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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 Oct 01 2008
Journal Name
Saudi Medical Journal
The therapeutic and prophylactic role of oral zinc sulfate in management of recurrent aphthous stomatitis (ras) in comparison with dapsone.
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KE Sharquie, RA Najim, RK Al-Hayani, AA Al-Nuaimy, DM Maroof, Saudi medical journal, 2008 - Cited by 74

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Building a mathematical model of the transportation problem under the dynamics of demand restrictions with practical application
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Abstract\

In this research we built a mathematical model of the transportation problem  for data of General Company for Grain Under the environment of variable demand ,and situations of incapableness to determining the supply required quantities as a result of economic and commercial reasons, also restrict flow of grain amounts was specified to a known level by the decision makers to ensure that the stock of reserves for emergency situations that face the company from decrease, or non-arrival of the amount of grain to silos , also it took the capabilities of the tanker into consideration and the grain have been restricted to avoid shortages and lack of processing capability, Function has been adopted

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Engineering
Synchronous Buck Converter with Perturb and Observe Maximum Power Point Tracking Implemented on a Low-Cost Arduino-microcontroller
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Maximum power point tracking (MPPT) is used in photovoltaic (PV) systems to enhance efficiency and maximize the output power of PV module, regardless the variation of temperature, irradiation, and the electrical characteristics of the load. A new MPPT system has been presented in this research, consisting of a synchronous DC-DC step-down Buck converter controlled by an Arduino microcontroller based unit. The MPPT process with Perturb and Observe method is performed with a DC-DC converter circuit to overcome the problem of voltage mismatch between the PV modules and the loads. The proposing system has high efficiency, lower cost and can be easily modified to handle more energy sources. The test results indicate that the u

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Publication Date
Fri Oct 31 2025
Journal Name
The Iraqi Geological Journal
Improving Carbonate Reservoir Development Decision: A Study of Controlling Factors Based on Geological and Engineering Objectives, Halfaya Oil Field
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Detecting the optimum layer for well placement, which requires a diverse assortment of tools and techniques, represents a significant challenge in petroleum studies due to its critical impact on minimizing drilling costs and time. This study aims to evaluate integrated geological, petrophysical, seismic, and geomechanical data to identify the optimum zones for well placement. Three different reservoirs were analyzed to account for lateral and vertical variations in reservoir properties. The integrated data from these reservoirs provides many tools for reservoir development, especially to detect appropriate well placement zones based on evaluations of reservoir and geomechanical quality. The Mechanical Earth Model (MEM) was construct

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Publication Date
Thu Jun 08 2023
Journal Name
Iraqi Journal Of Laser
PDF Lab-On-a-Chip an integrated microfluidic device sensitive low-Cost, and Rapid with a syringe pump for Analysis of Ibuprofen
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Abstract: Microfluidic devices present unique advantages for the development of efficient drug assay and screening. The microfluidic platforms might offer a more rapid and cost-effective alternative. Fluids are confined in devices that have a significant dimension on the micrometer scale. Due to this extreme confinement, the volumes used for drug assays are tiny (milliliters to femtoliters).

 In this research, a microfluidic chip consists of micro-channels carved on substrate materials built by using Acrylic (Polymethyl Methacrylate, PMMA) chip was designed using a Carbon Dioxide (CO2) laser machine. The CO2 parameters have influence on the width, depth, roughness of the chip. In order to have regular

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of a teaching program based on the McCarthy Model (4MAT) in developing creative writing skills and reflective thinking among university students
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The aim of this study was to determine the effect on using the McCarthy Model (4MAT) for developing creative writing skills and reflective thinking among undergraduate students. The quasi-experimental approach was adopted. And, in order to achieve the study objective, the educational content of Teaching Ethics (Approach 401), for the plan for the primary grades teacher preparation program  was dealt with by using a teaching program based on the McCarthy Model (4MAT) was used.

The study which was done had been based on the academic achievement test for creative writing skills, and the reflective thinking test. The validity and reliability of the study tools were also confirmed. The study was applied to a sample consisting of

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Publication Date
Mon Nov 03 2025
Journal Name
Frontiers In Dental Medicine
Effects of cavity depth (moderate vs. deep with pulp exposure) on the release of prostaglandin E2 and nitric oxide in rat mandibular incisors
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Background/objectives: Inflammatory mediators such as prostaglandin E2 (PGE2) and nitric oxide (NO) are key indicators of pulp response to mechanical trauma. However, the influence of cavity depth on their release dynamics remains unclear. This study aimed to evaluate the effects of different cavity depths—moderate (without pulp exposure) and deep (with pulp exposure)—on the release of PGE2 and NO in the pulp tissue of rat mandibular incisors at two time intervals (3 and 9 h).Methods: In total, 40 male Wistar rats were divided into two main groups (n = 20) based on cavity depth. A split-mouth design was used, with cavities of different depths prepared on the left mandibular incisors, leaving the right incisors without cavities as

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Indian Academy Of Oral Medicine And Radiology
The Degenerative Condylar Change in Temporomandibular Joint Disorder of Iraqi Population and their Variability Based on Clinical Diagnosis
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Background: As a multifactorial disorder, temporomandibular joint (TMD) is difficult to diagnose, and multiple factors affect the joint and cause the temporomandibular disorder. Standardization of clinical diagnosis of TMD should be used to reach a definite clinical diagnosis; the condylar bone may degenerate in accordance with these disorders. Aims: Evaluate the correlation between the clinical diagnosis and degenerative condylar change (flattening, sclerosis, erosion, and osteophyte). Materials and Methods: A prospective study with a study group of 97 TMD patients (total of 194 joints) aged 20 to 50. Patients were sent to cone beam computed tomography (CBCT) to assess the degenerative condylar change. Results: No association was found bet

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Publication Date
Mon Nov 27 2023
Journal Name
Korean Journal Of Orthodontics
Effectiveness of laser-engineered copper-nickel titanium versus superelastic nickel-titanium aligning archwires: A randomized clinical trial
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Publication Date
Thu Jan 30 2020
Journal Name
Al-kindy College Medical Journal
The Impact of Prophylactic Dexamethasone, Metoclopramide or both on Nausea and Vomiting After Laparoscopic Cholecystectomy
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Background: Postoperative nausea and vomiting (PONV) are one of the most common complaints following laparoscopic cholecystectomy.

Objective: This study was designed to compare the effects of dexamethasone, metoclopramide, and their combination on preventing PONV in patients undergoing laparoscopic cholecystectomy.

Methods: A total of 135 patients enrolled in the study. American Society of Anesthesiologists (ASA) physical status I and II patients were included in this randomized, double blind, placebo-controlled study. Patients were randomly assigned to group A administered 8mg iv dexamethasone, group B received metoclopramide 10 mg, group C received combination of 8mg de

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