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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
Thu Aug 08 2024
Journal Name
New Materials, Compounds And Applications
MOLECULAR MODELLING AND THEORETICAL DESIGN OF NOVEL NIRMATRELVIR DERIVATIVES AS SARS-COV-2 ENTRY INHIBITORS
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The pandemic SARS-CoV-2 is highly transmittable with its proliferation among nations. This study aims to design and exploring the efficacy of novel nirmatrelvir derivatives as SARS entry inhibitors by adapting a molecular modeling approach combined with theoretical design. The study focuses on the preparation of these derivatives and understanding their effectiveness, with a special focus on their binding affinity to the S protein, which is pivotal for the virus’s access to the host cell. Considering molecular docking aspects in the scope of a study on nirmatrelvir derivatives and S protein, dynamics simulations with 25 nanoseconds of their binding are explored. The study shows that these derivatives might work as effective antivi

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Publication Date
Fri Jan 01 2021
Journal Name
Materials Today: Proceedings
Synthesis of gamma biguanides butyric acid analogues as HDAC inhibitors and studying their cytotoxic activity
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Publication Date
Thu Jun 30 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Revision of public health and clinical importance of amoebiasis in Iraq
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Amebiasis, related to the pathogenic parasite Entamoeba histolytica, is a prominent cause of diarrhea globally. Amebiasis is primarily a disease of impoverished communities in developing nations, although it has recently arisen as a significant infection among returning tourists and immigrants. Severe cases are linked to a high case fatality rate. Although polymerase chain reaction (PCR)-based diagnosis is becoming more widely available, it is still underutilized. Treatment with nitroimidazoles is now suggested, however novel parasite medication research is a top priority. To avoid problems, amebiasis should be considered before corticosteroid therapy. Because there is no effective vaccination, sanitation and availability to clean w

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Publication Date
Thu Jun 30 2022
Journal Name
Gsc Biological And Pharmaceutical Sciences
Revision of public health and clinical importance of amoebiasis in Iraq
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Amebiasis, related to the pathogenic parasite Entamoeba histolytica, is a prominent cause of diarrhea globally. Amebiasis is primarily a disease of impoverished communities in developing nations, although it has recently arisen as a significant infection among returning tourists and immigrants. Severe cases are linked to a high case fatality rate. Although polymerase chain reaction (PCR)-based diagnosis is becoming more widely available, it is still underutilized. Treatment with nitroimidazoles is now suggested, however novel parasite medication research is a top priority. To avoid problems, amebiasis should be considered before corticosteroid therapy. Because there is no effective vaccination, sanitation and availability to clean w

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Publication Date
Mon Sep 01 2025
Journal Name
Journal Of Cancer Research Updates
Hematological Parameters in Liver Metastasis: A Comprehensive Clinical Evaluation for Early Detection in Iraqi Patients
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Background: Liver metastasis significantly complicates cancer prognosis, yet easily accessible markers for its early detection and monitoring remain crucial. This study aimed to comprehensively evaluate key hematological parameters as potential indicators for liver metastasis in Iraqi patients. Methods: We conducted a cross-sectional study comparing hematological profiles between 90 patients (presumably with liver metastasis) and 30 healthy controls. White Blood Cell (WBC) count, Lymphocyte percentage, Neutrophil percentage, and Neutrophil-to-Lymphocyte Ratio (NLR) were analyzed. Given non-normal data distributions (confirmed by the Shapiro-Wilk test), group comparisons were performed using the non-parametric Mann-Whitney U test.

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Publication Date
Tue Oct 29 2019
Journal Name
Journal Of Engineering
Mobile-based Human Emotion Recognition based on Speech and Heart rate
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Mobile-based human emotion recognition is very challenging subject, most of the approaches suggested and built in this field utilized various contexts that can be derived from the external sensors and the smartphone, but these approaches suffer from different obstacles and challenges. The proposed system integrated human speech signal and heart rate, in one system, to leverage the accuracy of the human emotion recognition. The proposed system is designed to recognize four human emotions; angry, happy, sad and normal. In this system, the smartphone is used to   record user speech and send it to a server. The smartwatch, fixed on user wrist, is used to measure user heart rate while the user is speaking and send it, via Bluetooth,

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Publication Date
Fri Jan 01 2021
Journal Name
International Journal Of Clinical Dentistry Preview Publication Details
The effect of surgical approaches on the stability and marginal bone loss of early loaded slactive implants with screw retention mean: Comparative clinical and radiological prospective study
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Purpose: This study aimed to compare the stability and marginal bone loss of implants inserted with flapped and flapless approaches 8 weeks after surgery and 3 months after loading. Material and Methods: Thirty SLActive implants were inserted in 11 patients and early loaded with final restoration 8 weeks after healing period. The stability values determined by Osstell and the marginal bone loss measured by CBCT at the initial time (1st) and 8 weeks of the healing period (2nd) and 3 months after loading (3rd). Results: The overall survival rate was 100%. A significant increase in the 3rd implant stability value in the age of ˂ 40. A significant decrease in the 2nd implant stability value in both gender and traumatic zone with a flapless app

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Applied Engineering Science
Design and implementation of a smart home automation system based on global system for mobile communications
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Recently, there has been an increasing advancement in the communications technology, and due to the increment in using the cellphone applications in the diverse aspects of life, it became possible to automate home appliances, which is the desired goal from residences worldwide, since that provides lots of comfort by knowing that their appliances are working in their highest effi ciency whenever it is required without their knowledge, and it also allows them to control the devices when they are away from home, including turning them on or off whenever required. The design and implementation of this system is carried out by using the Global System of Mobile communications (GSM) technique to control the home appliances – In this work, an ele

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Publication Date
Fri May 03 2024
Journal Name
Optical And Quantum Electronics
Design and analysis of a dual-core PCF biosensor based on SPR for cancerous cells detection
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Publication Date
Sun Jul 17 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Clinical Characteristics and Antibiotics Sensitivity of Culture Positive Typhoid Fever Patients in Baghdad Teaching Hospital - A Single Center Study
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BACKGROUND: Enteric fever caused by Salmonella Typhi is an endemic disease in Iraq. Variations in presentations make it a diagnostic challenge. If untreated or treated inappropriately then it is a serious disease with potentially life-threatening complications. The recent emergence of drug resistant strains of S. Typhi is a rising public health problem and a clinical concern to the physician. AIM: The objectives of the study were to assess and describe the patterns of antimicrobial resistance, clinical characteristics, epidemiological distribution, and complications of typhoid fever. PATIENTS AND METHODS: Fifty cases of typhoid fever (culture proven) were collected during the period from February 2019 to November 2019 in the me

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