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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 May 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Extraction of Penicillin V from Simulated Fermentation Broth by Liquid-Liquid Membrane Technique
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Liquid-liquid membrane extraction technique, pertraction, using three types of solvents (methyl isobutyl ketone, n-butyl acetate, and n-amyl acetate) was used for recovery of penicillin V from simulated fermentation broth under various operating conditions of pH value (4-6) for feed and (6-8) for receiver phase, time (0-40 min), and agitation speed (300-500 rpm) in a batch laboratory unit system. The optimum conditions for extraction were at pH of 4 for feed, and 8 for receiver phase, rotation speed of 500 rpm, time of 40 min, and solvent of MIBK as membrane, where more than 98% of penicillin was extracted. 

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Publication Date
Wed Jan 01 2014
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
Extraction of bio-active compounds extracted from Inula helenium roots by leaching process
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Leaching process applied for the extraction of bio active compounds from dried roots of (Elecampane) Inula helenium. Ethanol, hexane and distillated water were used as solvents. Roots were soaked with ethanol (5% w/v) with various concentration of ethanol (30 to 98%) at one day to know effect concentration of the solvent with concentration of bio active compound in Inula helenium. The same procedure was done using hexane as solvent. Also distilled water was used as solvent for extraction 5%(w/v) where plant material was soaked in water at different temperatures (25, 40, 65, 80, and 90) C. In all solvents undertaken, the effect of time duration on active ingredient (Thymol, Isoalatolactone, Alatolactone, 10-isobutyryl-oxy 8-9-epoxy thymol is

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Scopus
Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Engineering
Application of SWAT Model for Sediment Loads from Valleys Transmitted to Haditha Reservoir
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This study included the extraction properties of spatial and morphological basins studied using the Soil and Water Assessment Tool (SWAT) model linked to (GIS) to find the amount of sediment and rates of flow that flows into the Haditha reservoir . The aim of this study is determine the amount of sediment coming from the valleys and flowing into the Haditha Dam reservoir for 25 years ago for the period (1985-2010) and its impact on design lifetime of the Haditha Dam reservoir and to determine the best ways to reduce the sediment transport. The result indicated that total amount of sediment coming from all valleys about (2.56 * 106 ton). The maximum annual total sediment load was about (488.22 * 103 ton) in year 1988

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Publication Date
Sun Mar 20 2016
Journal Name
Al-academy
Mechanisms for Development of Scenography Galleries Iraq Natural History Museum: وعد عدنان محمود
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This paper deals with the problem of the mechanics of the operation of cinematography in the development of museum exhibition halls. In the first chapter, the researcher dealt with the problem and presented it to reach the goals and purpose of the research, which was represented in using and developing the methods and mechanisms of the presentation to keep pace with what is happening in the world of technology and access to the presented model to new formula and vision declares aesthetical and cognitive measure, thus the search constitutes an importance in absorbing Scenography dimensions in the theater and moved to the idea of the museum and the development of the display models and using them in drawing and representation of perception

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Experimental Study of Forced- Convection from Horizontal Rectangular Fins Array into Air Duct
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    In this work, an experimental study has been done to expect the heat characteristics and performance of the forced-convection from a heated horizontal rectangular fins array to air inside a rectangular cross-section duct. Three several configurations of rectangular fins array have been employed. One configuration without notches and perforations (solid) and two configurations with combination of rectangular-notches and circular-perforations for two various area removal percentages from fins namely 18% notches-9% perforations and 9% notches-18% perforations are utilized.  The rectangular fins dimensions and fins number are kept constant. The fins array is heated electrically from the base

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Publication Date
Fri Mar 01 2019
Journal Name
Optical Fiber Technology
Highly sensitive measurement of surrounding refractive index using tapered trench–assisted multicore fiber
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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
INVESTIGATION OF TWISTED TAPE TURBULATOR FOR FIRE TUBE BOILER Part I. Heat Transfer
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The present work presents a new experimental study of the enhancement of turbulent
convection heat transfer inside tubes for combined thermal and hydrodynamic entry length of one
popular “turbulator” (twisted tape with width slightly less than internal tube diameter) inserted for
fire tube boilers. Cylindrical combustion chamber was used to burn (1.6 to 7kg/h) fuel oil #2 to
deliver hot gases with ranges of Reynolds number (10500 to 21700), and (11400 to 24150) for both
empty and inserted tube respectively.A uniform wall temperature technique was used by keeping
approximately constant water temperature difference (25ºC) between inlet and exit cooling water in
parallel flow shell and tube heat exchanger. The test

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Crossref
Publication Date
Thu Dec 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Oil Removal from Wastewater of Al-Bezerqan Crude Oil Fields by Air Flotation
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Publication Date
Wed Sep 01 2010
Journal Name
Al-khwarizmi Engineering Journal
Extraction of Monocyclic Aromatic Hydrocarbons From Petroleum Products Using Sulfolane as Industrial Solvent
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            Liquid – liquid equilibria data were measured at 293.15 K for the pseudo ternary system (sulfolane + alkanol) + octane + toluene. It is observed that the selectivity of pure sulfolane increases with cosolvent methanol but decreases with increasing the chain length of hydrocarbon in 1-alkanol. The nonrandom two liquid (NRTL) model, UNIQUAC model and UNIFAC model were used to correlate the experimental data and to predict the phase composition of the systems studied. The calculation based on NRTL model gave a good representation of the experimental tie-line data for all systems studied. The agreement between the correlated and the experimental results was very good

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Publication Date
Sun Dec 01 2002
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EXTERNAL MORPHOLOGICAL STUDY OF THE LEAFHOPPER EMPOASCA DECEDENS PAOLI (HOMOPTERA: CICADELLIDAE) FROM IRAQ
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This work presents external morphological study of the leafhopper Empoasca decedens
Paoli, 1932 particularly male genitalia, which were dissected and illustrated.
The genus Empoasca Walsh (Typhlocybinae: Empoascini) contains small, slender, fragile
and generally green leafhoppers. The overall length ranges from 3-3.5 mm. Members of this
genus are charachterized by their uniformly green color, inner and outer apical cells of
forewing not attaining wing apex, second and third apical cells are sessile or triangular or
even short stalked, submarginal vein of hindwing extends around wing apex and turned
beneath costal margin, apical thirds of tibiae and tarsal segments including claws are
prominently green while other

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