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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 17 2018
Journal Name
Journal Of Engineering And Applied Sciences
PREPARATION, CHARACTERIZATION AND THERMAL ANALYSIS OF POLYMERIC BLEND NANOCOMPOSITES BASED ON PVA-PVPPEGDOPED WITH ZINC OXIDE NANOPARTICLES
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Publication Date
Sun Mar 28 2021
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of a Structural Theory- based Training Program in Enhancing Arabic Language Teachers’ Teaching Practices and their Tendencies towards Structural Teaching: مريم بنت حسن البلوشي، ريا بنت سالم المنذري، علي مهدي كاظم
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The study aims to identify the effectiveness of a structural theory-based training program in enhancing the teaching practices of Arabic language teachers teaching grade ten in South Al Batinah in Sultanate of Oman. The study used the quasi-experimental design, and the sample consisted of 40 male and female teachers. To achieve the objectives of the study, a training program, an observation form and a measurement tool of teachers’ tendencies towards a structural teaching were made. The program was implemented with an experimental group of 20 female and male teachers in the first semester of the academic year 2018/2019. The study has found that there is a statistically significant difference between the average grades before and after i

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Publication Date
Tue Aug 24 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
A plan for transportation and distribution the products based on multi-objective travelling salesman problem in fuzzy environmental
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Transportation and distribution are the most important elements in the work system for any company, which are of great importance in the success of the chain work. Al-Rabee factory is one of the largest ice cream factories in Iraq and it is considered one of the most productive and diversified factories with products where its products cover most areas of the capital Baghdad, however, it lacks a distribution system based on scientific and mathematical methods to work in the transportation and distribution processes, moreover, these processes need a set of important data that cannot in any way be separated from the reality of fuzziness industrial environment in Iraq, which led to use the fuzzy sets theory to reduce the levels of uncertainty.

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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
The effectiveness of the Iraqi banking system in dealing with the effects of fiscal austerity policy
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Abstract:

    Under the state scenario, fiscal policy will not be able to use the oil surpluses optimally and economically and society, as long as these surpluses are not directed by public expenditure towards new productive investments and by following the path of fiscal policy after one year 2003 and until 2013 we note that it is based on the method of spending (excessive) consumption, and did not take any action towards the budget deficit planned at the beginning of the fiscal year, and the actual surplus at the end of the fiscal year, which represents the highest expenditure in the budget, Salaries and wages of workers in various government agencies with the expansion of spending on the security side.&n

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Publication Date
Tue Feb 14 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Cognitive-Behavioral Guidance Program in Reducing the Level of Addiction on Social Media in a Sample of High School Students in Karak Schools
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Abstract

The current research aims to develop a guidance program suitable for high school students and apply it to them in order to ensure the reduction of addiction to the use of different means of communication. The researchers used the scale of addiction to the means of communication (SAS) to measure the level of addiction as well as to identify the impact of the proposed guidance program in reducing the degree of addiction to communication. It was applied to a sample of (20) female students divided equally into two groups: an experimental group of (10) female students and a control group of (10) female students from the secondary level in a school under the department of education in the education of the alma

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Publication Date
Thu Feb 01 2018
Journal Name
Research Journal Of Pharmaceutical,biological And Chemical Sciense
correlation of serum tumor necrosis factor alpha and high sensitive c-reactive protein with clinical periodontal parameters in osteoarthritis patients
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Publication Date
Mon May 29 2023
Journal Name
Rawal Medical Journal
Comparison of functional and radiological outcomes of lower third closed tibia fractures treated by nail VS plate osteosynthesis
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Objective: To determine the functional and radiological outcomes of lower third tibia closed fractures fixed by nail or plate osteosynthesis. Methodology: This randomized controlled trial included 20 patients presenting with closed fracture lower third tibia in Al-Kindy teaching hospital, Baghdad, Iraq. The patients were divided as every other one into two equal groups; group I had fractures fixed by 3.5 mm locked plate and group II by intramedullary locking nail. We followed all patients for 24 weeks to assess surgical complications, fracture union, alignment and functional outcome based on Knee society score (KSS). Results: The mean union time in both groups was 10.2 ± 1.48 and 9.3 ± 1.77 weeks, respectively (p = 0.003). Mean KSS in bot

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Publication Date
Sat Aug 01 2015
Journal Name
Journal Of Engineering
A Real-Time Fuzzy Load Flow and Contingency Analysis Based on Gaussian Distribution System
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Fuzzy logic is used to solve the load flow and contingency analysis problems, so decreasing computing time and its the best selection instead of the traditional methods. The proposed  method is very accurate with outstanding computation time, which made the fuzzy load flow (FLF) suitable for real time application for small- as well as large-scale power systems. In addition that, the FLF efficiently able to solve load flow problem of ill-conditioned power systems and contingency analysis. The FLF method using Gaussian membership function requires less number of iterations and less computing time than that required in the FLF method using triangular membership function. Using sparsity technique for the input Ybus sparse matrix data gi

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
Digital Data Encryption Using a Proposed W-Method Based on AES and DES Algorithms
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This paper proposes a new encryption method. It combines two cipher algorithms, i.e., DES and AES, to generate hybrid keys. This combination strengthens the proposed W-method by generating high randomized keys. Two points can represent the reliability of any encryption technique. Firstly, is the key generation; therefore, our approach merges 64 bits of DES with 64 bits of AES to produce 128 bits as a root key for all remaining keys that are 15. This complexity increases the level of the ciphering process. Moreover, it shifts the operation one bit only to the right. Secondly is the nature of the encryption process. It includes two keys and mixes one round of DES with one round of AES to reduce the performance time. The W-method deals with

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The Reflection of Lean Management Approach on Human Resource Management Practices A field research in telecom companies in Iraq (Zain-Asia cell)
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Abstract

The current research is attempt to test the reflection of the lean management on the human resources management practices of two of the most important communication companies operating in Iraq (`Zain & Asia cell), The research aims to Determine the extent of adoption of the lean management approach in the two researched companies, as it improving human resource management practices. The research problem represented in the existence of lack of in some aspects of the application the lean management approach in service sector and neglecting the impact of its tools on the human resource management practices. For this purpose three principle research hypotheses has been formulated, first there is a correlation rel

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