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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
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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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 Aug 01 2023
Journal Name
Journal Of Photochemistry And Photobiology A: Chemistry
Silver oxide-zeolite for removal of an emerging contaminant by simultaneous adsorption-photocatalytic degradation under simulated sunlight irradiation
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Publication Date
Thu Dec 01 2022
Journal Name
Chemical Data Collections
Removal of an anionic Eosin dye from aqueous solution using modified activated carbon prepared from date palm fronds
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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Assessing the efficiency Economic performance of the diyala General company for electrical industries for the Period (2000-2010)
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     Facing industrial companies many pressures and challenges due to rapid changes in the business environment of contemporary, which requires them to do their performance look more inclusive rather than limiting performance evaluation on the financial perspective in spite of its importance, prompting companies to rethink their reality competitive through the adoption of methodologies and new philosophies to manage competitiveness of total quality management, and re-engineering of production processes, and knowledge management,... etc., as This study framework cognitive and practical "to evaluate the performance of a company Diyala General Electric Industries and how to rehabilitate

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Publication Date
Sun Feb 05 2017
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY THE OPTIMUM CONDITIONS FOR THE REMOVAL OF HEAVY METAL ELEMENTS FROM AQUEOUS SOLUTIONS USING CONTAMINATED BACTERIA Bacillus subtilis LOCALLY ISOLATED: STUDY THE OPTIMUM CONDITIONS FOR THE REMOVAL OF HEAVY METAL ELEMENTS FROM AQUEOUS SOLUTIONS USING CONTAMINATED BACTERIA Bacillus subtilis LOCALLY ISOLATED
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We studied the effect of certain environmental conditions for removing heavy metal elements from contaminated aqueous solutions (Cd, Cu, Pb, Fe, Zn, Ni, Cr) using the bacterium Bacillus subtilis to appoint the optimal conditions for removal ,The best optimum temperature range for two isolate was 30-35○C while the hydrogen number for the maximum mineral removal range was 6-7. The best primary mineral removal was 100 mg/L, while the maximum removal for all minerals was obtained after 6 hrs of Cu element time and the maximum removal efficiency was obtained after 24 hrs of Cu element. The results have proved that the best aeration for maximum removal was obtained at rotation speed of 150 rpm/minute. Inoculums of 5ml/100ml which contained 1

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Publication Date
Fri Aug 18 2023
Journal Name
Journal Of Research In Medical And Dental Science
Morphologic Evaluation of the Permanent Mandibular First Molar within an Iraqi Population Using Cone Beam Computed Tomography (Retrospective Study)
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Publication Date
Thu Jan 30 2025
Journal Name
Iraqi Journal Of Agricultural Sciences
FIRST RECORD OF RED ALGAE POLYSIPHONIA SUBTILISSIMA (MONTAGNE, 1840) (FAMILY: RHODOMELACEAE) COLLECTED FROM KARACHI COAST PAKISTAN (NORTHERN ARABIAN SEA).
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This study presents a detailed morphology and taxonomic study of Polysiphonia subtilissima collected from Abdul Rehman Goth, Karachi coast, Pakistan. Polysiphonia is a filamentous heterotrichous red algae, characterized by its branching structures and attachment mechanisms. P. subtilissima is notable for its broad salinity tolerance and wide distribution across marine and freshwater ecosystems. This research provides an in-depth examination of the internal and external structures of P. subtilissima, contributing to its systematic study and documenting its first recorded occurrence in Pakistani coastal areas, bordering the northern Arabian Sea. The findings enhance the understanding of the species taxonomy and its ecological role in

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Publication Date
Thu Jun 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Compared of estimating two methods for nonparametric function to cluster data for the white blood cells to leukemia patients
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Abstract:                                        

   We can notice cluster data in social, health and behavioral sciences, so this type of data have a link between its observations and we can express these clusters through the relationship between measurements on units within the same group.

    In this research, I estimate the reliability function of cluster function by using the seemingly unrelate

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