It is the first study in Iraq that sheds light on the relationship between Chromogranin and other variables ( somatostatin, IGF-1,GH) ,also the prediction of Chromogranin A as a newly biochemical marker in children with growth hormone deficiency. In this study, 30 samples were collected from children

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Publication Date
Thu Jul 01 2021
Journal Name
Applied Thermal Engineering
Consecutive charging and discharging of a PCM-based plate heat exchanger with zigzag configuration
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Publication Date
Sun May 19 2024
Journal Name
Basrah Journal Of Agricultural Sciences
Investigation on Field Performance of Plowing and Harvesting Potatoes in Southern Baghdad
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This field experiment, was conducted to investigate a comparison of two methods for harvesting potatoes: mechanical and handy when using moldboard and chisel plow for primary tillage and three different distances for planting tubers in the rows 15, 25, and 35 cm in silt clay loam soil south of Baghdad. The factorial experiment followed a randomized complete block design with three replications using L.S.D. 5 % and 1 %. Mechanical harvest recorded the best valid potato tubers at 88.78 %, marketable yield of 31.74 ton. ha-1, efficiency lifted 95.68 %, tubers damage index 28.41, speeding up the harvesting process and reducing time and effort. Handy harvest gave the least damage to potato tubers, 6.02 %, and unlifted potato tubers, 4.32 %. Howe

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Publication Date
Wed Jun 30 2021
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
THE ROLE OF SATELLITE CHANNELS IN FORMING TRAFFIC AWARENESS AND PREVENTING ACCIDENTS - A FIELD STUDY: THE ROLE OF SATELLITE CHANNELS IN FORMING TRAFFIC AWARENESS AND PREVENTING ACCIDENTS - A FIELD STUDY
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The importance of the research comes from dealing with the problem of lack of traffic awareness, which causes accidents and the occurrence of human and material losses, and the research aims to study the role of satellite channels in forming traffic awareness among the public, and a sample was chosen from Baghdad consisting of (280) individuals, male and female, and used the questionnaire tool. To obtain the data, which included several questions, the results were analyzed statistically and several results were reached, the most important of which is that there is an interest among the public in following traffic programs at a rate of one to two hours to receive information through traffic programs and to identify and apply gener

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