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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
Tue Dec 22 2020
Journal Name
Lecture Notes In Civil Engineering
Geometric Nonlinear Synthetic Earthquake Analysis of Base Isolated Tall Steel Buildings Under Site-Specific Seismic Loading
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Publication Date
Mon Jan 01 2018
Journal Name
Al–bahith Al–a'alami
News website Analytical: study of news sites (Iraqi Media network, The Seventh Day,Huffington Post Arabic
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This research focuses on the services provided by news websites (IMN, Youm7, Huffington Post Arabic) to its audience of Internet users, as well as materials posted through its pages, trying to monitor and explain them to identify their types & features, and it›s functions, whether informational or non-informational, to know the technical potential of each of the news sites, with the entry of the latest technology information. The research used the analysis method to achieve the research objectives within the period from 1/1 to 31/1/2017. The researchers used the content analysis tool as a research tool to analyze the news sites and to know the services they provide through their pages. The research was divided into three parts, the

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Publication Date
Fri May 01 2015
Journal Name
Journal Of Engineering
Use of non-Conventional Material to Remove Cu+2 ions from Aqueous Solutions using Chemical Coagulation
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Coagulation - flocculation are basic chemical engineering method in the treatment of metal-bearing industrial wastewater because it removes colloidal particles, some soluble compounds and very fine solid suspensions initially present in the wastewater by destabilization and formation of flocs. This research was conducted to study the feasibility of using natural coagulant such as okra and mallow and chemical coagulant such as alum for removing Cu and increase the removal efficiency and reduce the turbidity of treated water. Fourier transform Infrared (FTIR) was carried out for okra and mallow before and after coagulant to determine their type of functional groups. Carbonyl and hydroxyl functional groups on the surface of

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Publication Date
Fri Sep 30 2016
Journal Name
Al-khwarizmi Engineering Journal
Modeling the removal of Cadmium Ions from Aqueous Solutions onto Olive Pips Using Neural Network Technique
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The uptake of Cd(II) ions from simulated wastewater onto olive pips was modeled using artificial neural network (ANN) which consisted of three layers. Based on 112 batch experiments, the effect of contact time (10-240 min), initial pH (2-6), initial concentration (25-250 mg/l), biosorbent dosage (0.05-2 g/100 ml), agitation speed (0-250 rpm) and temperature (20-60ºC) were studied. The maximum uptake (=92 %) of Cd(II) was achieved at optimum parameters of 60 min, 6, 50 mg/l, 1 g/100 ml, 250 rpm and 25ºC respectively.

Tangent sigmoid and linear transfer functions of ANN for hidden and output layers respectively with 7 neurons were sufficient to present good predictions for cadmium removal efficiency with coefficient of correlatio

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Publication Date
Mon Oct 14 2019
Journal Name
Applied Sciences
Synthesis of Novel Heteroatom-Doped Porous-Organic Polymers as Environmentally Efficient Media for Carbon Dioxide Storage
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The high carbon dioxide emission levels due to the increased consumption of fossil fuels has led to various environmental problems. Efficient strategies for the capture and storage of greenhouse gases, such as carbon dioxide are crucial in reducing their concentrations in the environment. Considering this, herein, three novel heteroatom-doped porous-organic polymers (POPs) containing phosphate units were synthesized in high yields from the coupling reactions of phosphate esters and 1,4-diaminobenzene (three mole equivalents) in boiling ethanol using a simple, efficient, and general procedure. The structures and physicochemical properties of the synthesized POPs were established using various techniques. Field emission scanning elect

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Publication Date
Wed Jun 19 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Disclosure of deferred taxes according to IAS-12: بحث تطبيقي في الهيئة العامة للضرائب قسم الشركات
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The research aims to clarify the importance of adoption of International Accounting  Standard No. (12) "Income Taxes" as a tool for the measurement and disclosure of income taxes in the financial statements، and how to deal with the differences that arise as a result of difference in net profit accounting for net tax profit ،The problem of the research focused on the disparity between the income tax estimate in Iraq in accordance with the accounting standards and financial reporting and assessment of income tax in accordance with the tax laws and legislation, this discrepancy has led to the emergence of differences between accounting profit and tax profit (temporary differences and permanent differences) and these differences of w

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Publication Date
Sat Jun 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Corrosion Inhibition of Carbon Steel under Two Phase Flow (Water-Petroleum) Simulated by Turbulently Agitated System
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The corrosion of carbon steel in single phase (water with 0.1N NaCl ) and two immiscible phases (kerosene-water) using turbulently agitated system is investigated. The experiments are carried out for Reynolds number (Re) range of 38000 to 95000 corresponding  to rotational velocities from 600 to 1400 rpm using circular disk turbine agitator at 40 0C. In two-phase system test runs are carried out in aqueous phase (water) concentrations of 1 % vol., 5 % vol., 8% vol., and 16% vol. mixed with kerosene at various Re. The effect of Reynolds number (Re), percent of dispersed phase, dispersed drops diameter, and number of drops per unit volume on the corrosion rate is investigated and discussed. Test runs are carried out using two types of

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Publication Date
Thu Jun 30 2011
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
CORRELATION FOR SOLUTION GAS -OIL RATIO OF IRAQI OILS AT PRESSURES BELOW THE BUBBLE POINT PRESSURE
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The solution gas-oil ratio is an important measurement in reservoir engineering calculations. The correlations are used when experimental PVT data from particular field are missing. Additional advantages of the correlations are saving of cost and time.
This paper proposes a correlation to calculate the solution gas -oil ratio at pressures below bubble point pressure. It was obtained by multiple linear regression analysis of PVT data collected from many Iraqi fields.
In this study, the solution gas-oil ratio was taken as a function of bubble point pressure, stock tank oil gravity, reservoir pressure, reservoir temperature and relative gas density.
The construction of the new correlation is depending on thirty seven PVT reports th

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering Science And Technology
Green synthesis of iron nanoparticle using tea leave extract for removal ciprofloxacin (CIP) from aqueous medium
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The approach of green synthesis of bio-sorbent has become simple alternatives to chemical synths as they use for example plant extracts, plus green synthesis outperforms chemical methods because it is environmentally friendly besides has wide applications in environmental remediation. This paper investigates the removal of ciprofloxacin (CIP) using green tea nano zero-valent iron (GT-NZVI) in an aqueous solution. The synthesized GT-NZVI was categorized using SEM, AFM, BET, FTIR, and Zeta potentials techniques. The spherical nanoparticles were found to be nano zero-valent, with an average size of 85 nm and a surface area of 2.19m2/g. The results showed that the removal efficiency of ciprofloxacin depends on the initial pH (2.5-10),

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Publication Date
Thu Dec 26 2019
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
FIRST RECORD OF THE CELLAR SPIDER GENUS NITA HUBER & EL-HENNAWY, 2007 (ARANEAE, PHOLCIDAE) FROM IRAQ
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    The current study presents the cellar spiders genus Nita Huber & El-Hennawy, 2007 (Araneae, Pholcidae) as the first record for Iraq spider fauna, this genus represented by the species Nita elsaff Huber & El-Hennawy, 2007 were identified based on morphological characteristics and DNA sequence data. A short morphological description is also presented for cellar spiders listed in Iraq; including this species in addition to Artema Atlanta Walckenaer, 1837.

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