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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 Feb 01 2023
Journal Name
Measurement: Sensors
Dynamic monitoring of saturated stiff clay soil foundation structure by falling weight deflectometer system under impact loads sensors effect
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Experiments research is done to determine how saturated stiff clayey soil responds to a single impulsive load. Models made of saturated, stiff clay were investigated. To supply the single pulse energy, various falling weights from various heights were tested using the falling weight deflectometer (FWD). Dynamic effects can range from the major failure of a sensitive sensor or system to the apparent destruction of structures. This study examines the response of saturated stiff clay soil to a single impulsive load (vertical displacement at the soil surface below and beside the bearing plates). Such reactions consist of displacements, velocities, and accelerations caused by the impact occurring at the surface depth induced by the impact loads

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Publication Date
Tue Nov 01 2022
Journal Name
Journal Of Engineering
Finite Element Modeling of One-Way Recycled Aggregate Concrete Slabs Strengthened using Near-Surface Mounted CFRPs under Repeated Loading
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This study offers numerical simulation results using the ABAQUS/CAE version 2019 finite element computer application to examine the performance, and residual strength of eight recycle aggregate RC one-way slabs. Six strengthened by NSM CFRP plates were presented to study the impact of several parameters on their structural behavior. The experimental results of four selected slabs under monotonic load, plus one slab under repeated load, were validated numerically. Then the numerical analysis was extended to different parameters investigation, such as the impact of added CFRP length on ultimate load capacity and load-deflection response and the impact of concrete compressive strength value on the structural performance of

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Publication Date
Tue Jul 29 2025
Journal Name
Plasmonics
Innovative Jet Plasma-Assisted Green Synthesis of TiO2@Ag Core–Shell Nanoparticles Using Chard Leaf Extract for Antibacterial Applications
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This study presents, for the first time, an innovative Jet Plasma-assisted technique for the green synthesis of TiO₂@Ag core–shell nanoparticles using chard leaf extract as a natural reducing and stabilizing agent. The Jet Plasma provides a highly energetic environment that accelerates nucleation and core–shell formation at low temperatures without toxic precursors. The synthesized nanoparticles exhibited uniform and stable structures, as confirmed by comprehensive characterization techniques including X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), ultraviolet–visible (UV–Vis) spectroscopy, transmission electron microscopy (TEM), and zeta potential analysis. XRD patterns confirmed the crystalline anatase

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Publication Date
Thu Feb 06 2020
Journal Name
Scientific Reports
Waste foundry sand/MgFe-layered double hydroxides composite material for efficient removal of Congo red dye from aqueous solution
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Abstract<p>We aimed to obtain magnesium/iron (Mg/Fe)-layered double hydroxides (LDHs) nanoparticles-immobilized on waste foundry sand-a byproduct of the metal casting industry. XRD and FT-IR tests were applied to characterize the prepared sorbent. The results revealed that a new peak reflected LDHs nanoparticles. In addition, SEM-EDS mapping confirmed that the coating process was appropriate. Sorption tests for the interaction of this sorbent with an aqueous solution contaminated with Congo red dye revealed the efficacy of this material where the maximum adsorption capacity reached approximately 9127.08 mg/g. The pseudo-first-order and pseudo-second-order kinetic models helped to describe the sorption measure</p> ... Show More
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Publication Date
Wed Jan 01 2014
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Reaction 32 70 70 33 Ge p n As (, ) γ Using a2-ratio Method.
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The δ-mixing of γ-transitions in 70As populated in the 32 70 70 33 Ge p n As (, ) γ reaction is calculated in the present work by using the a2-ratio methods. In one work we applied this method for two cases, the first one is for pure transition and the sacend one is for non pure transition, We take into account the experimental a2-coefficient for previous works and δ -values for one transition only.The results obtained are, in general, in a good agreement within associated errors, with those reported previously , the discrepancies that occur are due to inaccuracies existing in the experimental data of the previous works.

Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
Single Nucleotide Polymorphism of Interleukin-28β Subunit Genes Predict Host Susceptibility to Hepatitis C virus (HCV) Infection among Iraqi Patients
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Hepatitis C virus (HCV) is a liver disease that affects14 million people. Feasible research was conducted for identifying the genotypes and allele frequency of some single nucleotide polymorphisms (SNPs) of the IL-28β genes and their predictive role in disease incidence in Iraqi patients. The SNPs (rs28416813, rs4803219, rs11881222, and rs8103142) of IL-28β have been associated with susceptibility to several diseases. Ninety eight (98) HCV patients were included in this research; with average age ± SE (42.28 ± 3.44) years. Also, 80 healthy people (with average age ± SE (29.40 ± 2.84) years) were included as a control group. The SNPs were detected by allele-specific PCR (polymerase chain reaction) using specific primers. The re

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Skills of Intended Meaning behind the Context when Reading Poetry among Fifth Grade Students- Literary Branch from Teachers’ Perspectives
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        The current research aims to investigate the skills of the intended meaning beyond the context when reading poetry among fifth literary students. To achieve the aim of the research, the researcher has followed the descriptive approach and used two tools: an open questionnaire that includes an inquiry about the skills of the intended meaning beyond the poetic context, and a closed questionnaire that were examined by the juries, and modified accordingly. Besides, its validity and stability were examined by applying the study on an exploratory sample of (15) teachers to reach its final version and determine the time required to answer it. Then, the researcher applied it on the research sample of (9

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Choosing the best method for estimating the survival function of inverse Gompertz distribution by using Integral mean squares error (IMSE)
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In this research , we study the inverse Gompertz distribution (IG) and estimate the  survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes

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Publication Date
Sun Mar 06 2022
Journal Name
Nature Environment And Pollution Technology
Green Synthesis Of Bimetallic Iron/Copper Nanoparticles Using Ficus Leaves Extract For Removing Orange G(OG) Dye From Aqueous Medium
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This study shows that it is possible to fabricate and characterize green bimetallic nanoparticles using eco-friendly reduction and a capping agent, which is then used for removing the orange G dye (OG) from an aqueous solution. Characterization techniques such as scanning electron microscopy (SEM), Energy Dispersive Spectroscopy (EDAX), X-Ray diffraction (XRD), and Brunauer-Emmett-Teller (BET) were applied on the resultant bimetallic nanoparticles to ensure the size, and surface area of particles nanoparticles. The results found that the removal efficiency of OG depends on the G‑Fe/Cu‑NPs concentration (0.5-2.0 g.L-1), initial pH (2‑9), OG concentration (10-50 mg.L-1), and temperature (30-50 °C). The batch experiments showed

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Publication Date
Tue Mar 12 2024
Journal Name
مداد الآداب
“As if sky was blue”: An Eco-Marxist Reading of Caryl Churchill’s Play Not Not Not Not Not Enough Oxygen
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 Humanity is confronted with a growing array of environmental challenges that demand immediate attention and cannot be disregarded. One of the issues the world faces is air pollution, which presents a significant risk to both the environment and human well-being. The capitalist system has a great impact on the exacerbation of air pollution and environmental deterioration. This impact is reflected in Caryl Churchill’s post-apocalyptic play Not Not Not Not Not Enough Oxygen (1971). The play presents a futuristic scenario in which humanity faces grave consequences due to the polluting practices of capitalism and the unsustainable exploitation of natural resources. It depicts a future in which environmental degradation drives people

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