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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 Jan 01 2015
Journal Name
Journal Of Engineering
Reinforcement of Asphalt Concrete by Polyester Fibers to Improve Flexural Bending Fatigue Resistance
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Reinforcing asphalt concrete with polyester fibers considered as an active remedy to alleviate the harmful impact of fatigue deterioration. This study covers the investigation of utilizing two shapes of fibers size, 6.35 mm by 3.00 mm and 12.70 mm by 3.00 mm with mutual concentrations equal to 0.25 %, 0.50 % and 0.75 % by weight of mixture. Composition of asphalt mixture consists of different optimum (40-50) asphalt cement content, 12.50 mm nominal aggregate maximum size with limestone dust as a filler. Following the traditional asphalt cement and aggregate tests, three essential test were carried out on mixtures, namely: Marshall test (105 cylindrical specimens), indirect tensile strength test (21 cylindrical specimens)

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Publication Date
Wed Sep 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Time Dependent Behavior of Engineered Cementitious Composite Concrete Produced from Portland Limestone Cement
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Publication Date
Thu Mar 30 2023
Journal Name
College Of Islamic Sciences
The science of premeditation for Islamic scholars: Its causes, controls, etiquette, scientific effects
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Abstract

This study came to clarify the redemption in terms of being a method and a subject of knowledge that has its causes, controls, etiquette and scientific implications for Muslim scholars.

The science of redemption has a historical extension, starting from the era of the Companions - may God be pleased with them - and through the stages of codification and classification of works in an effort to document it and diversify its methods at the inductive, analytical, critical and argumentative levels, and to determine its causes and from the completion of the research conclude it with evidence of its scientific effects because it is a science that enriched the Islamic library in general, and hadith in particular.

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Publication Date
Tue May 01 2012
Journal Name
2012 Second International Conference On Digital Information And Communication Technology And It's Applications (dictap)
The compact Genetic Algorithm for likelihood estimator of first order moving average model
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Recently Genetic Algorithms (GAs) have frequently been used for optimizing the solution of estimation problems. One of the main advantages of using these techniques is that they require no knowledge or gradient information about the response surface. The poor behavior of genetic algorithms in some problems, sometimes attributed to design operators, has led to the development of other types of algorithms. One such class of these algorithms is compact Genetic Algorithm (cGA), it dramatically reduces the number of bits reqyuired to store the poulation and has a faster convergence speed. In this paper compact Genetic Algorithm is used to optimize the maximum likelihood estimator of the first order moving avergae model MA(1). Simulation results

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Some Properties of Carbon Fiber Reinforced Magnetic Reactive Powder Concrete Containing Nano Silica
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         This study involves the design of 24 mixtures of fiber reinforced magnetic reactive powder concrete containing nano silica. Tap water was used for 12 of these mixtures, while magnetic water was used for the others. The nano silica (NS) with ratios (1, 1.5, 2, 2.5 and 3) % by weight of cement, were used for all the mixtures. The results have shown that the mixture containing 2.5% NS gives the highest compressive strength at age 7 days. Many different other tests were carried out, the results have shown that the carbon fiber reinforced magnetic reactive powder concrete containing 2.5% NS (CFRMRPCCNS) had higher compressive strength, modulus of rupture, splitting tension, str

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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Production of Methyl Ester (Biodiesel) from Used Cooking Oils via Trans-esterification process
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Used cooking oil was undergoing trans-esterification reaction to produce biodiesel fuel. Method of production consisted of pretreatment steps, trans-esterification, separation, washing and drying. Trans-esterification of treated oils was studied at different operation conditions, the methanol to oil mole ratio were 6:1, 8:1, 10:1, and 12:1, at different temperature 30, 40, 50, and 60 º C, reaction time 40, 60, 80, and 120 minutes, amount of catalyst 0.5, 1, 1.5, and 2 wt.% based on oil and mixing speed 400 rpm. The maximum yield of biodiesel was 91.68 wt.% for treated oils obtained by trans-esterification reaction with 10:1 methanol to oil mole ratio, 60 º C reaction temperature, 80 minute reactio

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Engineering
Accuracy Evaluation of Digital Elevation Model Created Using Handheld Global Positioning System Receivers
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This study aims to assess the accuracy of digital elevation model (DEM) created with utilization of handheld Global Positioning System (GPS) and comparing with Advanced Spaceborne Thermal Emission and Reflection Radiometer Global Digital Elevation Model (ASTER GDEM), version 2. It is known that the quality of the DEM is affected by both of accuracy of elevation at each pixel (absolute accuracy) and accuracy of presented morphology (relative accuracy). The University of Baghdad, Al Jadriya campus was selected as a study area to create and analysis the resulting DEM. Additionally, Geographic Information System (GIS) was used to visualize, analyses and interpolate GPS track points (elevation data) of the study area. In this

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
Improving the productivity of single effect double slope solar still by modification simple
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The present paper is an experimental study to improve the productivity of the conventional solar still. This done by modifying conventional still in a way that the distilled basin is larger than distillation basin, thus providing an increase in the condensation surface and speeding up the condensation process. Moreover, increase in the dimensions of the distilled base helps coupling reflective panels to the distilled base to reflect incident solar radiation to the distillation basin. For this purpose , two solar stills were made, one conventional designand another made according to the proposed design. The two solar stills were tested during the period from February to July 2009 under varying weather conditions of Basra, Iraq (latitude o

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Publication Date
Fri Sep 01 2017
Journal Name
International Journal Of Science And Nature
FREQUENCY OF LOW BIRTH WEIGHT AMONG NEONATES ADMITTEDTO THE NEONATAL INTENSIVE CARE UNIT
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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Women's knowledge about Family Planning Methods at Omer Sawi Teaching Hospital
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Objectives:This study aimed to identify women perception and experience regarding family planning(FP) methods

 Methodology:Descriptive cross-sectional hospital based study,was conducted at Omer Sawi teaching hospital,from august to September 2019.Sample of 320 women, were selected randomly after their agreement.Data were collected through interview questionnaire and analyzed using a statistical package for social sciences (SPSS)and descriptive and inferential statistical methods were used.With accepted P.< 0.05.for the correlation significant. 

Results:Age group between 21-25 years represent (53.1%),most common education levels were secondary school 56%.Majority of women had 2-5 children.Half of the wo

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