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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 Sep 30 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Use The Cost Leadership Strategy in Throughput Accounting: An Applied Research In Wasit Textile And Knitting Factory
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The aim of this research is to apply Throughput Accounting in improving the cost leadership strategy for the woven fabric department (polyester blended - polyester 150/1) in the Waist Textile and Knitting Factory. The problem of the research is that the research sample laboratory does not apply modern cost management methods represented in Throughput Accounting, as the Iraqi economic units suffer from their inability to compete in the labor market in light of the competitive environment. The Ministry of Interior improved the cost leadership strategy for the product of blended polyester and polyester fabrics 1/150. Through the research, a set of conclusions was reached, the most important of which are:  Improving the cost lea

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Publication Date
Wed Jan 01 2025
Journal Name
Lecture Notes In Networks And Systems
The Impact of AI-Based Pronunciation and Dialogue Apps on English Language Acquisition: A Comparative Phonetic Study of ELSA Speak and Mondly
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Publication Date
Sat Oct 01 2011
Journal Name
Journal Of Engineering
MAGNETO HYDRODYNAMIC NATURAL CONVECTION FLOW ON A VERTICAL CYLINDER WITH A PRESENCE OF HEAT GENERATION AND RADIATION
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The present work investigates the effect of magneto – hydrodynamic (MHD) laminar natural convection flow on a vertical cylinder in presence of heat generation and radiation. The governing equations which used are Continuity, Momentum and Energy equations. These equations are transformed to dimensionless equations using Vorticity-Stream Function method and the resulting nonlinear system
of partial differential equations are then solved numerically using finite difference approximation. A thermal boundary condition of a constant wall temperature is considered. A computer program (Fortran 90) was built to calculate the rate of heat transfer in terms of local Nusselt number, total mean Nusselt number, velocity distribution as well as te

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Publication Date
Sat Feb 03 2018
Journal Name
Chinese Journal Of Physics
A true random number generator based on the photon arrival time registered in a coincidence window between two single-photon counting modules
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True random number generators are essential components for communications to be conconfidentially secured. In this paper a new method is proposed to generate random sequences of numbers based on the difference of the arrival times of photons detected in a coincidence window between two single-photon counting modules

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Publication Date
Mon Mar 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Nursing Staffs' Knowledge about Uses of Steroids and Their Side Effects in Al-Diwaniya Teaching hospital
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Objective: To determine the effectiveness of the educational program on nursing staffs' knowledge about uses of steroids and their side effects.
Methodology: A pre-experimental study design (one group design: pre-test and post-test) was used. This study was conducted in Al-Diwaniya Teaching Hospital for the period from ( 28th May to 10 th June, 2020) on a non-probability (purposive) sample consisting of (30 nurses) working in Oncology unit. A questionnaire was built as a data collection tool and consisted of two parts:
First part: The demographic characteristics of the nursing staff (gender, age, level of education, years of experience in hospital, participation in training courses related to nursing care for a patients undergoing

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Publication Date
Thu Dec 12 2013
Journal Name
Iraqi Journal Of Science
Determination of Optimum Mechanical Drilling Parameters for an Iraqi Field with Regression Model
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Publication Date
Wed Jan 28 2015
Journal Name
Al-khwarizmi Engineering Journal
Thermal Field Analysis of Oblique Machining Process with Infrared Image for AA6063-T6
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Abstract

 Metal cutting processes still represent the largest class of manufacturing operations. Turning is the most commonly employed material removal process. This research focuses on analysis of the thermal field of the oblique machining process. Finite element method (FEM) software DEFORM 3D V10.2 was used together with experimental work carried out using infrared image equipment, which include both hardware and software simulations. The thermal experiments are conducted with AA6063-T6, using different tool obliquity, cutting speeds and feed rates. The results show that the temperature relatively decreased when tool obliquity increases at different cutting speeds and feed rates, also it

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Enhancement Solution to Improve Remediation of Soil Contaminated with Lead by Electrical Field
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A laboratory investigation of six different tests were conducted on silty clay soil spiked with lead in concentrations of 1500 mg/kg. A constant DC voltage gradient of 1 V/cm was applied for all these tests with duration of 7 days remediation process for each test. Different purging solutions and addition configurations, i.e. injection wells, were investigated experimentally to enhance the removal of lead from Iraqi soil during electro-kinetic remediation process. The experimental results showed that the overall removal efficiency of lead for tests conducted with distilled water, 0.1 M acetic acid, 0.2 M EDTA and 1 M  ammonium citrate as the purging solutions were equal to 18 %, 37 %, 42 %, and 29 %, respectively. H

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Publication Date
Thu Apr 01 2021
Journal Name
Computer Methods And Programs In Biomedicine
A hybrid approach based on multiple Eigenvalues selection (MES) for the automated grading of a brain tumor using MRI
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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Nurses’ Knowledge Concerning the Infection Control Guideline in Baghdad Teaching Hospital
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Objectives: the study aims to findout the effectiveness of educational program concerning infection control guideline on nurses, and to find out the relationship between effectiveness of program and types of hospital unit, age, level of education, and years of experience of nurses. Methodology: A quasi-experimental design study was carried out in Baghdad teaching hospital in the wards, for the period of December, 20th 2013 to September, 30th of July 2014, The study samples is composed of (60) nurses who have been actually working in the medical ward, blood disease, psychiatric ward, and neurological war

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