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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 Jan 14 2018
Journal Name
Journal Of Engineering
Efficient Cost Management in the Housing Projects
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The cost management of cost indicators in housing projects, on the level of planning and design, is the most important quality indicators, for adoption of strategies of planning and design efficient in managing these indicators. So this research points out the need to highlight the most effective and influential cost indicators in housing projects, and to determine strategies in the management of these indicators in order to raise the efficiency of housing projects quality, to seemly the income level target group, taking into consideration the quality of housing standards, to achieve the basic requirements of housing. This paper highlights the importance of the cost  management, the types of housing cost, the method

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Publication Date
Mon Oct 17 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the incidence and the clinical significance of gray zone in the clinical phases of chronic hepatitis B infection
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Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases

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Publication Date
Sat Aug 30 2025
Journal Name
Iraqi Journal Of Science
A Face Mask Detection Method in the Era of the COVID-19 Pandemic Based on GLCM and YOLO
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In recent decades, the identification of faces with and without masks from visual data, such as video and still images, has become a captivating research subject. This is primarily due to the global spread of the Corona pandemic, which has altered the appearance of the world and necessitated the use of masks as a vital measure for epidemic prevention. Intellectual development based on artificial intelligence and computers plays a decisive role in the issue of epidemic safety, as the topic of facial recognition and identifying individuals who wear masks or not was most prominent in the introduction and in-depth education. This research proposes the creation of an advanced system capable of accurately identifying faces, both with and

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Publication Date
Tue Jul 22 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Effectiveness of Intralesional Vitamin D and Bleomycin Injections in Treating Recalcitrant Plantar Wart: A Comparative Study
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Background: Intralesional injections of vitamin D and bleomycin have gained growing clinical interest in the treatment of recalcitrant plantar warts, with pain as a major limitation associated with their use. Objective: To assess the clinical outcomes of vitamin D and bleomycin in managing treatment-resistant plantar warts. Methods: An interventional comparative study conducted on patients diagnosed with recalcitrant plantar warts over 9 months and not treated for two months. Patients were divided randomly into two groups: group A (24 patients received intralesional vitamin D) and group B (24 patients received intralesional bleomycin). The clearance rate and pain score were estimated by visual analogue scale (VAS). Results: 48 patie

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Polygamy in light of societal changes in Iraq (A Field Study in Baghdad)
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The polygamy as a social was known before Islam, has kept Islam on this system after it organized and put his controls and conditions, as justice between wives and the ability to alimony, it was not the purpose of satisfying the instinct of man and enjoyment, but his goal nominal than that, because it addresses problems humanity has goals noble, so the pluralism overlap of the fabric of families belonging to governance and benefits for women and men and society, which leads to increased ties of love between people of the same society and thus increases the cohesion and importance of the topic and its association with financial conditions have emerged as needed so you viewed in the second scientific Conference of the Department social Ser

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Publication Date
Wed Jan 01 2020
Journal Name
Aip Conference Proceedings
Developing a lightweight cryptographic algorithm based on DNA computing
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This work aims to develop a secure lightweight cipher algorithm for constrained devices. A secure communication among constrained devices is a critical issue during the data transmission from the client to the server devices. Lightweight cipher algorithms are defined as a secure solution for constrained devices that require low computational functions and small memory. In contrast, most lightweight algorithms suffer from the trade-off between complexity and speed in order to produce robust cipher algorithm. The PRESENT cipher has been successfully experimented on as a lightweight cryptography algorithm, which transcends other ciphers in terms of its computational processing that required low complexity operations. The mathematical model of

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Publication Date
Fri Dec 31 2010
Journal Name
International Journal Of Advancements In Computing Technology
A proposed Technique for Information Hiding Based on DCT
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The aim of this work is to design an algorithm which combines between steganography andcryptography that can hide a text in an image in a way that prevents, as much as possible, anysuspicion of the hidden textThe proposed system depends upon preparing the image data for the next step (DCT Quantization)through steganographic process and using two levels of security: the RSA algorithm and the digitalsignature, then storing the image in a JPEG format. In this case, the secret message will be looked asplaintext with digital signature while the cover is a coloured image. Then, the results of the algorithmare submitted to many criteria in order to be evaluated that prove the sufficiency of the algorithm andits activity. Thus, the proposed algorit

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Publication Date
Mon Sep 01 2025
Journal Name
Journal Of Information Hiding And Multimedia Signal Processing
Steganography Based on Image Compression Using a Hybrid Technique
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Information security is a crucial factor when communicating sensitive information between two parties. Steganography is one of the most techniques used for this purpose. This paper aims to enhance the capacity and robustness of hiding information by compressing image data to a small size while maintaining high quality so that the secret information remains invisible and only the sender and recipient can recognize the transmission. Three techniques are employed to conceal color and gray images, the Wavelet Color Process Technique (WCPT), Wavelet Gray Process Technique (WGPT), and Hybrid Gray Process Technique (HGPT). A comparison between the first and second techniques according to quality metrics, Root-Mean-Square Error (RMSE), Compression-

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Publication Date
Wed Mar 20 2019
Journal Name
Journal Of Legal Sciences
Sale Based on an Open Price – A Comparative Study
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The ultimate goal of any sale contract is to maximize the combined returns of the parties, knowing that these returns are not realized (in long-term contracts) except in the final stages of the contract. Therefore, this requires the parties to the contract to leave some elements open, including the price, because the adoption of a fixed price and inflexible will not be appropriate to meet their desires when contracting, especially with ignorance of matters beyond their will and may affect the market conditions, and the possibility of modifying the fixed price through The elimination is very limited, especially when the parties to the contract are equally in terms of economic strength. Hence, in order to respond to market uncertainties, the

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Publication Date
Fri Mar 31 2023
Journal Name
Journal Of Al-qadisiyah For Computer Science And Mathematics
A Cryptosystem for Database Security Based on RC4 Algorithm
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Because of vulnerable threats and attacks against database during transmission from sender to receiver, which is one of the most global security concerns of network users, a lightweight cryptosystem using Rivest Cipher 4 (RC4) algorithm is proposed. This cryptosystem maintains data privacy by performing encryption of data in cipher form and transfers it over the network and again performing decryption to original data. Hens, ciphers represent encapsulating system for database tables

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