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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 Oct 01 2025
Journal Name
Journal Of Economics And Administrative Sciences
A Modified Fama-MacBeth Model based on the Single-Index Model
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The aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth.  Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment.  Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Applying A* Path Planning Algorithm Based on Modified C-Space Analysis
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In this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons

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Publication Date
Mon Feb 04 2019
Journal Name
Iraqi Journal Of Physics
Chemical sensor based on a solid-core photonic crystal fiber interferometer
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Photonic crystal fiber interferometers are used in many sensing applications. In this work, an in-reflection photonic crystal fiber (PCF) based on Mach-Zehnder (micro-holes collapsing) (MZ) interferometer, which exhibits high sensitivity to different volatile organic compounds (VOCs), without the needing of any permeable material. The interferometer is robust, compact, and consists of a stub photonic crystal fiber of large-mode area, photonic crystal fiber spliced to standard single mode fiber (SMF) (corning-28), this splicing occurs with optimized splice loss 0.19 dB In the splice regions the voids of the holey fiber are completely collapsed, which allows the excitation and recombination of core and cladding modes. The device reflection

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Publication Date
Tue Feb 01 2022
Journal Name
Journal Of Engineering
Self-Repairing Technique Based on Microcapsules for Cementitious Composites- A Review
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Self-repairing technology based on micro-capsules is an efficient solution for repairing cracked cementitious composites. Self-repairing based on microcapsules begins with the occurrence of cracks and develops by releasing self-repairing factors in the cracks located in concrete. Based on previous comprehensive studies, this paper provides an overview of various repairing factors and investigative methodologies. There has recently been a lack of consensus on the most efficient criteria for assessing self-repairing based on microcapsules and the smart solutions for improving capsule survival ratios during mixing. The most commonly utilized self-repairing efficiency assessment indicators are mechanical resistance and durab

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Publication Date
Sun Jan 01 2012
Journal Name
International Journal Of Reasoning-based Intelligent Systems
SLMS: a smart library management system based on an RFID technology
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Publication Date
Tue Aug 23 2022
Journal Name
Journal Of Craniofacial Surgery
Differences Between Impression Stone Pouring and Digital Pouring in Fully Guided Dental Implant Surgery: A Prospective Clinical Study
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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
A New Model Design for Combating COVID -19 Pandemic Based on SVM and CNN Approaches
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       In the current worldwide health crisis produced by coronavirus disease (COVID-19), researchers and medical specialists began looking for new ways to tackle the epidemic. According to recent studies, Machine Learning (ML) has been effectively deployed in the health sector. Medical imaging sources (radiography and computed tomography) have aided in the development of artificial intelligence(AI) strategies to tackle the coronavirus outbreak. As a result, a classical machine learning approach for coronavirus detection from      Computerized Tomography (CT) images was developed. In this study, the convolutional neural network (CNN) model for feature extraction and support vector machine (SVM) for the classification of axial

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Publication Date
Tue Sep 23 2025
Journal Name
مجلة اكليل للدراسات الانسانية
The educational counselor in the school and his role in guidance and problem solving: a field study in the city of Baghdad
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Summary: The study focused on the role of the educational counselor in schools, as an integral part of the educational system that faces multiple challenges and difficulties. In this context, the counselor’s role becomes crucial in attempting to reduce or eliminate such difficulties, in addition to guiding students in an appropriate manner. Methodes: The study employed a descriptive field approach, using interviews and direct observation as tools to examine the actual role performed by school counselors. Results: The study concluded with several key findings, most notably the numerous challenges faced by counselors, including students’ negative behaviors, school dropouts, and the limited administrative support for counselors’ work. Fu

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Publication Date
Wed Mar 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Anti-inflammatory effects of manuka honey on salivary cytokines (clinical study)
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Background: Manuka honey (MH) is a mono-floral honey derived from the Manuka tree (Leptospermum scoparium). MH is a highly recognized for its non-peroxide antibacterial activities, which are mostly related to its unique methylglyoxal content (MGO) in MH. The beneficial phytochemicals in MH is directly related to their favorable health effects, which include wound healing, anticancer, antioxidant, and anti-inflammatory properties. Aims: The purpose of this study was to evaluate the effect of MH on pro-inflammatory cytokines (IL-8 and TNF-α) in patients with gingivitis and compare it with chlorhexidine (CHX) and distilled water (DW). Materials and Methods: This study was a randomized, double blinded, and parallel clinical trial. Forty-fiv

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Effectiveness of Digital journalism in developing political awareness among Iraqi feminist activists "A survey study"
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The paper aims to reveal the effectiveness of digital journalism in developing political awareness among Iraqi feminist activists. This paper is descriptive, and it adopted the analytical descriptive survey method. A snowball sample composed of (102) respondents of Iraqi feminist activists was adopted and questionnaire was used to collect data. The research has reached the following conclusions: The rate of Iraqi Feminist Activists dependence on digital Journalism have increased; to develop their political awareness, and their preference - in this regard - (the pages of journalistic institutions to social media) in a way that exceeds other types of digital journalism. (Variety of languages) has topped the priorities of Iraqi feminist act

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