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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
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 Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional program on patients with ulcerative colitis adherence for Medication and Diet to prevent Colorectal Cancer: case and control study
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ABSTRACT:

Objectives: The study aims to know the effectiveness of the educational program in the patient’s adherence to medication and diet and to know the relationship between the effectiveness of the education program and their demographic data related to the patient’s age, gender, marital status, education level, occupation, monthly income and residence.

Methodology: A quasi -experimental design study was performed on patient who attended to Gastroenterology and Hepatology Teaching Hospital, from March 2021 to September 2021. The non-probability sampling including 50 patients for case study and 30 patients for control group. The questionnaire consists of 3 parts, part one the socio

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Publication Date
Mon Apr 01 2024
Journal Name
Medical Journal Of Babylon
Clinical Evaluation and Comparison between Effects of Rituximab and Prednisolone with Imuran to Neutrophils and Platelet Counts in Pemphigus Vulgaris Patients
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Background: Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV. Objectives: This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine). Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory. Results

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Publication Date
Fri Dec 01 2023
Journal Name
Case Studies In Construction Materials
Enhancing asphalt binder performance through nano-SiO2 and nano-CaCO3 additives: Rheological and physical insights
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During the last two decades, nanomaterial application has gained a significant attraction into asphalt technology due to their effect in enhancing asphalt binder improving the asphaltic mixture. This study will modify the asphalt binder with two different nano types, nano SiO2 and CaCO3, at levels ranging from 1% to 7%. The resulting optimum nano-modified Asphalt will be subject to a series of rheological tests, including dynamic shear rheometer (DSR), Viscosity, and bending beam rheometer (BBR) to determine asphalt binder sensitivity towards low-medium-high temperature range. Results indicate that both nano types improved the physical characteristics of Asphalt, and 5% by weight of Asphalt was suggested as a reasonable dosage of nano-SiO2

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Engineering
A Proposal Algorithm to Solve Delay Constraint Least Cost Optimization Problem
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Traditionally, path selection within routing is formulated as a shortest path optimization problem. The objective function for optimization could be any one variety of parameters such as number of hops, delay, cost...etc. The problem of least cost delay constraint routing is studied in this paper since delay constraint is very common requirement of many multimedia applications and cost minimization captures the need to
distribute the network. So an iterative algorithm is proposed in this paper to solve this problem. It is appeared from the results of applying this algorithm that it gave the optimal path (optimal solution) from among multiple feasible paths (feasible solutions).

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using Mehar method to change fuzzy cost of fuzzy linear model with practical application
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  Many production companies suffers from big losses because of  high production cost and low profits for several reasons, including raw materials high prices and no taxes impose on imported goods also consumer protection law deactivation and national product and customs law, so most of consumers buy imported goods because it is characterized by modern specifications and low prices.

  The production company also suffers from uncertainty in the cost, volume of production, sales, and availability of raw materials and workers number because they vary according to the seasons of the year.

  I had adopted in this research fuzzy linear program model with fuzzy figures

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Forced displacement in Iraq its causes and its effects on displaced families (A field study of displaced families to the city of Baghdad)
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After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th

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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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