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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 Jan 01 2020
Journal Name
Medico-legal Update
Flexible ureterorenoscopy versus extracorporeal shock wave lithotripsy for treatment of lower pole renal stones
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Publication Date
Sun Jan 01 2023
Journal Name
8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
Preliminary quality assurance of printgrammetry technique-3D modeling from Google Earth 3D imagery data
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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
An Improved Cuckoo Search Algorithm for Maximizing the Coverage Range of Wireless Sensor Networks
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The issue of increasing the range covered by a wireless sensor network with restricted sensors is addressed utilizing improved CS employing the PSO algorithm and opposition-based learning (ICS-PSO-OBL). At first, the iteration is carried out by updating the old solution dimension by dimension to achieve independent updating across the dimensions in the high-dimensional optimization problem. The PSO operator is then incorporated to lessen the preference random walk stage's imbalance between exploration and exploitation ability. Exceptional individuals are selected from the population using OBL to boost the chance of finding the optimal solution based on the fitness value. The ICS-PSO-OBL is used to maximize coverage in WSN by converting r

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Publication Date
Wed Mar 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Catalytic Conversion of Glucose into 5-hydroxymethyl furfural over Spent Dry Batteries as Catalysts
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Biomass is a popular renewable carbon source because it has a lot of potential as a substitute for scarce fossil fuels and has been used to make essential compounds like 5-hydroxymethylfurfural (HMF). One of the main components of biomass, glucose, has been extensively studied as a precursor for the production of HMF. Several efforts have been made to find efficient and repeatable procedures for the synthesis of HMF, a chemical platform used in the manufacturing of fuels and other high-value compounds. Sulfonated graphite (SG) was produced from spent dry batteries and utilized as a catalyst to convert glucose to 5-hydroxymethylfurfural (HMF). Temperature, reaction time, and catalyst loading were the variables studied. When dimethyl sulfo

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Publication Date
Wed Apr 30 2025
Journal Name
Iraqi Journal Of Science
Calculating the Variation of the Universal Parameter (Variable) Using Kepler's Equation for Different Orbits
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Stumpff functions are an infinite series that depends on the value of z. This value results from multiplying the reciprocal semi-major axis with a universal anomaly. The purpose from those functions is to calculate the variation of the universal parameter (variable) using Kepler's equation for different orbits. In this paper, each range for the reciprocal of the semi-major axis, universal anomaly, and z is calculated in order to study the behavior of Stumpff functions C(z) and S(z). The results showed that when z grew, Stumpff functions for hyperbola, parabola, and elliptical orbits were also growing. They intersected and had a tendency towards zero for both hyperbola and parabola orbits, but for elliptical orbits, Stumpff functions

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Publication Date
Wed Jun 27 2018
Journal Name
Journal Of The College Of Education For Women
The Referential Aspect of the Quranic Text Az-Zahraa’s)Peace Be Upon Her( Speech
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In the present paper, the researcher attempts to shed some light on the objective behind inserting some Qur'anic verses by Al-Zahraa (Peace Be Upon Her) in her revered speech. Besides, it tries to investigate the hidden meaning of these verses and to study them in the light of pragmaticreferences. This task is supported by Books of Tafseer as well as the books that explained this speech to arrive at its intended meaning. It is possible say that this is astep towards studying speeches of 'Ahlul Bayt' (People of the Prophet's household) in terms of modern linguistic studies, as well as employing modern methods to explore the aesthetic values of these texts.

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Publication Date
Thu Dec 01 2022
Journal Name
Structural Concrete
Enhancement of RC T‐beams toughness using laced stirrups reinforcement for blast response predictions
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Publication Date
Wed Sep 01 2021
Journal Name
Iraqi Journal Of Physics
The Thermal Properties of Gliding arc Plasma Produced by Laboratory Reverse Vortex Flow System
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A low-cost reverse flow plasma system powered by argon gas pumping was built using homemade materials in this paper. The length of the resulting arc change was directly proportional to the flow rate, while using the thermal camera to examine the thermal intensity distribution and demonstrating that it is concentrated in the centre, away from the walls at various flow rates, the resulting arc's spectra were also measured. The results show that as the gas flow rate increased, so did the ambient temperature. The results show that the medium containing the arc has a maximum temperature of 34.1 ˚C at a flow rate of 14 L/min and a minimum temperature of 22.6 ˚C at a flow rate of 6 L/min.

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Microscopic study of nuclear structure for some Si-isotopes using Skyrme-Hartree-Fock-method
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In this paper the nuclear structure of some of Si-isotopes namely, 28,32,36,40Si have been studied by calculating the static ground state properties of these isotopes such as charge, proton, neutron and mass densities together with their associated rms radii, neutron skin thicknesses, binding energies, and charge form factors. In performing these investigations, the Skyrme-Hartree-Fock method has been used with different parameterizations; SkM*, S1, S3, SkM, and SkX. The effects of these different parameterizations on the above mentioned properties of the selected isotopes have also been studied so as to specify which of these parameterizations achieves the best agreement between calculated and experimental data. It can be ded

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
PROJECT MANAGEMENT OF BALAD`S MAJOR SEWERAGE SYSTEM BY USING THE GOAL PROGRAMMING METHOD
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Abstract

          The project of balad's major sewerage system is one of the biggest projects who is still in progress in salahulddin province provincial - development plan that was approved in 2013 . This project works in two parts ; the 1st is installing the sewerage networks (both of heavy sewerage & rain sewerage) and the 2nd is installing the     life – off units (for heavy sewerage & rain sewerage , as well) . the directorate of salahuiddin is aiming that at end of construction it will be able to provide services for four residential quarters , one of the main challenges that project's  management  experience is how to achieve thes

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