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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 24 2020
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
NEW RECORD OF PLEUROBRACHIA PILEUS (O. F. MÜLLER, 1776) (CTENOPHORA, CYDIPPIDA) FROM CORAL REEF, IRAQI MARINE WATERS
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   The aim of this paper is to present the first record of ctenophore species Pleurobrachia pileus (O. F. Müller, 1776) in the coral reef as was recently found in Iraqi marine waters. The specimens were collected from two sites, the first was in Khor Abdullah during May 2015, and the second site was located in the pelagic water of the coral reef area, near the Al-Basrah deep sea crude oil marine loading terminal. Three samples were collected at this site during May 2015, February and March 2018 which showed that P. pileus were present at a densities of 3.0, 2.2 and 0.55 ind./ m3 respectively. The species can affect on the abundance of other zooplankton community through predation.

 

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The technique of converting multi-choice mathematical programming into linear mathematical programming to find the optimal solution
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The study deals with the issue of multi-choice linear mathematical programming. The right side of the constraints will be multi-choice. However, the issue of multi-purpose mathematical programming can not be solved directly through linear or nonlinear techniques. The idea is to transform this matter into a normal linear problem and solve it In this research, a simple technique is introduced that enables us to deal with this issue as regular linear programming. The idea is to introduce a number of binary variables And its use to create a linear combination gives one parameter was used multiple. As well as the options of linear programming model to maximize profits to the General Company for Plastic Industries product irrigation sy

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Publication Date
Sat Sep 30 2017
Journal Name
College Of Islamic Sciences
Book of Musaka (by Imam Abu al-Qasim Abdul-Karim Muhammad ibn Abd al-Karim al-Rafii)
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Al-Aziz's book was chosen as a subject for research as it is one of the important books in the Islamic world in general and the Shafi'i school in particular and its author Imam Abdul Karim bin Mohammed bin Abdul Karim Al-Rafi's, who in the doctrine of the jurisprudence has made prominent lines and left behind invaluable scientific treasures in the service of religion. Its importance is summarized as follows:
1. Being an explanation of the book (brief) of the argument of Islam Imam Ghazali (God's mercy), one of the five books adopted in Shafi'i jurisprudence.
2. His work is Imam Abu al-Qasim al-Rafii known for the brilliance of the investigation and the power of weighting in the doctrine.
3. It is considered an encyclopedia in Sh

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Publication Date
Sat Dec 02 2023
Journal Name
Journal Of Engineering
Performance Assessment of Pile Models Chemically Grouted by Low-Pressure Injection Laboratory Device for Improving Loose Sand
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The complexity and partially defined nature of jet grouting make it hard to predict the performance of grouted piles. So the trials of cement injection at a location with similar soil properties as the erecting site are necessary to assess the performance of the grouted piles. Nevertheless, instead of executing trial-injected piles at the pilot site, which wastes money, time, and effort, the laboratory cement injection devices are essential alternatives for evaluating soil injection ability. This study assesses the performance of a low-pressure laboratory grouting device by improving loose sandy soil injected using binders formed of Silica Fume (SF) as a chemical admixture (10% of Ordinary Portland Cement OPC mass) to di

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Engineering
Improving the Direction of Arrival Estimation Using the Parasitic Subspace Generated by Active-Parasitic Antenna (APA) Arrays
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The improvement in Direction of Arrival (DOA) estimation when the received signals impinge on Active-Parasitic Antenna (APA) arrays will be studied in this work. An APA array consists of several active antennas; others are parasitic antennas. The responses to the received signals are measured at the loaded terminals of the active element. The terminals of the parasitic element are shorted. The effect of the received signals on the parasites, i.e., the induced short-circuit current, is mutually coupled to the active elements. Eigen decomposition of the covariance matrix of the measurements of the APA array generates a third subspace in addition to the traditional signal and noise subspaces generated by the all-active ante

