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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 Jun 01 2022
Journal Name
Journal Of Water Process Engineering
Antibiotics adsorption from contaminated water by composites of ZSM-5 zeolite nanocrystals coated carbon
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The presence of antibiotic residues such as ciprofloxacin (CIPR) in an aqueous environment is dangerous when their concentrations exceed the allowable. Therefore, eliminating these residues from the wastewater becomes an essential issue to prevent their harm. In this work, the potential of efficient adsorption of ciprofloxacin antibiotics was studied using eco-friendly ZSM-5 nanocrystals‑carbon composite (NZC). An inexpensive effective natural binder made of the sucrose-citric acid mixture was used for preparing NZC. The characterization methods revealed the successful preparation of NZC with a favorable surface area of 103.739 m2/g, and unique morphology and functional groups. Investigating the ability of NZC for adsorbing CIPR antibioti

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Publication Date
Sat Jun 01 2024
Journal Name
Journal Of Ecological Engineering
Using Machine Learning Algorithms to Predict the Sweetness of Bananas at Different Drying Times
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Publication Date
Mon Feb 06 2023
Journal Name
3c Tecnología_glosas De Innovación Aplicadas A La Pyme
Bond Strength Of Acrylic Soft Liner To Nd:Yag Laser-Treated Thermoplastic Acrylic Denture Base Material
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Aim of the study: Using surface roughness and tensile bond strength tests, the objective of this investigation was to ascertain the impact of laser surface modification on the binding strength of injectable thermoplastic acrylic denture base material to acrylic-based soft-liner material. Materials and methods: Acrylic base soft liner material was bonded to injectable thermoplastic acrylic resin (Deflex). Forty specimens were created (20 disc, 20 dumbbells) 10 of each specimen type as control specimens, and 10 were treated with nano pulse Nd: YAG laser. The data were analyzed using the Kruskal-Wallis test and unpaired t-test (a=.05) and the roughness test was performed utilizing a double column universal test machine. Results: Compar

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Publication Date
Mon Oct 01 2018
Journal Name
Materials Research Bulletin
Fabrication of CdSe nanoparticles sensitized TiO 2 nanotube arrays via pulse electrodeposition for photoelectrochemical application
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Publication Date
Mon May 01 2023
Journal Name
Ain Shams Engineering Journal
Neural network modeling of rutting performance for sustainable asphalt mixtures modified by industrial waste alumina
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Publication Date
Fri Dec 25 2015
Journal Name
مجلة اتحاد الجامعات العربية للدراسات والبحوث الهندسية
Smart Sensing for Variable Pressure of Oil Well Safety Valve Using Proportional Pressure Control valve
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Protection of the oil pipelineswhich extracted from the wells was found to shut the well and prevent the leakage of oil when broken using safety valve. This valve is automatically activated by loss of pressure between the well and pipelines, which take the pressure, signal from hydraulic pressure sensor through pressure control valve which has constant or variable value but it is regulated manually. The manual regulatory process requires the presence of monitoring workers continuously near the wells which are always found in remote areas. In this paper, a smart system has been proposed that work with proportional pressure control valve and also electronic pressure sensor through Arduino controller, which is programmed in a way that satisfie

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Publication Date
Mon Mar 01 2021
Journal Name
Energy Ecological Environment
Removal of pathogenic bacteria from synthetic contaminated water using packed bed silver nanoparticle-coated substrates
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In this study, a packed bed was used to remove pathogenic bacteria from synthetic contaminated water. Two types of packing material substrates, sand and zeolite, were used. These substrates were coated with silver nanoparticles (AgNPs), which were prepared by decomposition of Ag ions from AgNO3 solution. The prepared coated packings were characterized using scanning electron microscopy, energy-dispersive X-ray spectroscopy and transmission electron microscopy. The packed column consisted of a PVC cylinder of 2 cm diameter and 20 cm in length. The column was packed with silver nanoparticlecoated substrates (sand or zeolite) at a depth of 10 cm. Four types of bacteria were studied: Escherichia coli, Shigella dysenteriae, Pseudomonas aerugi

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Publication Date
Wed Dec 02 2020
Journal Name
Iraqi Journal Of Applied Physics
Characterization of Multilayer Highly-Pure Metal Oxide Structures Prepared by DC Reactive Magnetron Sputtering Technique
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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
Sun May 01 2016
Journal Name
Journal Of Multidisciplinary Engineering Science Studies
The Thickness Effects Characterization Properties Of Copper Oxide Thin Films Prepared By Thermal Evaporation Technique
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In This paper, CuO thin films having different thickness (250, 300 , 350 and 400) nm were deposited on glass substrates by thermal vacuum evaporator. The thermal oxidation of this evaporated film was done in heated glass at temperature (300 in air at one hour. The study of X-ray diffraction investigated all the exhibit polycrystalline nature with monoclinic crystal structure include uniformly grains. Thin film’s internal structure topographical and optical properties. Furthermore, the crystallization directions of CuO (35.54 , 38.70 ) can be clearly observed through an X-ray diffraction analysis XRD, Atomic Force Microscope AFM (topographic image) showed that the surface Characteristics , thin films crystals grew with increases in either

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Publication Date
Sun Mar 17 2019
Journal Name
Baghdad Science Journal
Faber Polynomial Coefficient Estimates for Subclass of Analytic Bi-Bazilevic Functions Defined by Differential Operator
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In this work,  an explicit formula for a class of Bi-Bazilevic univalent functions involving differential operator is given, as well as the determination of upper bounds for the general Taylor-Maclaurin coefficient of a functions belong to this class, are established Faber polynomials are used as a coordinated system to study the geometry of the manifold of coefficients for these functions. Also determining bounds for the first two coefficients of such functions.

         In certain cases, our initial estimates improve some of the coefficient bounds and link them to earlier thoughtful results that are published earlier.

 

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