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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
Sun Nov 01 2020
Journal Name
2020 8th Ieee Ras/embs International Conference For Biomedical Robotics And Biomechatronics (biorob)
Estimating Wrist Joint Torque Using Regression Ensemble of Bagged Trees under Multiple Wrist Postures
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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Biogas Recovery from Anaerobic Co-Digestion of Poultry House Wastes for Clean Energy Production
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Anaerobic digestion is a technology widely used for treatment of organic waste for biogas production as a source for clean energy. In this study, poultry house wastes (PHW) material was examined as a source for biogas production. The effects of inoculum addition, pretreatment of the substrate, and temperature on the biogas production were taken into full consideration. Results revealed that the effect of inoculum addition was more significant than the alkaline pretreatment of raw waste materials. The biogas recovery from inoculated waste materials exceeds its production from wastes without inoculation by approximately 70% at mesophilic conditions. Whereby, the increase of biogas recovery from pretreated wastes was by 20% higher than its

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Publication Date
Sun May 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Force decay of orthodontic elastomeric chains by using three different mechanisms simulating canine retraction
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Background: The ideal force-delivery system must: provide optimal tooth moving forces that elicit the desired effects, be comfortable and hygienic for the patient, require minimal operator manipulation and patient cooperation and provide rapid tooth movement with minimal mobility during orthodontic therapy, the elastomeric chains have the greatest potential to fulfill these requirements. Materials and Methods: This in vitro study was designed to determine the effect of three different mechanisms for canine retraction : (6-3 , 6-5-3 and chain loop ) on the load relaxation behavior of three types of elastomeric chains : (maximum clear , maximum silver and extreme silver) from the same company (Ortho Technology company) with two different bran

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Publication Date
Sun Dec 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Treatment of Waste Extract Lubricating Oil by Thermal Cracking Process to Produce Light Fractions
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This work deals with thermal cracking of three samples of extract lubricating oil produced as a by-product from furfural extraction process of lubricating oil base stock in AL-Dura refinery. The thermal cracking processes were carried out at a temperature range of 325-400 ºC and atmospheric pressure by batch laboratory reactor. The distillation of cracking liquid products was achieved by general ASTM distillation (ASTM D -86) for separation of gasoline fraction up to 220 ºC from light cycle oil fraction above 220 ºC. The comparison between the conversions at different operating conditions of thermal cracking processes indicates that a high conversion was obtained at 375°C, according to gasoline production. According to gasoline produ

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Publication Date
Mon Apr 17 2023
Journal Name
International Journal Of Veterinary Science And Medicine
Donor variability of ovine bone marrow derived mesenchymal stem cell - implications for cell therapy
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Publication Date
Sun Jun 26 2022
Journal Name
International Journal Of Early Childhood Special Education
Analysis of the Chemistry Book for the third intermediate grade according to environmental ethics
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Abstract The current research aimed at analyzing the content of the chemistry book for the third intermediate grade according to environmental ethics. The two researchers adopted the descriptive analytical approach, as the research community and its sample of the chemistry book for the third intermediate grade, approved by the Iraqi Ministry of Education for the academic year (2021-2022). The two researchers built a list ( +- standard) of environmental ethics, which included three main areas ( ethics of protecting the environment from pollution, ethics of protecting environmental resources from consumption (rationalization of consumption) and protecting living organisms, and the ethics of environmental literacy), and then derived from it (

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Performance Evaluation of Mobility Models over UDP Traffic Pattern for MANET Using NS-2
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  The current study presents the simulative study and evaluation of MANET mobility models over UDP traffic pattern to determine the effects of this traffic pattern on mobility models in MANET which is implemented in NS-2.35 according to various performance metri (Throughput, AED (Average End-2-end Delay), drop packets, NRL (Normalize Routing Load) and PDF (Packet Delivery Fraction)) with various parameters such as different velocities, different environment areas, different number of nodes,  different traffic rates, different traffic sources, different pause times and different simulation times .  A routing protocol.…was exploited AODV(Adhoc On demand Distance Vector) and RWP (Random Waypoint), GMM (Gauss Markov Model), RPGM (Refere

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Publication Date
Mon Sep 30 2024
Journal Name
Iraqi Journal Of Materials
Characterization of Multilayer Highly-Pure Metal Oxide Structures Prepared by DC Reactive Magnetron Sputtering
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In this work, multilayer nanostructures were prepared from two metal oxide thin films by dc reactive magnetron sputtering technique. These metal oxide were nickel oxide (NiO) and titanium dioxide (TiO2). The prepared nanostructures showed high structural purity as confirmed by the spectroscopic and structural characterization tests, mainly FTIR, XRD and EDX. This feature may be attributed to the fine control of operation parameters of dc reactive magnetron sputtering system as well as the preparation conditions using the same system. The nanostructures prepared in this work can be successfully used for the fabrication of nanodevices for photonics and optoelectronics requiring highly-pure nanomaterials.

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Publication Date
Fri Jul 21 2023
Journal Name
Journal Of Engineering
Quality Evaluation of Al-Rasheed Ready Concrete Mixture Plant By Using Six Sigma Approach
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The objective of this research work is to evaluate the quality of central concrete plant of Al-Rasheed Company by using Six Sigma approach which is a measure of quality that strives for near elimination of defects using the statistical methods to improve outputs that are critical to customers. The fundamental objective of Six Sigma methodology is the implementation of a measurement-based strategy that focuses on process improvement and variation reduction to reach delighting customers, and then suggesting an improvement system to improve the production of concrete in Al-Rasheed State Contracting Construction Company.
A field survey includes two parts (open and close questionnaire) that aimed to get the data and information required f

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Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Study the random walking of the ISX60 market index For the Iraq Stock Exchange
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This paper aimed to test random walking through the ISX60 market index for the ability to judge market efficiency at a weak level. The study used Serial Correlation Test, the Runs Test, the Variance Ratio Test, as well as the Rescaled Range Test.The population of the study represents of Iraq Stock Exchange. The study concluded accepting the hypothesis of the study that the returns of the ISX60 market index in the Iraqi market for securities does not follow the random walking in general and as a result the Iraq market for securities is inefficient within the weak level of efficiency and the study recommended need a supervisors work in the Iraqi market for securities to activate all means a which will work to communication with information

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