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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 Feb 07 2022
Journal Name
Cogent Engineering
A partial image encryption scheme based on DWT and texture segmentation
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Publication Date
Fri Mar 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Improving the Effectiveness of Internal Control System In Accordance with COSO Model
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        The research aims to improve the effectiveness of internal control system according to a model COSO, by identifying the availability of system components according to the model and then improve the effectiveness of each component by focusing on areas for improvement in each component, as it was addressed to a model COSO and then Maamth with the environment, the current Iraqi by introducing some improvements on the form of some mechanisms of corporate governance of the Council of Directors, and senior management, the Audit Committee, Committee appointments, especially that supplies application available in the laws and legislation, the current Iraqi, taking into consideration to make some

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of intellectual capital on sustainable competitive performance: field research in a sample of private colleges
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Abstract:

                  This research seeks to test the influence of intellectual capital as an explanatory variable and its components (human capital, structural capital, relational capital) and sustainable competitive performance as a responsive variable and its components (reducing service delivery cycle time, rapid response to market demand, increasing customer satisfaction, providing better Quality of service, increasing market share)” through a field study, and here the research problem was diagnosed in an attempt to answer the following question: Is there awareness among the senior management within the private colle

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Servant Leadership and its Impact on the Effectiveness of Teamwork
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   The research problem stems from the suffering of organizations from the weakness of their organizing aspect and the weak influence of the leadership on the subordinates and their dispersion. Organizations today are in rapid development and therefore work relations are not dominated by the humanitarian aspect and the first goal has become productivity. The research aims to identify the influence of servant leadership and its dimensions as an independent variable on the effectiveness of work teams as an approved variable and their importance increases when these organizations are service organizations, and how their influence increases when this leadership is the servant leadership and its dimensions in the Health Depa

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Publication Date
Tue Apr 01 2025
Journal Name
Georgian Medical News
THE EFFECT OF SOFT ROBOTIC GLOVE ON THE FLEXION AND EXTENSION OF HAND FOR STROKE PATIENTS: A CLINICAL TRIAL
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Background: Stroke defined by diminished cerebral blood flow, results in brain damage and neurological impairments. It often leads to considerable difficulties, such as limited mobility and compromised hand function, usually manifesting as a weakening in the ability to open and shut the hand. Objective: The study evaluates the differences between opening and closing hands when utilizing a soft robot. Methods: The study was conducted in the Mosul Specialist Rehabilitation Center which involved 68 participants, all over 20 years old, with visual impairments. The Iranian Clinical Trials Registry and Ministry of Planning approved the study, The Fugl-Meyer Assessment for Upper Extremity Action Research Arm Test, and Arm Motor Ability Test were

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Publication Date
Tue Jan 01 2019
Journal Name
The Turkish Journal Of Endocrinology And Metabolism
Cell-free DNA as a Clinical Indicator in Maternal Blood
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As many expensive and invasive procedures are used for the diagnosis or follow-up of clinical conditions, the measurement of cell-free DNA is a promising, noninvasive method, which considers using blood, follicular fluid, or seminal fluid. This method is used to determine chromosomal abnormalities, genetic disorders, and indicators of some diseases such as polycystic ovary syndrome, pre-eclampsia, and some malignancies. Cell-free DNA, which are DNA fragments outside the nucleus, originates from an apoptotic process. However, to be used as a marker for the previously mentioned diseases is still under investigation. We discuss some aspects of using cell-free DNA measurements as an indicator or marker for pathological conditions.

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Fri Dec 03 2021
Journal Name
Baghdad Journal Of Biochemistry And Applied Biological Sciences
A clinical-statistical study on COVID-19 infection and death status at the Alshifaa Healthcare Center/ Baghdad
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Background: COVID-19 is an ongoing disease that caused, and still causes, many challenges for humanity. In fact, COVID-19 death cases reached more than 4.5 million by the end of August 2021, although an improvement in the medical treatments and pharmaceutical protocols was obtained, and many vaccines were released. Objective: To, statistically, analyze the data of COVID-19 patients at Alshifaa Healthcare Center (Baghdad, Iraq). Methods: In this work, a statistical analysis was conducted on data included the total number, positive cases, and negative cases of people tested for COVID-19 at the Alshifaa Healthcare Center/Baghdad for the period 1 September – 31 December 2020. The number of people who got the test was 1080, where 424 w

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Publication Date
Mon Mar 02 2020
Journal Name
Journal Of Applied Research In Higher Education
Proposal of a guide for talent evaluation and management based on a qualitative and three-staged approach
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Purpose

The key objective of the study is to understand the best processes that are currently used in managing talent in Australian higher education (AHE) and design a quantitative measurement of talent management processes (TMPs) for the higher education (HE) sector.

Design/methodology/approach

The three qualitative multi-method studies that are commonly used in empirical studies, namely, brainstorming, focus group discussions and semi-structured individual interviews were considered. Twenty-three individuals from six Australian universities parti

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Publication Date
Wed Dec 15 2021
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Recipient Jaw and Implant Dimensions on Pre- and Post- Loading Dental Implant Stability: A Prospective Clinical Study
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Background: Implant stability is a mandatory factor for dental implant (DI) osseointegration and long-term success. The aim of this study was to evaluate the effect of implant length, diameter, and recipient jaw on the pre- and post-functional loading stability. Materials and methods: This study included 17 healthy patients with an age range of 24-61 years. Twenty-two DI were inserted into healed extraction sockets to replace missing tooth/ teeth in premolar and molar regions in upper and lower jaws. Implant stability was measured for each implant and was recorded as implant stability quotient (ISQ) immediately (ISQ0), and at 8 (ISQ8) and 12 (ISQ12) weeks postoperatively, as well as post-functional loading (ISQPFL). The pattern of implant

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