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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 Apr 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
The Clinical Effect of Super Oxidized Water Mouthwash on The Periodontal Parameters (Plaque Index, Gingival Index And Bleeding on Probing) for Patients with Dental Biofilm Induced Gingivitis
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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of projects during the trial operation period in accordance with the cost, quality and time - applied research in the Directorate-General for the distribution
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Research includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.

The importance of research Focus on the evaluation of received projects from contractors executing the projec

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Publication Date
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
Epidemiological and Clinical Factors Affecting the Response to Etanercept Among Patients with Rheumatoid Arthritis
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Publication Date
Fri Apr 02 2010
Journal Name
Journal Of The University Of Karbala
Spectrophotometric determination of Cisapride Based on ion-pair complex formation with Bromophenol blue
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A new simple, sensitive and inexpensive method has been developed for the spectrophotometric determination of cisapride in pharmaceutical formulation. The turbidimetric method is based on the formation of the ion-pair complex between the drug and bromophenol blue (BPB) in presence of potassium chloride at pH= 2.6, with a maximum absorbance at 520 nm. The calibration graph is linear in the concentration range 5-50µg.ml-1 , with good correlation coefficient (r = 0.9989).The limit of detection was found to be 1.14 µg.ml-1 and no interference was observed from common excipients in the pharmaceutical preparation that contain cisapride with good accuracy and precision.

Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Application Artificial Forecasting Techniques in Cost Management (review)
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For the duration of the last few many years many improvement in computer technology, software program programming and application production had been followed with the aid of diverse engineering disciplines. Those trends are on the whole focusing on synthetic intelligence strategies. Therefore, a number of definitions are supplied, which recognition at the concept of artificial intelligence from exclusive viewpoints. This paper shows current applications of artificial intelligence (AI) that facilitate cost management in civil engineering tasks. An evaluation of the artificial intelligence in its precise partial branches is supplied. These branches or strategies contributed to the creation of a sizable group of fashions s

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Publication Date
Fri Mar 19 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
New cost control techniques in mega construction projects
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Publication Date
Mon Jul 31 2023
Journal Name
Iraqi Geological Journal
Building of a Static Model for Jeribe Formation in Jambour Oil Field
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The Jeribe Formation, the Jambour oil field, is the major carbonate reservoir from the tertiary reservoirs of the Jambour field in northern Iraq, including faults. Engineers have difficulty organizing carbonate reserves since they are commonly tight and heterogeneous. This research presents a geological model of the Jeribe reservoir based on its facies and reservoir characterization data (Permeability, Porosity, Water Saturation, and Net to Gross). This research studied four wells. The geological model was constructed with the Petrel 2020.3 software. The structural maps were developed using a structural contour map of the top of the Jeribe Formation. A pillar grid model with horizons and layering was designed for each zone. Followin

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Publication Date
Tue Oct 01 2019
Journal Name
2019 Ieee 9th International Conference On System Engineering And Technology (icset)
A Digital Signature System Based on Real Time Face Recognition
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This study proposed a biometric-based digital signature scheme proposed for facial recognition. The scheme is designed and built to verify the person’s identity during a registration process and retrieve their public and private keys stored in the database. The RSA algorithm has been used as asymmetric encryption method to encrypt hashes generated for digital documents. It uses the hash function (SHA-256) to generate digital signatures. In this study, local binary patterns histograms (LBPH) were used for facial recognition. The facial recognition method was evaluated on ORL faces retrieved from the database of Cambridge University. From the analysis, the LBPH algorithm achieved 97.5% accuracy; the real-time testing was done on thirty subj

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Chemical Sensor Based on a Hollow-Core Photonic Crystal Fiber
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In this work a chemical sensor was built by using Plane Wave Expansion (PWE) modeling technique by filling the core of 1550 hollow core photonic crystal fiber with chloroform that has different concentrations after being diluted with distilled water. The minimum photonic bandgap width is.0003 and .0005 rad/sec with 19 and 7 cells respectively and a concentration of chloroform that filled these two fibers is 75%.

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Publication Date
Wed Feb 29 2012
Journal Name
Al-khwarizmi Engineering Journal
A New Audio Steganography System Based on Auto-Key Generator
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Stenography is the art of hiding the very presence of communication by embedding secret message into innocuous looking cover document, such as digital image, videos, sound files, and other computer files that contain perceptually irrelevant or redundant information as covers or carriers to hide secret messages.

In this paper, a new Least Significant Bit (LSB) nonsequential embedding technique in wave audio files is introduced. To support the immunity of proposed hiding system, and in order to recover some weak aspect inherent with the pure implementation of stego-systems, some auxiliary processes were suggested and investigated including the use of hidden text jumping process and stream ciphering algorithm. Besides, the suggested

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