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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 Dec 01 2025
Journal Name
Results In Engineering
From the waste: High selective recovery of scandium REEs from the bauxite residue
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Bauxite residue (red mud) is a waste material from alumina refineries in the Bayer process, containing significant quantities of valuable metals, notably scandium (Sc). The objective of this study is to recover Sc (III) from Hungarian bauxite residue by using hydrometallurgical processes, including solvent extraction and leaching. Red mud directly leached with hydrochloric acid to generate the leachate solution. The significant iron content (~38 %) in red mud makes it hard to recover scandium selectively due to comparable physicochemical characteristics. According to the findings, Fe (III) could be effectively extracted from hydrochloric acid leachate as HFeC14 using diethyl ether before Sc extraction. Protocol B demonstrated superior recov

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Publication Date
Mon Sep 04 2023
Journal Name
2023 International Conference On Advanced Mechatronic Systems (icamechs)
Performance Analysis of Finite-Time Generalized Proportional Integral Observer for Uncertain Brunovsky Systems
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This paper proposes a novel finite-time generalized proportional integral observer (FTGPIO) based a sliding mode control (SMC) scheme for the tracking control problem of high order uncertain systems subject to fast time-varying disturbances. For this purpose, the construction of the controller consists of two consecutive steps. First, the novel FTGPIO is designed to observe unmeasurable plant dynamics states and disturbance with its higher time derivatives in finite time rather than infinite time as in the standard GPIO. In the FTGPO estimator, the finite time convergence rate of estimations is well achieved, whereas the convergence rate of estimations by classical GPIO is asymptotic and slow. Secondly, on the basis of the finite and fast e

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Publication Date
Mon Jan 18 2021
Journal Name
Materials Science And Engineering
Properties of engineered cementitious composite concrete (bendable concrete) produced using Portland limestone cement
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Bendable concrete, also known as Engineered Cementitious Composite (ECC) is a type of ultra-ductile cementitious composites reinforced with fibres to control the width of cracks. It has the ability to enhance concrete flexibility by withstanding strains of 3% and higher. The properties of bendable concrete mixes (compressive strength, flexural strength, and drying shrinkage) are here assessed after the incorporation of supplementary cementitious materials, silica fume, polymer fibres, and the use of ordinary Portland cement (O.P.C) and Portland limestone cement (IL). Mixes with Portland limestone cement show lower drying shrinkage and lower compressive and flexural strength than mixes with ordinary Portland cement, due to the ratio o

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Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Engineering
Abrasive Wear Characteristics of Composite Material (AA 7075 / SiC) Synthesized by Stir Casting
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Aluminum Metal Matrix Composites (ALMMCs) was prepared by using stir casting technique for AA 7075 aluminum alloy as a matrix reinforced with SiC particles at various percentages (3, 6, 9 and 12 wt. % ) and 75µm in grain size. The prepared composite material can be used for many applications such as aerospace, automobiles and many industrial sectors. Abrasive wear test was carried out by two stages: the first stage was done by changing the emery papers at various grit sizes 180, 320, 500, and 1000µm with constant applied load 15N. While the second stage was carried out by changing the applied loads 5, 10, 15, 20 and 25N with constant emery paper at 320 µm grit size. Microstructure examination, hardness test and roughn

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
Using Spatial Analysis Methods to Evaluate the Soil Contamination of Baghdad City, Iraq
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Abstract<p>The current study aims to identify soil pollutants from heavy metals The study utilized 40 topsoil (5 cm) samples, which adapted and divided into seven regions lies in Baghdad governorate, included (Al-Husainya,(Hs) Al-Doura (Do), Sharie Al-Matar (SM), Al-Waziria (Wz), Nharawan (Nh), Abu Ghraib (Abu) and Al-Mahmoodyia (Mh)). Spatial distribution maps of Nickel (Ni), Manganese (Mn), Lead (Pb) and Zinc (Zn) were created for Baghdad city using Geographic Information Systems (GIS). The concentrations of four heavy metals in the soil of different area of Baghdad were measured and observed using XRF instrument. The result found highest values of Pb and Zn at the middle of the Baghdad in (Wz</p> ... Show More
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Publication Date
Fri Jun 23 2023
Journal Name
Journal The College Of Basic Education / Al-mustansiriyah University
Numerical Solution of Non-linear Delay Differential Equations Using Semi Analytic Iterative Method
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We present a reliable algorithm for solving, homogeneous or inhomogeneous, nonlinear ordinary delay differential equations with initial conditions. The form of the solution is calculated as a series with easily computable components. Four examples are considered for the numerical illustrations of this method. The results reveal that the semi analytic iterative method (SAIM) is very effective, simple and very close to the exact solution demonstrate reliability and efficiency of this method for such problems.

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Publication Date
Thu May 28 2026
Journal Name
Journal Of Physical Education
Standard Levels of Modern Administration for the Iraqi Central Olympic Committee's Olympic Federations
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The problem of the research lies in the lack of standard levels for modern administration as a guide for evaluating weaknesses and strengths as well as finding solutions. The aim of the research lies in identifying standard levels for modern administration in Iraqi central Olympic committee and international federations. The subjects were (24) Olympic committee' federations. All procedures were standardized to fit our modern administration work. The data was collected and treated using proper statistical operations. The researcher concluded standard levels for modern administration in international federation of the Iraqi Olympic committee, in addition to that he concluded that most administrations levels ranged within four levels (good, fa

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Publication Date
Wed Oct 09 2019
Journal Name
Engineering, Technology &amp; Applied Science Research
Numerical Analysis of Segmental Post Tensioned Concrete Beams Exposed to High Fire Temperature
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The main objective of this study is to characterize the main factors which may affect the behavior of segmental prestressed concrete beams comprised of multi segments. The 3-D finite element program ABAQUS was utilized. The experimental work was conducted on twelve simply supported segmental prestressed concrete beams divided into three groups depending on the precast segments number. They all had an identical total length of 3150mm, but each had different segment numbers (9, 7, and 5 segments), in other words, different segment lengths. To simulate the genuine fire disasters, nine beams were exposed to high-temperature flame for one hour, the selected temperatures were 300°C (572°F), 500°C (932°F) and 700°C (1292°F) as recomm

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Publication Date
Mon Apr 15 2019
Journal Name
Proceedings Of The International Conference On Information And Communication Technology
Optimal control of compliant planar robot for safe impact using steepest descent technique
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Publication Date
Mon Oct 03 2016
Journal Name
International Journal Of Civil Engineering
Development of Excess Pore Water Pressure around Piles Excited by Pure Vertical Vibration
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