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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
Tue Feb 01 2022
Journal Name
Civil Engineering Journal
Calibration of a New Concrete Damage Plasticity Theoretical Model Based on Experimental Parameters
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The introduction of concrete damage plasticity material models has significantly improved the accuracy with which the concrete structural elements can be predicted in terms of their structural response. Research into this method's accuracy in analyzing complex concrete forms has been limited. A damage model combined with a plasticity model, based on continuum damage mechanics, is recommended for effectively predicting and simulating concrete behaviour. The damage parameters, such as compressive and tensile damages, can be defined to simulate concrete behavior in a damaged-plasticity model accurately. This research aims to propose an analytical model for assessing concrete compressive damage based on stiffness deterioration. The prop

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Publication Date
Mon Dec 01 2014
Journal Name
2014 Ieee Symposium On Differential Evolution (sde)
Comparative analysis of a modified differential evolution algorithm based on bacterial mutation scheme
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A new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever

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Publication Date
Fri May 15 2026
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Management by Walking Around on the Strategic Renewal of Business Organizations (Field Research in a Sample of Excellent grade hotels - in Baghdad)
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يهدف هذا العمل الى بيان طبيعة العلاقة بين الادارة بالتجوال والتجديد الاستراتيجي ، ومدى تأثير المتغير المستقل في المتغير التابع. تضمنت فقرات الاستبانة بوصفه الأداة الرئيسة لجمع البيانات ثلاث جوانب اساسية، تضمن الاول البيانات الشخصية للمستجيبين، فيما تضمن الجانب الثاني الفقرات الخاصة بمتغير الادارة بالتجوال من خلال خمسة ابعاد، فيما اشتمل الجانب الثالث على فقرات التجديد الاستراتيجي عبر تناول اربعة ابعاد. ي

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Management by Walking Around on the Strategic Renewal of Business Organizations (Field Research in a Sample of Excellent grade hotels - in Baghdad)
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This work aims to show the nature of the relationship between management by walking around  (the independent variable) and strategic renewal (the dependent variable), as well as it shows the effect of the independent variable on the dependent variable. Questionnaire items were considered the main tool for data collection by three basic aspects. The first involved the personal data of the respondents, while the second included items related to management by walking in five dimensions, and the third is strategic renewal items by addressing four dimensions. The tourism sector, while the community has six Excellent grade hotels was taken into account in this wor

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Publication Date
Tue Nov 03 2020
Journal Name
Modern Sport
Exercises based on the phosphogenic energy system to develop the ability to perform with precision and accuracy
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Each sport has its own energy requirements that differ from the energy requirements of other sports, and a different method is used in each of them, so the trainer must first rely on the principle of privacy in training first, that is, privacy according to the working energy system, that is, he defines the controlling energy system In that event, and how the muscles use the available energy to perform according to the energy production systems. As we find the serving skill is the first volleyball skill with which the team starts the match in order to be able to gain points directly, through knowledge it turns out that there is a weakness in the skill performance, especially the skill of serving and being The key to victory for volle

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Publication Date
Fri May 15 2026
Journal Name
Journal Of The College Of Basic Education
Fuzzy Nonparametric Regression Model Estimation Based on some Smoothing Techniques With Practical Application
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In this research, we use fuzzy nonparametric methods based on some smoothing techniques, were applied to real data on the Iraqi stock market especially the data about Baghdad company for soft drinks for the year (2016) for the period (1/1/2016-31/12/2016) .A sample of (148) observations was obtained in order to construct a model of the relationship between the stock prices (Low, high, modal) and the traded value by comparing the results of the criterion (G.O.F.) for three techniques , we note that the lowest value for this criterion was for the K-Nearest Neighbor at Gaussian function .

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Product Innovation on an Improvement of the Organization's Reputation /A Field Study in State Organization for Marketing of Oil (SOMO)
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 This paper aims to verify the existence of relationships between product innovation and the reputation of the organization. The study problem is that the State Organization for Marketing of Oil (SOMO) system is inflexible in terms of marketing procedures and needs innovative, unconventional methods in innovating its products and improving performance. The reputation of the organization. The importance of the study lies in that it is an attempt to raise the interest of SOMO in its approach to the research variables in order to enhance its competitive position in the future and improve the marketing business environment, which contributes to enhancing the reputation of the organization by product innovation. The study sample

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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of Endodontics
Synthesis and Preliminary Evaluation of a Polyolefin-based Core for Carrier-based Root Canal Obturation
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Introduction: Carrier-based gutta-percha is an effective method of root canal obturation creating a 3-dimensional filling; however, retrieval of the plastic carrier is relatively difficult, particularly with smaller sizes. The purpose of this study was to develop composite carriers consisting of polyethylene (PE), hydroxyapatite (HA), and strontium oxide (SrO) for carrier-based root canal obturation. Methods: Composite fibers of HA, PE, and SrO were fabricated in the shape of a carrier for delivering gutta-percha (GP) using a melt-extrusion process. The fibers were characterized using infrared spectroscopy and the thermal properties determined using differential scanning calorimetry. The elastic modulus and tensile strength tests were dete

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Publication Date
Fri May 15 2026
Journal Name
Iraqi Journal Of Science
Synthesis and characterization of some 2-sulphanyl benzimidazole derivatives and study of effect as corrosion inhibitors for carbon steel in sulfuric acid solution
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This research involves the synthesis of some sulphanyl benzimidazole derivatives (Ia-c), which were prepared from reaction of 2-mercaptobenzimidazole substituted benzyl halide, and structures were identified by spectral methods[FTIR, 1H-NMR and 13C-NMR].These compounds were investigated as corrosion inhibitors for carbon steel in 1M H2SO4 solution using weight loss, potentiostatic polarization methods; obtained results showed that the sulphanyl benzimidazole derivatives retard both cathodic and anodic reactions in acidic media, by virtue of adsorption on the carbon steel surface. This adsorption obeyed Langmuir’s adsorption isotherm. The inhibition efficiency of (Ia-c) ranging between (65-92) %. By using different Ib derivative conc

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Publication Date
Thu Mar 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Waterpipe Smoking Effect on Clinical Periodontal Parameters, Salivary Flow Rate and Salivary pH in Chronic ‎Periodontitis Patient
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Background: Waterpipe tobacco smoking has become common especially among young people, Waterpipe smoking misconcepted as a safer mean of smoking, so in this study we will highlight the effect of Waterpipe smoking ‎on periodontal and oral health.‎ Materials and method. The selected ‎‎‎100 male subjects of 30-40 years, ‎categorized into 4 groups (each group ‎‎25 subject): Waterpipe smoker ‎with ‎healthy periodontium, ‎Waterpipe smoker ‎‎with chronic periodontitis, Non-‎‎smoker ‎with healthy periodontium and Non-smoker ‎with chronic periodontitis. Whole ‎unstimulated ‎saliva was collected. Clinical measurements: plaque ‎index

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