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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 Jan 01 2020
Journal Name
Journal Of Child Science
Clinical and Genetic Varieties of Gaucher Disease in Iraqi Children
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Abstract<p>Gaucher disease (GD), which is due to a deficiency in the lysosomal enzyme β-glucocerebrosidase, is a rare genetic disorder. It is characterized by a wide variety of clinical manifestations and severity of symptoms, making it difficult to manage. A cross-sectional hospital-based genetic study was undertaken with 32 pediatric patients. We recruited 21 males and 11 females diagnosed with GD, with a male-to-female ratio of 1.91:1. The mean age of the study population was 8.79 ± 4.37 years with an age range from 8 months to 17 years. We included patients on clinical evaluation from 2011 to 2019. An enzyme assay test was used to measure β-glucosidase enzyme activity in leukocytes and the GBA gene s</p> ... Show More
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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Freedom of movement of capital and its impact on the effectiveness of monetary policy In Iraq (2005-2016)
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The interest in the issue of capital movement as an economic phenomenon has increased because of its effects and effects and its ability to influence the economic balance and the effectiveness of monetary policy. All countries seek to attract capital and benefit from it because of its effects and results such as supporting economic development process and optimal allocation of economic resources. The problem of the financing gap that most countries suffer from, and others, but sometimes the movement of capital creates challenges for monetary policy makers in achieving their goals.

   After 2003, the Iraqi economy witnessed an openness and economic liberalization unlike previous years, which

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Engineering
A High Resolution 3D Geomodel for Giant Carbonate Reservoir- A Field Case Study from an Iraqi Oil Field
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Constructing a fine 3D geomodel for complex giant reservoir is a crucial task for hydrocarbon volume assessment and guiding for optimal development. The case under study is Mishrif reservoir of Halfaya oil field, which is an Iraqi giant carbonate reservoir. Mishrif mainly consists of limestone rocks which belong to Late Cenomanian age. The average gross thickness of formation is about 400m. In this paper, a high-resolution 3D geological model has been built using Petrel software that can be utilized as input for dynamic simulation. The model is constructed based on geological, geophysical, pertophysical and engineering data from about 60 available wells to characterize the structural, stratigraphic, and properties distribution along

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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Engineering
A High Resolution 3D Geomodel for Giant Carbonate Reservoir- A Field Case Study from an Iraqi Oil Field
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Constructing a fine 3D geomodel for complex giant reservoir is a crucial task for hydrocarbon volume assessment and guiding for optimal development. The case under study is Mishrif reservoir of Halfaya oil field, which is an Iraqi giant carbonate reservoir. Mishrif mainly consists of limestone rocks which belong to Late Cenomanian age. The average gross thickness of formation is about 400m. In this paper, a high-resolution 3D geological model has been built using Petrel software that can be utilized as input for dynamic simulation. The model is constructed based on geological, geophysical, pertophysical and engineering data from about 60 available wells to characterize the structural, stratigraphic, and properties distri

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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
Sat Sep 30 2017
Journal Name
Al-khwarizmi Engineering Journal
Programming a Pneumatic Processes Sequence based on PLC by Demonstration
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Abstract

Pneumatic processes sequence (PPS) is used widely in industrial applications. It is common to do a predetermined PPS to achieve a specific larger task within the industrial application like the PPS achieved by the pick and place industrial robot arm. This sequence may require change depending on changing the required task and usually this requires the programmer intervention to change the sequence’ sprogram, which is costly and may take long time. In this research a PLC-based PPS control system is designed and implemented, in which the PPS is programmed by demonstration. The PPS could be changed by demonstrating the new required sequence via the user by following simple series of manual steps without h

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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
Thu Oct 01 2020
Journal Name
Defence Technology
A novel facial emotion recognition scheme based on graph mining
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Recent years have seen an explosion in graph data from a variety of scientific, social and technological fields. From these fields, emotion recognition is an interesting research area because it finds many applications in real life such as in effective social robotics to increase the interactivity of the robot with human, driver safety during driving, pain monitoring during surgery etc. A novel facial emotion recognition based on graph mining has been proposed in this paper to make a paradigm shift in the way of representing the face region, where the face region is represented as a graph of nodes and edges and the gSpan frequent sub-graphs mining algorithm is used to find the frequent sub-structures in the graph database of each emotion. T

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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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Publication Date
Sat Oct 29 2022
Journal Name
Computers
Intelligent Robotic Welding Based on a Computer Vision Technology Approach
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Robots have become an essential part of modern industries in welding departments to increase the accuracy and rate of production. The intelligent detection of welding line edges to start the weld in a proper position is very important. This work introduces a new approach using image processing to detect welding lines by tracking the edges of plates according to the required speed by three degrees of a freedom robotic arm. The two different algorithms achieved in the developed approach are the edge detection and top-hat transformation. An adaptive neuro-fuzzy inference system ANFIS was used to choose the best forward and inverse kinematics of the robot. MIG welding at the end-effector was applied as a tool in this system, and the wel

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