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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 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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Publication Date
Wed Nov 20 2024
Journal Name
Future Medicinal Chemistry
New 4-amino-3-chloro benzoate ester derivatives as EGFR inhibitors: synthesis, in silico and biological analyses
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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
Epidemiological, Clinical, and immunological characteristics of Mycoplasma pneumonia infections among a group of hospitalized children in Suleimani city/Iraq
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Background: Mycoplasma pneumoniae (M. pneumoniae) is an important respiratory bacterial pathogen, especially among children. It causes acute upper and lower respiratory infections.Objective: This study was aimed to measure anti- M. pneumoniae antibodies among hospitalized children who were admitted to hospital diagnosed with acute respiratory tract infections.Method: Automated ELISA technique was performed to detect anti- M. pneumoniae antibodies (IgM and IgG antibodies) in serum from 108 children less than 5 years old. The children were admitted to the Pediatric Teaching Hospital in Suleimani city/Kurdistan Region/Iraq because of acute respiratory tract infections. A questionnaire was designed to collect demographic and clinical data fr

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of wages and benefits systems on the performance of employees A field study in the General Company for Food Industries in the city of Baghdad
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The research aims to find out the impact of wages and benefits systems on the performance of employees, which included the research community on a sample of employees in the company, and the sample consisted of (50) employees and an employee, A questionnaire composed as prepared (23) paragraph, use the promised statistically methods in data collected by the questionnaire analysis. The research reached a number of results, the most prominent of which were: There is a correlation between wage systems, benefits and performance of employees, and the presence of the impact of the systems of wages and benefits to the performance of employees. The research was presented a set of recommendations including: increasing the effectiveness of

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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
Sat Apr 30 2022
Journal Name
Al-kindy College Medical Journal
Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up
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Background Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq. Objectives To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women. Subjects and Methods A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the ute

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Promoting Clinical Breast Examination as A screening Tool for Breast Cancer in Iraq
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Breast cancer constitutes about one fourth of the registered cancer cases among the Iraqi population (1)
and it is the leading cause of death among Iraqi women (2)
. Each year more women are exposed to the vicious
ramifications of this disease which include death if left unmanaged or the negative sequels that they would
experience, cosmetically and psychologically, after exposure to radical mastectomy.
The World Health Organization (WHO) documented that early detection and screening, when coped
with adequate therapy, could offer a reduction in breast cancer mortality; displaying that the low survival rates
in less developed countries, including Iraq, is mainly attributed to the lack of early detection programs couple

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Publication Date
Wed May 13 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Micro CT analysis of amount of dentin removal created by SAF vs. ProTaper systems
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Background: Dentin removed during root canal system instrumentation for creating adequate geometry for the canal and cleaning the canal. A new instrument had been marketed with the aim of optimum shaping of all parts of the canal system, however, no information present about the amount of dentin removal compared to conventional rotary system. This study investigated the amount of dentin removal when the canal instrumented by SAF compared with ProTaper by using high resolution computed tomography (micro CT). Materials and Methods: Twenty extracted single canalled teeth were utilized for this study; and randomly divided into 2 groups. In the first group, the root canals were prepared by using protaper rotary system till F2 and the root canal

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Publication Date
Mon Jan 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The use of IT infrastructure and its impact on the performance of human resources in public universities: A field study at the University of Diyala
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This study aims to identify the impact of using the infrastructure of the Information Technology (IT) on the performance of human resources in the public universities. This process is done by doing research in the size, quality, and efficiency of the performance, also speed of achievement and simplification of procedures. Diyala University was chosen for the diagnosis through the opinions and attitudes of its employees.  Consequently, suggestions that contribute to improve the performance of the employees and thus its overall performance are obtained. Another objective of this study is identifying the human resources which are currently used in academic institutions and educational services systems because the significant role of th

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Generating a Strong Key for a Stream Cipher Systems Based on Permutation Networks
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The choice of binary Pseudonoise (PN) sequences with specific properties, having long period high complexity, randomness, minimum cross and auto- correlation which are essential for some communication systems. In this research a nonlinear PN generator is introduced . It consists of a combination of basic components like Linear Feedback Shift Register (LFSR), ?-element which is a type of RxR crossbar switches. The period and complexity of a sequence which are generated by the proposed generator are computed and the randomness properties of these sequences are measured by well-known randomness tests.

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