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Publication Date
Wed May 01 2019
Journal Name
Journal Of Engineering
Optimization of Friction Stir Welding Process Parameters to joint 7075-T6 Aluminium Alloy by Utilizing Taguchi Technique
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In this study, a 3 mm thickness 7075-T6 aluminium alloy sheet was used in the friction stir welding process. Using the design of experiment to reduce the number of experiments and to obtain the optimum friction stir welding parameters by utilizing Taguchi technique based on the ultimate tensile test results. Orthogonal array of L9 (33) was used based on three numbers of the parameters and three levels for each parameter, where shoulder-workpiece interference depth (0.20, 0.25, and 0.3) mm, pin geometry (cylindrical thread flat end, cylindrical thread with 3 flat round end, cylindrical thread round end), and thread pitch (0.8, 1, and 1.2) mm) this technique executed by Minitab 17 software. The results showed th

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Publication Date
Wed Feb 20 2019
Journal Name
Iraqi Journal Of Physics
The measurements of neutron Fermi Age for selected Nuclear Reactor shielding materials using the Indium foil technique
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The Neutron Fermi Age, t, and the neutron slowing down density,   q (r, t) , have been measured for some materials such as Graphite and Iron by using gamma spectrometry system UCS-30 with NaI (Tl) detector. This technique was applied for Graphite and Iron materials by using Indium foils covered by Cadmium and the measurements done at the Indium resonance of 1.46 eV. These materials are exposed to a plane 241Am/Be neutron source with recent activity 38 mCi. The measurements of the Fermi Age were found to be t = 297 ± 21 cm2 for Graphite, t = 400 ± 28 cm2 for Iron. Neutron slowing down density was also calculated depending on the recent experimental t value and distance.

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Engineering
Extraction of Manganese Element from Electric Arc Furnace Steel Slag (EAFS) by Liquid-liquid extraction (LLE) method
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This research investigates manganese (Mn) extraction from Electric Arc Furnace Steel Slag (EAFS) by using the Liquid-liquid extraction (LLE) method. The chemical analysis was done on the slag using X-ray fluorescence, X-ray diffraction, and atomic absorption spectroscopy. This work consisted of two parts: the first was an extensive study of the effect of variables that can affect the leaching process rate for Mn element from slag (reaction time, nitric acid concentration, solid to liquid ratio, and stirring speed), and the second part evaluates the extraction of Mn element from leached solution. The results showed the possibility of leaching  83.5 % of  Mn element from the slag at a temperature of 25°C, nitric acid co

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
Spectrophotometric Determination of Copper(II) using 2,2[O-Tolidine-4,4-bis azo]bis[4,5-diphenyl imidazole](MBBAI)
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            Spectrophotometric method was developed for the determination of copper(II) ion. Synthesized (2,2[O-Tolidine-4,4-bis azo]bis[4,5-diphenyl imidazole]) (MBBAI) was used as chromogenic reagent at pH=5. Various factors affecting complex formation, such as, pH effect, reagent concentration, time effect and temperature effect, have been considered and studied. Under optimum conditions concentration ranged from (5.00-80.00) µg/mL of copper(II) obeyed Beer`s Low. Maximum absorption of the complex was 409nm with molar absorpitivity 0.127x104 L mol-1 cm-1. Limit of detection(LOD) and Limit of quantification were 1.924 and 6.42 μg/mL, respectively.

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Publication Date
Sun Jun 02 2019
Journal Name
Baghdad Science Journal
New Fluorometric Method for the Determination of Ketotifen Fumarate Using Continuous Flow Injection Analysis via ISNAG-fluorimeter
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        A newly developed analytical method was conducted for the determination of Ketotifen fumarate (KTF) in pharmaceuticals drugs via quenching of continuous fluorescence of 9(10H)-Acridone (ACD). The method was applied using flow injection system of a new homemade ISNAG fluorimeter with fluorescence measurements at ± 90◦ via 2×4 solar cell. The calibration graph was linear in the range of 1-45 mmol/L, with correlation coefficient r = 0.9762 and the limit of detection 29.785 µg/sample from the stepwise dilution for the minimum concentration in the linear dynamic ranged of the calibration graph. The method was successfully applied to the determination of Ketotifen fumarate in two different pharma

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