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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 Jul 01 2020
Journal Name
Journal Of Engineering
Using Adaptive Neuro Fuzzy Inference System to Predict Rate of Penetration from Dynamic Elastic Properties
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Rate of penetration plays a vital role in field development process because the drilling operation is expensive and include the cost of equipment and materials used during the penetration of rock and efforts of the crew in order to complete the well without major problems. It’s important to finish the well as soon as possible to reduce the expenditures. So, knowing the rate of penetration in the area that is going to be drilled will help in speculation of the cost and that will lead to optimize drilling outgoings. In this research, an intelligent model was built using artificial intelligence to achieve this goal.  The model was built using adaptive neuro fuzzy inference system to predict the rate of penetration in

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Publication Date
Fri Jul 01 2022
Journal Name
Journal Of Oral And Maxillofacial Surgery, Medicine, And Pathology
Rhinocerebral mucormycosis: An Iraqi experience of 16 consecutive cases followed up for up ten years
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Publication Date
Sun Mar 01 2020
Journal Name
International Journal For Light And Electron Optics
Optical properties of Ag-doped nickel oxide thin films prepared by pulsed-laser deposition technique
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In this work, pure and Ag-doped nickel oxide (NiO) thin films were deposited on glass substrates with different dopant concentrations (0.1, 0.2, 0.3 and 0.4 wt.%) by pulsed-laser deposition (PLD) technique at room temperature. These films were annealed at temperature of 450 °C. The structural and optical properties of the prepared thin films were studied. It was found that annealing process has lead to increase the transmittance of the deposited films. Also, the transmittance was found to increase with doping concentration of silver in the deposited NiO films. The optical energy gap was decreased from 3.5 to 3.2 eV as the doping concentration was increased to 0.4 %.

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Publication Date
Mon Jan 01 2018
Journal Name
Matec Web Of Conferences
Assessing the performance of commercial Agisoft PhotoScan software to deliver reliable data for accurate3D modelling
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3D models delivered from digital photogrammetric techniques have massively increased and developed to meet the requirements of many applications. The reliability of these models is basically dependent on the data processing cycle and the adopted tool solution in addition to data quality. Agisoft PhotoScan is a professional image-based 3D modelling software, which seeks to create orderly, precise n 3D content from fixed images. It works with arbitrary images those qualified in both controlled and uncontrolled conditions. Following the recommendations of many users all around the globe, Agisoft PhotoScan, has become an important source to generate precise 3D data for different applications. How reliable is this data for accurate 3D mo

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Publication Date
Tue Mar 12 2019
Journal Name
Lubricants
Absorption Wavebands for Discriminating Oxidation Time of Engine Oil as Detected by FT-IR Spectroscopy
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Fourier Transform-Infrared (FT-IR) spectroscopy was used to analyze gasoline engine oil (SAE 5W20) samples that were exposed to seven different oxidation times (0 h, 24 h, 48 h, 72 h, 96 h, 120 h, and 144 h) to determine the best wavenumbers and wavenumber ranges for the discrimination of the oxidation times. The thermal oxidation process generated oil samples with varying total base number (TBN) levels. Each wavenumber (400–3900 cm−1) and wavenumber ranges identified from the literature and this study were statistically analyzed to determine which wavenumbers and wavenumber ranges could discriminate among all oxidation times. Linear regression was used with the best wavenumbers and wavenumber ranges to predict oxidation time.

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Publication Date
Sun Jan 01 2023
Journal Name
Alexandria Engineering Journal
Calcium/iron-layered double hydroxides-sodium alginate for removal of tetracycline antibiotic from aqueous solution
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Publication Date
Wed Oct 09 2024
Journal Name
Engineering, Technology &amp; Applied Science Research
Experimental Investigation of Composite Circular Encased GFRP I-Section Concrete Columns under Different Load Conditions
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Pultruded materials made of Fiber-Reinforced Polymer (FRP) come in a broad range of shapes, such as bars, I-sections, C-sections, etc. FRP materials are starting to compete with steel as structural materials owing to their great resistance, low self-weight, and cheap maintenance costs, especially in corrosive conditions. This study aims to evaluate the effectiveness of a novel concrete Composite Column (CC) using Encased I-Section (EIS) as a reinforcement in contrast to traditional steel bars by using Glass Fiber-Reinforced Polymer (GFRP) as I-section (CC-EIS) to evaluate the effectiveness of the hybrid columns which have been built by combining GFRP profiles with concrete columns. To achieve the aims of this study, nine circular co

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Publication Date
Thu Jun 01 2023
Journal Name
Chemical Physics Impact
An efficient Ag decorated CeO2 synergetic catalyst for improved catalytic reduction of lethal 4-nitrophenol
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Catalytic reduction is considered an effective approach for the reduction of toxic organic pollutants from the environment, but finding an active catalyst is still a big challenge. Herein, Ag decorated CeO2 catalyst was synthesized through polyol reduction method and applied for catalytic reduction (conversion) of 4-nitrophenol (4-NP) to 4-aminophenol (4-AP). The Ag decorated CeO2 catalyst displayed an outstanding reduction activity with 99% conversion of 4-NP in 5 min with a 0.61 min−1 reaction rate (k). A number of structural characterization techniques were executed to investigate the influence of Ag on CeO2 and its effect on the catalytic conversion of 4-NP. The outstanding catalytic performances of the Ag-CeO2 catalyst can be assigne

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Engineering
Removal of Methyl Orange from Aqueous Solutions by Adsorption Using Corn Leaves as Adsorbent Material
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A comparative study was done on the adsorption of methyl orange dye (MO) using non-activated and activated corn leaves with hydrochloric acid as an adsorbent material. Scanning electron microscopy (SEM) and Fourier Transform Infrared spectroscopy (FTIR) were utilized to specify the properties of adsorbent material. The effect of several variables (pH, initial dye concentration, temperature, amount of adsorbent and contact time) on the removal efficiency was studied and the results indicated that the adsorption efficiency increases with the increase in the concentration of dye, adsorbent dosage and contact time, while inversely proportional to the increase in pH and temperature for both the treated and untreated corn leav

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Publication Date
Thu Oct 01 2020
Journal Name
Alexandria Engineering Journal
Biodegradation of reactive dyes by some bacteria using response surface methodology as an optimization technique
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Water pollution as a result of contamination with dye-contaminating effluents is a severe issue for water reservoirs, which instigated the study of biodegradation of Reactive Red 195 and Reactive Blue dyes by E. coli and Bacillus sp. The effects of occupation time, solution pH, initial dyes concentrations, biomass loading, and temperature were investigated via batch-system experiments by using the Design of Experiment (DOE) for 2 levels and 5 factors response surface methodology (RSM). The operational conditions used for these factors were optimized using quadratic techniques by reducing the number of experiments. The results revealed that the two types of bacteria had a powerful effect on biodegradable dyes. The regression analysis reveale

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