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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
Fri Oct 02 2015
Journal Name
American Journal Of Applied Sciences
Advances in Document Clustering with Evolutionary-Based Algorithms
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Document clustering is the process of organizing a particular electronic corpus of documents into subgroups of similar text features. Formerly, a number of conventional algorithms had been applied to perform document clustering. There are current endeavors to enhance clustering performance by employing evolutionary algorithms. Thus, such endeavors became an emerging topic gaining more attention in recent years. The aim of this paper is to present an up-to-date and self-contained review fully devoted to document clustering via evolutionary algorithms. It firstly provides a comprehensive inspection to the document clustering model revealing its various components with its related concepts. Then it shows and analyzes the principle research wor

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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
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Use ofBang marking in the management of the cost of food and beverages in the hotel: sector (Case study in a sample of hotels in Baghdad governorate)
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The competition in the hotel sector, globalization and the development of new information have forced the sector to continuously seek new techniques and arrangements to remain competitive through hotel industry companies, including Benchmarking and the application of this method in the hotel sector. The selection of the Rashid International Hotel by the Ministry of Tourism as a leading hotel or benchmark for comparison of other hotels in Iraq, and the selection of two hotels in Baghdad for comparison, namely (Ishtar International Hotel, Baghdad International Hotel) and the choice also by the Ministry of Tourism, N is to correct the course of practice to manage the cost and diagnosis of the weakness of the strengths and weaknesses in the

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Publication Date
Fri Oct 10 2025
Journal Name
Pharmakeftiki
Genetic polymorphisms and adverse effects that affect the natalizumab clinical response: a review
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The clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4

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Publication Date
Thu Nov 19 2020
Journal Name
The Iraqi Journal For Information And Documentation Studies
The use of still and animated comics in providing user services in university information institutions: a field study
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Comics is a visual art (Still and motion pictures) it seeks to provide a Training courses are a series of intensive important educational and complementary programs, based on previous foundation experiences. Create to development the participants in aspects of specialization according to the requirements of the educational system to continue developing the previous scienti􀂡c and practical experiences. Personally, or adopted by the trainee institution, where the trainee gets a professional skill certi􀂡cate that contributes to the development his work.Development and Continuous Education Center (DCEC) at the University of Baghdad (UoBaghdad) is a center dedicated to continuing education courses in which the participant is awarded a cert

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of a dietary education program upon hypertensive clients' information
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Objective: To determine the effectiveness of a dietary educational program upon the hypertensive client’s
information.
Methodology: The sample of the study consists of (60) hypertensive clients who attended Al Anbar Health Office –Al
Andalus Health Center during the period of the study from the14th of March 2010 to the 30th of September 2010. The
sample is divided into two groups; study group (30) hypertensive clients who received dietary educational program
and control group (30) hypertensive clients who received a routine care from the center. Three major instruments
were used; these instruments included (1) knowledge test which was applied on both groups pretest and eight weeks
post-test (2) questions to know

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Publication Date
Thu Jun 25 2020
Journal Name
International Journal Of Drug Delivery Technology
The Effects of Salvia officinalis Gel as an Adjunct to Scaling and Root Planning in Patients with Periodontitis (Clinical and Immunological Study)
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Background: Phytotherapy is the usage of herbal species with medicinal properties for the management of various diseases. Gingivitis and periodontitis are diseases that involve the role of both the bacteria and the host immune response. Over the years, various researches have shown the importance of herbal products in the management of periodontal diseases. Aims of the study: To evaluate the efficacy of locally applied Salvia officinalis gel as adjunctive in the treatment of chronic periodontitis. Subjects and methods: Fourteen patients (10 males and 4 females) with chronic periodontitis were enrolled in the present study with total number of twenty-eight periodontal pockets utilizing a split mouth design, the pockets were divided i

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Publication Date
Tue Feb 03 2026
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
XGBOOST AND COST-SENSITIVE CART FOR IMBALANCED MULTICLASS DIABETES CLASSIFICATION IN IRAQ
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Diabetes imposes a substantial public health burden; according to the International Diabetes Federation, there were about 3.4 million diabetes related deaths worldwide in 2024, and in Iraq, the Federation reports that one in nine adults lives with diabetes in 2024, with 14,683 adult deaths attributable to diabetes and a total diabetes related health expenditure of 2,078 million United States dollars. The dataset analyzed in this study contains 1,000 records collected in 2020 from two Iraqi teaching hospitals and includes multiple clinical and laboratory measurements with three outcome classes, namely Non diabetic, Pre diabetic, and Diabetic, with a low prevalence of the Pre diabetic class and an imbalanced overall class distribution; the da

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Publication Date
Tue Oct 08 2002
Journal Name
Iraqi Journal Of Laser
Design Considerations of Laser Source in a Ring Network Based on Fiber Distributed Data Interface (FDDI)
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This work presents the use of laser diode in the fiber distributed data interface FDDI networks. FDDI uses optical fiber as a transmission media. This solves the problems resulted from the EMI, and noise. In addition it increases the security of transmission. A network with a ring topology consists of three computers was designed and implemented. The timed token protocol was used to achieve and control the process of communication over the ring. Nonreturn to zero inversion (NRZI) modulation was carried out as a part of the physical (PHY) sublayer. The optical system consists of a laser diode with wavelength of 820 nm and 2.5 mW maximum output power as a source, optical fiber as a channel, and positive intrinsic negative (PIN) photodiode

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