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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
Sun Nov 01 2015
Journal Name
Journal Of Engineering
A Spike Neural Controller for Traffic Load Parameter with Priority-Based Rate in Wireless Multimedia Sensor Networks
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Wireless Multimedia Sensor Networks (WMSNs) are a type of sensor network that contains sensor nodes equipped with cameras, microphones; therefore the WMSNS are able to   produce multimedia data such as video and audio streams, still images, and scalar data from the surrounding environment. Most multimedia applications typically produce huge volumes of data, this leads to congestion. To address this challenge, This paper proposes Modify Spike Neural Network control for Traffic Load Parameter with Exponential Weight of Priority Based Rate Control algorithm (MSNTLP with EWBPRC). The Modify Spike Neural Network controller (MSNC) can calculate the appropriate traffi

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Publication Date
Wed Aug 07 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Post-Abortion Family Planning Counseling Program on Nurses and Midwives' Practices in Middle Euphrates Maternity Hospitals
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Objectives: To determine the effectiveness of post-abortion family planning counseling program on nurses and midwives' practices and to predict the variables which may effect on their practices Methodology: A quasi experimental study was conducted from 23th April 2017 to 14th March 2018 in three governorates in Middle Euphrates of Iraq: (Holy Karbala, Al - Najef Al Ashraf and Babylon) on nurses and midwives who work at maternity hospitals. Systematic random sampling was used to select 122 nurses and midwives, (60) of them for study group and (62) for control group. A checklist is an instrument that evaluate the practices which included 50 items. Validity of content was determined through reviewing it by (16) experts and reliability of to

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Publication Date
Sun Jan 01 2023
Journal Name
Second International Conference On Innovations In Software Architecture And Computational Systems (isacs 2022)
Permeability estimation of Yamama formation in a Southern Iraqi oil field, case study
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Permeability is one of the essential petrophysical properties of rocks, reflecting the rock's ability to pass fluids. It is considered the basis for building any model to predict well deliverability. Yamama formation carbonate rocks are distinguished by sedimentary cycles that separate formation into reservoir units and insulating layers, a very complex porous system caused by secondary porosity due to substitute and dissolution processes. Those factors create permeability variables and vary significantly. Three ways used for permeability calculation, the firstly was the classical method, which only related the permeability to the porosity, resulting in a weak relationship. Secondly, the flow zone indicator (FZI) was divided reservoir into

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of artificial intelligence in achieving Customer satisfaction and its reflection on cost accounting: An applied research in the Iraqi electronic industries company
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Based economic units to technology to add innovations that lead to contribute to customer satisfaction, under intense competition and rapid development in customer taste, the economic units tend to apply the concepts that contribute to customer satisfaction led by the introduction of artificial intelligence techniques. In the production prominent role in the contributing and responding to the rapid changes in customer tastes, and consequent impact this in achieving customer satisfaction. Search gained importance of relying on artificial intelligence techniques to achieve customer satisfaction through speed of response to changes in the tastes of customers and thus be able to increase its market share، and sales growth، and to achieve a

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Publication Date
Thu May 14 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Augmentation of the localized bony defects with synthetic bone substitute in simultaneous dental implant surgery(Clinical study)
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Background: Simultaneous and staged guided bone regeneration (GBR) is one of the several surgical techniques that have been developed in the past two decades to regenerate bone and thus to allow implant placement in compromised sites (fenestration and dehiscence). It is a surgical procedure that consists of the placement of a cell-occlusive physical barrier between the connective tissue and the alveolar bone defect. The treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabi

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Publication Date
Thu May 14 2026
Journal Name
Al–bahith Al–a'alami
THE IDEOLOGY OF UNIVERSITY STUDENTS TOWARDS POLITICAL DISCOURSE IN SATELLITE CHANNELS: A field study on media students at Al-Mustansiriya University))
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‏The speech delivered by political blocs and parties and broadcasted by satellite channels, social and communication media has different ideologies and orientations: moderate speech calling for calm or one raising crises.‏The latter is considered very challenging due to its local and international reference.‏, this paper aims at uncovering these challenges especially during the political crisis witnessed in Iraq. This paper sheds light on the most important crisis that spread in public opinion, broadcasted by satellite, and raised by politicians who are competing to gain authority leading to a lack of peoples, confidence in them.‏This matter should not be neglected at all; e

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Optimization of Inventory Inflation Budget Based on Spare-parts and Miscellaneous Costs of a Typical Automobile Industry
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Brainstorming has been a common approach in many industries where the result is not always accurate, especially when procuring automobile spare parts. This approach was replaced with a scientific and optimized method that is highly reliable, hence the decision to optimize the inventory inflation budget based on spare parts and miscellaneous costs of the typical automobile industry. Some factors required to achieve this goal were investigated. Through this investigation, spare parts (consumables and non-consumables) were found to be mostly used in Innoson Vehicle Manufacturing (IVM), Nigeria but incorporated miscellaneous costs to augment the cost of spare parts. The inflation rate was considered first due to the market's

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Engineering
Pharmaceutical Wastewater Treatment Associated with Renewable Energy Generation in Microbial Fuel Cell Based on Mobilized Electroactive Biofilm on Zeolite Bearer
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In this study, a novel application of lab-scale dual chambered air-cathode microbial fuel cell (MFC) has been developed for simultaneous bio-treatment of real pharmaceutical wastewater and renewable electricity generation. The microbial fuel cell (MFC) was provided with zeolite-packed anodic compartment and a cation exchange membrane (CEM) to separate the anode and cathode. The performance of the proposed MFC was evaluated in terms of COD removal and power generation based on the activity of the bacterial consortium in the biofilm mobilized on zeolite bearer. The MFC was fueled with real pharmaceutical wastewater having an initial COD concentration equal to 800 mg/L and inoculated with anaerobic aged sludge. Results demo

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Publication Date
Wed Apr 05 2023
Journal Name
International Journal Of Interactive Mobile Technologies (ijim)
A Partial Face Encryption in Real World Experiences Based on Features Extraction from Edge Detection
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User confidentiality protection is concerning a topic in control and monitoring spaces. In image, user's faces security in concerning with compound information, abused situations, participation on global transmission media and real-world experiences are extremely significant. For minifying the counting needs for vast size of image info and for minifying the size of time needful for the image to be address computationally. consequently, partial encryption user-face is picked. This study focuses on a large technique that is designed to encrypt the user's face slightly. Primarily, dlib is utilizing for user-face detection. Susan is one of the top edge detectors with valuable localization characteristics marked edges, is used to extract

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Applied Sciences And Nanotechnology
Characterization of Prepared Polyaniline Nanofibers Based on a Hydrothermal Variation of Aniline Concentration
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Polyaniline nanofibers (PAni-NFs) have been synthesized under various concentrations (0.12, 0.16, and 0.2 g/l) of aniline and different times (2h and 3 h) by hydrothermal method at 90°C. Was conducted with the use of X-ray diffraction (XRD), Fourier Transform Infrared spectra (FTIR), Ultraviolet-Visible (UV-VIS) absorption spectra, Thermogravimetric Analysis (TGA), and Field Emission-Scanning Electron Microscopy (FE-SEM). The X-ray diffraction patterns revealed the amorphous nature of all the produced samples. FE-SEM demonstrated that Polyaniline has a nanofiber-like structure. The observed typical peaks of PAni were (1580, 1300-1240, and 821 cm-1 ), analyzed by the chemical bonding of the formed PAni through FTIR spectroscopy. Also, tests

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