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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 Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Using Genetic Algorithm to Estimate the Parameters of the Gumbel Distribution Function by Simulation
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In this research, the focus was on estimating the parameters on (min- Gumbel distribution), using the maximum likelihood method and the Bayes method. The genetic algorithmmethod was employed in estimating the parameters of the maximum likelihood method as well as  the Bayes method. The comparison was made using the mean error squares (MSE), where the best  estimator  is the one who has the least mean squared error. It was noted that the best estimator was (BLG_GE).

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Publication Date
Wed Apr 19 2017
Journal Name
Iraqi Dental Journal
Matching the Iris Color of Ocular Prosthesis Using an Eye Contact Lens: New Technique
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Publication Date
Wed Dec 01 2021
Journal Name
Iraqi Journal Of Physics
Optical, Structural, Morphological Properties of Chromium (III) Oxide Nanostructure Synthesized Using Spray Pyrolysis Technique
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Nanostructure of chromium oxide (Cr2O3-NPs) with rhombohedral structure were successfully prepared by spray pyrolysis technique using Aqueous solution of Chromium (III) chloride CrCl3 as solution. The films were deposited on glass substrates heated to 450°C using X-ray diffraction (XRD) shows the nature of polycrystalline samples. The calculated lattice constant value for the grown Cr2O3 nanostructures is a = b = 4.959 Å & c = 13.594 Å and the average crystallize size (46.3-55.6) nm calculated from diffraction peaks, Spectral analysis revealed FTIR peak characteristic vibrations of Cr-O Extended and Two sharp peaks present at 630 and 578 cm-1 attributed to Cr-O “stretching

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Experimental Study to Investigate the Effect of Polyacrylamide Gel to Reduce the Lost Circulation
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One of the challenging issues encountered during drilling operations is the lost circulation. Numerous issues might arise because of losses, such as wasting of time and higher drilling cost. Several types of lost circulation materials have been developed and are being used to limit mud losses and avoid associated issues. Each solution has benefits and drawbacks.

In this study, a core flooding test was performed to study the effectiveness of polyacrylamide (PAM) granular gel on the reduction of the circulation lost. One common type of fracture characteristic is fractures with tips, commonly known as partially open fracture (POF). However, PAM gel therapy in POFs received little attention in prior research. Models of partly open fra

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Publication Date
Wed Dec 28 2022
Journal Name
Structural Concrete
Enhancement of RC T‐beams toughness using laced stirrups reinforcement for blast response predictions
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Abstract<p>The dynamic behavior of laced reinforced concrete (LRC) T‐beams could give high‐energy absorption capabilities without significantly affecting the cost, which was offered through a combination of high strength and ductile response. In this paper, LRC T‐beams, composed of inclined continuous reinforcement on each side of the beam, were investigated to maintain high deformations as predicted in blast resistance. The beams were tested under four‐point loading to create pure bending zones and obtain the ultimate flexural capacities. Transverse reinforcement using lacing reinforcement and conventional vertical stirrups were compared in terms of deformation, strain, and toughness changes of the tes</p> ... Show More
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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Environmental Engineering And Science
Fenton-like degradation of direct blue dye using green synthesised Fe/Cu bimetallic nanoparticles
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This study relates to synthesis of bentonite-supported iron/copper nanoparticles through the biosynthesis method using eucalyptus plant leaf extract, which were then named E-Fe/Cu@B-NPs. The synthesised E-Fe/Cu@B-NPs were examined by a set of experiments involving a heterogeneous Fenton-like process that removed direct blue 15 (DB15) dye from wastewater. The resultant E-Fe/Cu@B-NPs were characterised by scanning electron microscopy, Brunauer–Emmet–Teller analysis, zeta potential analysis, Fourier transform infrared spectroscopy and atomic force microscopy. The operating parameters in batch experiments were optimised using Box–Behnken design. These parameters were pH, hydrogen peroxide (H2O2

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Publication Date
Thu Feb 01 2018
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Performance of composite unprotected steel Beam-deck floor exposed to high temperature (fire flame)
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An experimental program was conducted to determine the residual of composite Steel Beams-Reinforced Concrete (SB-RC) deck floors fabricated from a rolled steel beam topped with a reinforced concrete slab, exposed to high temperatures (fire flame) of 300, 500, and 700ºC for 1 hour, and then allowed to cool down by leaving them in the lab condition to return to the ambient temperature. The burning results showed that, by exposing them to a fire flame of up to 300ºC, no serious permanent deflection occurred. It was also noticed that the specimen recovered 93% of 19.2 mm of the deflection caused by burning. The recovered deflection of burned composite SB-RC deck floor at 500ºC was 40% of 77.9 mm of the deflection caused by burning with a res

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Publication Date
Thu Aug 25 2016
Journal Name
International Journal Of Mathematics Trends And Technology
Pretest Single Stage Shrinkage Estimator for the Shape Parameter of the Power Function Distribution
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Publication Date
Wed Nov 01 2017
Journal Name
International Journal Of Greenhouse Gas Control
Wettability of nano-treated calcite/CO2 /brine systems: Implication for enhanced CO2 storage potential
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Nanofluids are proven to be efficient agents for wettability alteration in subsurface applications including enhanced oil recovery (EOR). Nanofluids can also be used for CO2-storage applications where the CO2-wet rocks can be rendered strongly water-wet, however no attention has been given to this aspect in the past. Thus in this work we presents contact angle (θ) measurements for CO2/brine/calcite system as function of pressure (0.1 MPa, 5 MPa, 10 MPa, 15 MPa, and 20 MPa), temperature (23 °C, 50 °C and 70 °C), and salinity (0, 5, 10, 15, and 20% NaCl) before and after nano-treatment to address the wettability alteration efficiency. Moreover, the effect of treatment pressure and temperature, treatment fluid concentration (SiO2 wt%) and

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Publication Date
Mon Aug 03 2020
Journal Name
Rawal Medical Journal
Functional outcomes of sandwich reconstruction technique for giant cell tumor around the knee joint
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Objective: To evaluate the functional outcomes after extended curettage and reconstruction using a combination of bone graft and bone cement (sandwich). Methodology: In this prospective case series 16 skeletally mature patients with primary giant cell tumor around the knee were included. Patients with previous surgically treated, malignant transformation, degenerative knee changes and those presenting with pathological fracture were excluded. The tumor was excised with bone graft filling space beneath the articular cartilage and a block of gel foam was placed over the cortical surface of picked bone graft. Remaining cavity was filled with polymethylmethacrylate cement (sandwich) with or without internal fixation. The func tional evaluation

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