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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
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Synthesis of New Heterocyclic Derivatives from 4-(3, 5-Dimethyl-1-phenyl-1H-pyrazol-4-ylazo)- benzoic acid
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In this work pyrazolin derivatives were prepared from the diazonium chloride salt of 4-aminobenzoic acid. Azo compounds were prepared from the reaction of an ethanolic solution of sodium acetate and calculated amount of active methylene compound namely, acetyl acetone to obtain the corresponding hydrazono derivative (1). Cyclocondensation reaction of compounds (1) with hydrazine hydrate and phenyl hydrazine in boiling ethanol affording the corresponding pyrazoline-5-one derivatives of 4-aminobenzoic acid (2,3). Then compound (3) was reacted with thionyl chloride to give the corresponding acid chloride derivative(4), followed by conversion into the corresponding acid hydrazide derivative (5) carboxylic acid thiosemicarbazide (11), esters

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Publication Date
Thu Sep 01 2016
Journal Name
Journal Of Engineering
Calculating the Transport Density Index from Some of the Productivity Indicators for Railway Lines by Using Neural Networks
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The efficiency evaluation of the railway lines performance is done through a set of indicators and criteria, the most important are transport density, the productivity of enrollee, passenger vehicle production, the productivity of freight wagon, and the productivity of locomotives. This study includes an attempt to calculate the most important of these indicators which transport density index from productivity during the four indicators, using artificial neural network technology. Two neural networks software are used in this study, (Simulnet) and (Neuframe), the results of second program has been adopted. Training results and test to the neural network data used in the study, which are obtained from the international in

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Publication Date
Fri Jan 25 2019
Journal Name
Journal Of Al-qadisiyah For Computer Science And Mathematics Vol
Predicate the Ability of Extracorporeal Shock Wave Lithotripsy (ESWL) to treat the Kidney Stones by used Combined Classifier
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Extracorporeal Shock Wave Lithotripsy (ESWL) is the most commonplace remedy for kidney stone. Shock waves from outside the body frame are centered at a kidney stone inflicting the stone to fragment. The success of the (ESWL) treatment is based on some variables such as age, sex, stone quantity stone period and so on. Thus, the prediction the success of remedy by this method is so important for professionals to make a decision to continue using (ESWL) or tousing another remedy technique. In this study, a prediction system for (ESWL) treatment by used three techniques of mixing classifiers, which is Product Rule (PR), Neural Network (NN) and the proposed classifier called Nested Combined Classi

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of The College Of Languages (jcl)
Das Drama ( Minna von Barnhelm) von Lessing Eine analytische Studie Vorgelegt von The play of Minna von Barnhelm
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Zusammenfassung: Das Drama " Minna von Barnhelm von Lessing ist ein weltbekannts Drama, das in verschiedene Sprachen übersetzt wurde. Es beschreibt die Schwierigkeiten eines Offiziers, der bestraft wurde. Er verlor seinen Job und auch seine Ehre. Minna ist seine Verlobte, die ihn suchte und auch neben ihm stehen wollte. Trotzdem sie ihm in einem Hotel zufällig begegnete, hatten die beide immer noch Probleme. Am Ende des Dramas könnten sie alle ihrer Probleme lösen und hatten schönes Ende.

 

Abstract:
Mina von Barnhelm is a German play written by the author ( Lessing ) , it's a well-known comedy play that was translated into many languages including Arabic language .
This play is about a

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Publication Date
Thu Feb 29 2024
Journal Name
Iraqi Journal Of Science
Finding the Exact Solution of Kepler’s Equation for an Elliptical Satellite Orbit Using the First Kind Bessel Function
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     In this study, the first kind Bessel function was used to solve Kepler equation for an elliptical orbiting satellite. It is a classical method that gives a direct solution for calculation of the eccentric anomaly. It was solved for one period from (M=0-360)° with an eccentricity of (e=0-1) and the number of terms from (N=1-10). Also, the error in the representation of the first kind Bessel function was calculated. The results indicated that for eccentricity of (0.1-0.4) and (N = 1-10), the values of eccentric anomaly gave a good result as compared with the exact solution. Besides, the obtained eccentric anomaly values were unaffected by increasing the number of terms (N = 6-10) for eccentricities (0.8 and 0.9). The Bessel

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Publication Date
Tue Jan 01 2019
Journal Name
Research Journal Of Pharmacy And Technology
New Mode Semi-Automated Turbidimetric Determination of Mefenamic Acid by Ayah 6SX1-ST-2D Solar cell-CFI Analyser
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Publication Date
Fri Sep 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Removal of Ciprofloxacin Antibiotic from Synthesized Aqueous Solution Using Three Different Metals Nanoparticles Synthesized Through the Green Method
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This study investigates the possibility of removing ciprofloxacin (CIP) using three types of adsorbent based on green-prepared iron nanoparticles (Fe.NPs), copper nanoparticles (Cu. NPS), and silver nanoparticles (Ag. NPS) from synthesized aqueous solution. They were characterized using different analysis methods. According to the characterization findings, each prepared NPs has the shape of a sphere and with ranges in sizes from of 85, 47, and 32 nanometers and a surface area of 2.1913, 1.6562, and 1.2387 m2/g for Fe.NPs, Cu.NPs and Ag.NPs, respectively. The effects of various parameters such as pH, initial CIP concentration, temperature, NPs dosage, and time on CIP removal were investigated through batch experiments. The res

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Design of PV Solar Energy Generator using MPPT Technique to Control Single Input/Multiple Outputs (DC-DC) Converter
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The paper presents the design of a system consisting of a solar panel with Single Input/Multiple Outputs (DC-DC) Buck Converter by using Simulink dialogue box tools in MATLAB software package for simulation the system. Maximum Power Point Tracking (MPPT) technique depending on Perturb and Observe (P&O) algorithm is used to control the output power of the converter and increase the efficiency of the system. The characteristics of the MSX-60 PV module is chosen in design of the system, whereas the electrical characteristics (P-V, I-V and P-I curves) for the module are achieved, that is affected by the solar radiation and temperature variations. The proposed design module has been found to be stable for any change in atmospheric tempera

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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Laser
Hong-Ou-Mandel Dip Measurements of Two Independent Weak Coherent Pulses for Free Space Quantum Key Distribution Systems
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Preparation of identical independent photons is the core of many quantum applications such as entanglement swapping and entangling process. In this work, Hong-Ou-Mandel experiment was performed to evaluate the degree of indistinguishability between independent photons generated from two independent weak coherent sources working at 640 nm. The visibility was 46%, close to the theoretical limit of 50%. The implemented setup can be adopted in quantum key distribution experiments carried out with free space as the channel link, as all the devices and components used are operative in the visible range of the electromagnetic spectrum.

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Publication Date
Mon Mar 23 2020
Journal Name
Journal Of Engineering
Utilization of Glycerol for Glycerol Carbonate Synthesis via Transesterfication Reaction over Bio-Char Catalyst prepared from reed plant
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Biodiesel production process was attracted more attention recently due to the surplus quantity of glycerol (G) as a byproduct from the process. Glycerol Utilization must take in to consideration to fix this issue also, to ensure biodiesel industry sustainability. Highly amount of Glycerol converted to more benefit material Glycerol carbonate (GC) was one of the most allurement compound derived from glycerol by transesterification of glycerol with dimethyl carbonate (DMC). Various parameters have highly impact on transesterification was investigated like catalyst loading (1-5) %wt., molar ratio of DMC: glycerol (5:1 – 1:1), reaction time (30 - 150) min and temperature (40 – 80) ᴼC. The Optimum glycerol carbonate yie

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