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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
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Hydrodesulfurization of Iraqi Atmospheric Gasoil by Ti-Ni-Mo/γ-Al2O3 Prepared Catalyst
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This study investigates the improvement of Iraqi atmospheric gas oil characteristics which contains 1.402 wt. % sulfur content and 16.88 wt. % aromatic content supplied from Al-Dura Refinery by using hydrodesulfurization (HDS) process using Ti-Ni-Mo/γ-Al2O3 prepared catalyst in order to achieve low sulfur and aromatic saturation gas oil. Hydrodearomatization (HDA) occurs simultaneously with hydrodesulfurization (HDS) process. The effect of titanium on the conventional catalyst Ni-Mo/γ-Al2O3 was investigated by physical adsorption and catalytic activity test.Ti-Ni-Mo/γ-Al2O3 catalyst was prepared under vacuum impregnation condition to ensure efficient pr

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Publication Date
Wed Mar 30 2016
Journal Name
College Of Islamic Sciences
Problematic understanding of the question "What I overlooked something about you" when Sibweh
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This research is an attempt to unveil the cover and unveil a matter that has become mysterious to those who came after Sibweh of the grammar scholars; It took place as a result of the work of the scribes.

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Engineering
Fabrication Of TiO2 , V2O5 Thin Film (Super Hydrophobic Surface )By Powder Coating Technique
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In this research, deposition of titanium oxide (TiO2) and vanadium oxide (V2O5) thin film  in different mixing percentage  (0, 25 ,50, 75 and100)%   on the substrate of glass .The coating thickness was ( 50 nm  ).

In this research contact angle was measured and the effect of weather conditions. Results showed that the value of the contact angle of the prepared films reached its highest value at 50% (TiO2+V2O5) was 160º.

The results showed that the optical transmittance of TiO2 and V2O5 thin film decrease with increasing the deposition angle and decrease with increasing V2O5 pro

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Publication Date
Wed Jul 05 2023
Journal Name
Chalcogenide Letters
Optimization physical properties of CdTe /Si solar cell devices fabricated by vacuum evaporation
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We investigated at the optical properties, structural makeup, and morphology of thin films of cadmium telluride (CdTe) with a thickness of 150 nm produced by thermal evaporation over glass. The X-ray diffraction study showed that the films had a crystalline composition, a cubic structure, and a preference for grain formation along the (111) crystallographic direction. The outcomes of the inquiry were used to determine these traits. With the use of thin films of CdTe that were doped with Ag at a concentration of 0.5%, the crystallization orientations of pure CdTe (23.58, 39.02, and 46.22) and CdTe:Ag were both determined by X-ray diffraction. orientations (23.72, 39.21, 46.40) For samples that were pure and those that were doped with

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Preparation of Vaccine against Diabetic Foot Pathogenic Bacteria Using Low Level Diode Laser
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Background: Since the invention of laser in 1960, lasers have been developed and approved in many fields. Lasers can now be regarded as practical tools with unique properties that have been utilized effectively in several applications in fields of medical and biological sciences.Objectives: The aim of the current study was to preparation of vaccines (live attenuated and killed) by irradiation of the bacteria by the low level diode laser.Methods: six bacterial isolates were isolated from human samples of diabetic foot infections, which used for preparation of vaccines. The experiment was conducted on fifteen adult male rabbits; they were divided into three groups with 5 rabbits each. Blood samples were collected from the marginal ear vein

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Publication Date
Fri Mar 01 2019
Journal Name
Iraqi Journal Of Physics
Enhancement of NO2 gas sensing behavior for ZnS/PPy nanostructure by loading graphene
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The pure ZnS and ZnS-Gr nanocomposite have been prepared
successfully by a novel method using chemical co-precipitation. Also
conductive polymer PPy nanotubes and ZnS-PPy nanocomposite
have been synthesized successfully by chemical route. The effect of
graphene on the characterization of ZnS has been investigated. X-ray
diffraction (XRD) study confirmed the formation of cubic and
hexagonal structure of ZnS-Gr. Dc-conductivity proves that ZnS and
ZnS-Gr have semiconductor behavior. The SEM proved that
formation of PPy nanotubes and the Gr nanosheet. The sensing
properties of ZnS-PPy/ZnS-Gr for NO2 gas was investigated as a
function of operating temperature and time under optimal condition.
The sensitivity,

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
“The Strategic Partnership to Strategic Leadership of Upgrade Higher Education Quality (Global Perspective)”
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The higher education has become an enterprise integrate system that described as knowledge society, the essential part in its electronic and virtual format in the shadow of globalization challenges with its various dimensions . Until the logical ryles aboat a strategic partnership between the Iraqi higher education establishments and their international equivalent ones Strategic windows should be invested for the purpose of enhancing the quality of higher education in a sustainable way. This forms a challenge before the international education leaders on the social, operational and establishment's level to determinte knowledge gap, observing, diagnosing and processing in the present and future, e

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Publication Date
Wed Jan 01 2020
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees20
Opto- electrical properties of p-SnSe:S/N-Si heterojunction for solar cell application
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Publication Date
Mon Nov 01 2010
Journal Name
Iraqi Journal Of Physics
New Technique for Treatment of the dust accumulation from PV solar panels surface
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One of the most important problems facing the world today is the energy problem. The solution was in finding renewable energy sources such as solar energy. The solar energy applications in Iraq is facing many problems . One of the most important problems is the accumulation of dust on the solar panels surface which causes decreasing its performance sharply. In the present work, a new technique was presented by using two-axis solar tracking system to reduce the accumulated dust on the solar panel surface and compared it with the fixed solar panels which installed at tilt angles 30° and 45°. The results indicated that the maximum losses of the output power due to accumulation of dust on the fixed solar panels is about 31.4% and 23.1% res

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Publication Date
Fri Jun 30 2017
Journal Name
Journal Of Engineering
Adsorption of Mefenamic Acid From Water by Bentonite Poly urea formaldehyde Composite Adsorbent
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Poly urea formaldehyde –Bentonite (PUF-Bentonite) composite was tested as new adsorbent
for removal of mefenamic acid (MA) from simulated wastewater in batch adsorption
procedure. Developed a method for preparing poly urea formaldehyde gel in basic media by
using condensation polymerization. Adsorption experiments were carried out as a function of
water pH, temperature, contact time, adsorbent dose and initial MA concentration .Effect of
sharing surface with other analgesic pharmaceuticals at different pH also studied. The
adsorption of MA was found to be strongly dependent to pH. The Freundlich isotherm model
showed a good fit to the equilibrium adsorption data. From Dubinin–Radushkevich model the
mean free

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