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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 05 2022
Journal Name
Baghdad Science Journal
An Asymptotic Analysis of the Gradient Remediability Problem for Disturbed Distributed Linear Systems
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The goal of this work is demonstrating, through the gradient observation of a   of type linear ( -systems), the possibility for reducing the effect of any disturbances (pollution, radiation, infection, etc.) asymptotically, by a suitable choice of related actuators of these systems. Thus, a class of  ( -system) was developed based on finite time  ( -system). Furthermore, definitions and some properties of this concept -system and asymptotically gradient controllable system ( -controllable) were stated and studied. More precisely, asymptotically gradient efficient actuators ensuring the weak asymptotically gradient compensation system ( -system) of known or unknown disturbances are examined. Consequently, under convenient hypo

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Engineering
Frequency Domain Analysis for Geometric Nonlinear Seismic Response of Tall Reinforced Concrete Buildings
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This paper aims to study the second-order geometric nonlinearity effects of P-Delta on the dynamic response of tall reinforced concrete buildings due to a wide range of earthquake ground motion forces, including minor earthquake up to moderate and strong earthquakes. The frequency domain dynamic analysis procedure was used for response assessment. Reinforced concrete building models with different heights up to 50 stories were analyzed. The finite element software ETABS (version 16.0.3) was used to analyze reinforced concrete building models.

The study reveals that the percentage increase in buildings' sway and drift due to P-Delta effects are nearly constant for specific building height irrespective of the seism

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Publication Date
Sun Sep 01 2019
Journal Name
10.31272/jeasd.23.5.9
EVALUATION OF HOT MIX ASPHALT CONTAINING RECLAIMED ASPHALT PAVEMENT TO RESIST MOISTURE DAMAGE
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Due to increasing cost of asphalt binder, significant economic savings can be realized by using the amount from reclaimed asphalt pavement (RAP) in the production of new hot mix asphalt (HMA). Moreover, this is an environmentally friendly option as it reduces the demand for virgin materials. It has to be remarked that in Iraq RAP is not used in the production of HMA and this valuable material is mostly degraded for use in lower value applications. Four mixtures were designed, which contains three different percent RAP, it is (0%, 5%, 15%) with asphalt grade (40-50) and (25%) with asphalt grade (60-70), it has been changed the grade of asphalt when adding RAP (25%) to compensate for the aged binder in the RAP when adding to mixture. All type

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Publication Date
Tue Nov 07 2017
Journal Name
Spe Symposium: Production Enhancement And Cost Optimisation
Wettability Alteration of Carbonate Rocks via Nanoparticle-Anionic Surfactant Flooding at Reservoirs Conditions
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Nanofluids, liquid suspensions of nanoparticles (NPs) dispersed in deionized (DI) water, brine, or surfactant micelles, have become a promising solution for many industrial applications including enhanced oil recovery (EOR) and carbon geostorage. At ambient conditions, nanoparticles can effectively alter the wettability of the strongly oil-wet rocks to water-wet. However, the reservoir conditions present the greatest challenge for the success of this application at the field scale. In this work, the performance of anionic surfactant-silica nanoparticle formulation on wettability alteration of oil-wet carbonate surface at reservoir conditions was investigated. A high-pressure temperature vessel was used to apply nano-modification of oil-wet

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Publication Date
Sat Nov 30 2024
Journal Name
Iraqi Journal Of Science
Admissible Classes of Seven-Parameter Mittag-Leffler Operatorwith Third-Order Differential Subordination Properties
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The main purpose of this paper, is to characterize new admissible classes of linear operator in terms of seven-parameter Mittag-Leffler function, and discuss sufficient conditions in order to achieve certain third-order differential subordination and superordination results. In addition, some linked sandwich theorems involving these classes had been obtained.  

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Publication Date
Sun Mar 01 2026
Journal Name
Journal Of Engineering
Heat Dissipation Performance of High-Power CPUs using Finned Copper Foam Heat Sinks
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Thermal management has become a major issue in the latest high performance computing machines because high CPU temperatures result in inefficient performance and decreased hardware life span. In this work, the cooling performance of a finned metal foam heat sink (FMFHS) was examined. The pore density values of tested copper metal foam (CMF) samples with different values of PPI 5, 10 and 20, with a constant porosity of 90%. For reference, these samples were measured by a conventional Aluminum plate-fin heat sink (CHS). The work was performed under experimental conditions in which air directed over the heat sink surface at air velocities (2.5, 3.0 and 3.5 m/s). The environmental temperature was fixed at 27 °C. Findings

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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
The Biofilm Inhibitory Potential of Compound Produced from Chlamydomonas reinhardtii Against Pathogenic Microorganisms
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Microalgae present much usefulness for antimicrobial research because of its enormous biodiversity and rapid growth rate. From this study results it is reaveled that Chlamydomonas reinhardtii were isolated from a pond of water in the province of Diwaniyah. The culture supernatants were obtained when extracted with methanol solvent. Antimicrobial activity of extracts was tested for pathogens, and the best inhibition zone obtained was against Candida albicans (32mm), S.aureus (15mm), and to E.coli (9mm). While it showed no effect against both S.epidermidis and Klebsiella spp. Biofilm was formed by all tested isolates with differences in its strength formation. The C. reinhardtii

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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
Tue Nov 01 2016
Journal Name
Renewable Energy
Biodiesel production by esterification of oleic acid over zeolite Y prepared from kaolin
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Publication Date
Tue Dec 31 2019
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Extending the storage life of some fruits by using Pullulan produced from locally isolate Aureobasidium pullulans: Extending the storage life of some fruits by using Pullulan produced from locally isolate Aureobasidium pullulans
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Six isolates of A. pullulans were collected from many sources including Hibiscus sabdariffa (Roselle), old Roofs of houses and bathroom surface that referred as Ap ros1, Ap or2, 3, 4 and Ap bs5, 6 respectively, all these isolates were identified based on morphological characteristics and nutritional physiology profiles, all were able to utilize various carbon and nitrogen sources such as glucose, xylose, sucrose, maltose, ammonium sulfate, ammonium nitrate and ammonium chloride, also they showed positive test for starch and amylase, while α-cellulose, ethanol, and methanol were could not be ass

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