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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
Thu May 21 2026
Journal Name
Aip Conference Proceedings
Solving linear fractional Fredholm integro-differential equations using linear programming method via different types of polynomials
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This article introduces a novel procedure to detect an approximate solution to Fredholm fractional integro-differential equations with linear type (LFFIDE) defined using Caputo fractional derivative. The new procedure approximates the solution using three types of polynomials: Laguerre polynomials, Hermite polynomials, and Legendre polynomials, thereafter transforming the problem into a linear programming problem. The approximate solutions are compared using testing examples to examine the efficiency of the suggested approach. Also, a comparison with the other methods using the same polynomials illustrates The effectiveness and consistency of the proposed technique. Finally, the error analysis of the proposed technique and convergent are di

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Publication Date
Sat Dec 20 2025
Journal Name
Bulletin Of The Iraq Natural History Museum
DNA BARCODING OF NORTH AFRICAN CATFISH CLARIAS GARIEPINUS (BURCHELL, 1822) (SILURIFORMES, CLARIIDAE) FROM TIGRIS RIVER, IRAQ
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The conservation for biodiversity in Iraqi freshwater environments is important to protecting native species from the environmental impacts of alien species. Clarias gariepinus (Burchell, 1822) (Siluriformes, Clariidae) has been recognized as an alien species in Iraqi water bodies. This study aims to use molecular DNA to identify this catfish and trace its origins using. The DNA sequences of C. gariepinus were done using the mitochondrial DNA cytochrome c oxidase subunit 1 (COI) gene, and a specific primer set. The polymerase chain reaction (PCR) amplification was used to align the COI gene as a barcoding marker. After analysis, the sequences were compared with sequences in the National Center for Biology Information (NCBI) database

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Risks assessment for the retrieval of radioactive waste from the old Russian cemetery Al -Tuwaitha site
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In this work the radioactive wastes in the Old Russian
Cemetery Al -Tuwaitha site were classified according to risks for
workers who are involved in the retrieval process. The exposure
assessment results expressed as estimates of radionuclide intakes by
inhalation and ingestion, exposure rates and duration for external
exposure pathways, and committed effective dose equivalents to
individuals from all relevant radionuclides and pathways. Results
showed the presence of natural radionuclides Ra-226, Th-234 and K-
40, as well as the produced radionuclide Cs-137 and Eu-152 in the
cemetery wells. The absorbed doses from the waste were classified to
two categories; exempt waste and low level waste according to

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Removal of Dissolved Trivalent Chromium Ions from Contaminated Wastewater using Locally Available Raw Scrap Iron-Aluminum Waste
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The present study is to investigate the possibility of using wastes in the form of scrap iron (ZVI) and/ or aluminum ZVAI for the detention and immobilization of the chromium ions in simulated wastewater. Different batch equilibrium parameters such as contact time (0-250) min, sorbent dose (2-8 g ZVI/100 mL and 0.2-1 g ZVAI/100 mL), initial pH (3-6), initial pollutant concentration of 50 mg/L, and speed of agitation (0-250) rpm were investigated. Maximum contaminant removal efficiency corresponding to (96 %) at 250 min contact time, 1g ZVAI/ 6g ZVI sorbent mass ratio, pH 5.5, pollutant concentration of 50 mg/L initially, and 250 rpm agitation speed were obtained.

The best isotherm model for the batch single Cr(III) uptake by ZVI

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Crossref (12)
Crossref
Publication Date
Mon Sep 21 2026
Journal Name
Journal Of Physical Education
Using of special exercises to mtaulp speed to pass the test (150×20) for women football referees
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Publication Date
Sun Sep 02 2012
Journal Name
Baghdad Science Journal
Evaluation of bread wheat Triticum aestivum L. callus genotypes for water stress tolerance using Polyethylene Glycol (PEG)
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A fixed callus weight of 150 mg was induced from immature embryos of three bread wheat Triticum aestivum L. genotypes (Tamos 2, El-izz and Mutant 1) cultured on nutrient medium {MS) containing Polyethylene glycol (PEG-6000) supplemented with concentrations (0.0, 3.0, 6.0, 9.0 or 12.0%) to evaluate their tolerance to water stress. Cultures were incubated in darkness at temperature of 25?1 ?C. Callus fresh and dry weights were recorded and soluble Carbohydrate and the amino acid Proline concentrations were determined. Results showed that there were significant differences in studied parameters among bread wheat genotypes of which Tamos 2 was higher in callus average fresh and dry weights which gave 353.33 and 38.46 mg/cultured tube respecti

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Crossref
Publication Date
Sun Apr 02 2017
Journal Name
International Workshop In Physics Applications
Antifungal activity of wide band gap Thioglycolic acid capped ZnS:Mn semiconductor nanoparticles against some pathogenic fungi(Article)
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The manganese doped zinc sulfide nanoparticles were synthesized by simple aqueous chemical reaction of manganese chloride, zinc acetate and thioacitamide in aqueous solution. Thioglycolic acid is used as capping agent for controlling the nanoparticle size. The main advantage of the ZnS:Mn nanoparticles of diameter ~ 2.73 nm is that the sample is prepared by using non-toxic precursors in a cost effective and eco-friendly way. The structural, morphological and chemical composition of the nanoparticles have been investigated by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM) with energy dispersion spectroscopy (EDS) and Fourier transform infrared (FTIR) spectroscopy. The nanosize of the prepared nanoparticles was elucidated by Scan

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Publication Date
Mon Sep 01 2014
Journal Name
Al-khwarizmi Engineering Journal
Comparison of Fatigue Life Behavior between Two Different Composite Materials Subjected to Shot Peening at Different Times
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This paper investigated the fatigue life behavior of two composite materials subjected to different times of shot peening (2, 4 and 6 min).The first material prepared from unsaturated polyester with E-glass reinforcement by 33% volume fraction. While, the second one was prepared from unsaturated polyester with aluminum powder by2.5% volume fraction. The experimental results showed that the improvement in endurance limit was obtained (for the first material) at 2, 4 and 6 min shot peening times where the percentage of maximum improvement was 25% at shot peening time of 6 min. While, the endurance limit of the second material decreased at shot peening times of 2, 4 and 6 min where the percentage of maximum reduction was 29 % at shot peenin

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Publication Date
Thu Jan 01 2009
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multiple Mixing Ratios of Gamma Rays Erγ)nEr(n, From 168 168 Reaction  Using a2 – Ratio Method
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The -mixing of  - transition in Er 168 populated in Er)n,n(Er 168168  reaction is calculated in the present work by using a2- ratio method. This method has used in previou studies [4, 5, 6, 7] in case that the second transition is pure or for that transition which can be considered as pure only, but in one work we applied this method for two cases, in the first one for pure transition and in the 2nd one for non pure transitions. We take into accunt the experimental a2- coefficient for p revious works and -values for one transition only [1]. The results obtained are, in general, in agood agreement within associated errors, with those reported previously [1], the discrepancies that occur are due to inaccuracies existing

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Publication Date
Wed Jul 11 2018
Journal Name
دراسات تربوية
Understanding the nature of the scientific endeavor among chemistry teachers according to the Educational Reform Project 2061
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