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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 Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Target cost tool to achieve competitive advantage
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Target costing is one of the modern techniques in strategic Management accounting, Is has shown active adoption to changes in current business environments, In addition, is has seen a growth in strategic approach, The goal of using target costing is to build and strengthen competition abilities of economic units through introducing appropriate ways to decrease cost values while maintaining and improving quality of product, So this study is aim to show how can  economic units use target costing to achieve competitive advantages .

 

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
A Proposed Adaptive Bitrate Scheme Based on Bandwidth Prediction Algorithm for Smoothly Video Streaming
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A robust video-bitrate adaptive scheme at client-aspect plays a significant role in keeping a good quality of video streaming technology experience. Video quality affects the amount of time the video has turned off playing due to the unfilled buffer state. Therefore to maintain a video streaming continuously with smooth bandwidth fluctuation, a video buffer structure based on adapting the video bitrate is considered in this work. Initially, the video buffer structure is formulated as an optimal control-theoretic problem that combines both video bitrate and video buffer feedback signals. While protecting the video buffer occupancy from exceeding the limited operating level can provide continuous video str

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
A New Fractal Printed Dipole Antenna Based on Tent Transformations for Wireless Communication Applications
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In this paper, a compact multiband printed dipole antenna is presented as a candidate for use in wireless communication applications. The proposed fractal antenna design is based on the second level tent transformation. The space-filling property of this fractal geometry permits producing longer lengths in a more compact size. Theoretical performance of this antenna has been calculated using the commercially available software IE3D from Zeland Software Inc. This electromagnetic simulator is based on the method of moments (MoM). The proposed dipole antenna has been found to possess a considerable size reduction compared with the conventional printed or wire dipole antenna designed at the same design frequency and using the same substrate

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Publication Date
Mon Jan 01 2024
Journal Name
Global Heart
Challenges in Clinical Research in Low and Middle Income Countries: Early Career Cardiologists’ Perspective
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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications
Rock facies classification and its effect on the estimation of original oil in place based on petrophysical properties data
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The most significant function in oil exploration is determining the reservoir facies, which are based mostly on the primary features of rocks. Porosity, water saturation, and shale volume as well as sonic log and Bulk density are the types of input data utilized in Interactive Petrophysics software to compute rock facies. These data are used to create 15 clusters and four groups of rock facies. Furthermore, the accurate matching between core and well-log data is established by the neural network technique. In the current study, to evaluate the applicability of the cluster analysis approach, the result of rock facies from 29 wells derived from cluster analysis were utilized to redistribute the petrophysical properties for six units of Mishri

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Publication Date
Sat Oct 30 2021
Journal Name
Iraqi Journal Of Science
The Effects of Conductance on Metastable Switches in Memristive Devices Based on Anti-Hebbian and Hebbian (AHaH) Learning Rules
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     In the last few years, the literature conferred a great interest in studying the feasibility of using memristive devices for computing. Memristive devices are important in structure, dynamics, as well as functionalities of artificial neural networks (ANNs) because of their resemblance to biological learning in synapses and neurons regarding switching characteristics of their resistance. Memristive architecture consists of a number of metastable switches (MSSs). Although the literature covered a variety of memristive applications for general purpose computations, the effect of low or high conductance of each MSS was unclear. This paper focuses on finding a potential criterion to calculate the conductance of each MMS rather t

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Engineering
Evaluation of the Current Status of the Cost Control Processes in Iraqi Construction Projects
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One of the most important problems of Iraqi construction projects is the cost variances, so it is important to identify the problems and shortcomings that cause poor cost control. Through the utilization of questionnaires, the study evaluated how project costs were managed and reported. The questionnaire was distributed to 180 professionals working in the Iraqi construction sector, with a response rate of 91%. The results showed that a high percentage of projects are implemented with a difference between real and estimated costs, and the process of documenting cost data needs to be more secure. On the other hand, there is a weakness in providing the necessary work structure information to monitor costs and a lack of proc

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Hybrid Transform Based Denoising with Block Thresholding
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A frequently used approach for denoising is the shrinkage of coefficients of the noisy signal representation in a transform domain. This paper proposes an algorithm based on hybrid transform (stationary wavelet transform proceeding by slantlet transform); The slantlet transform is applied to the approximation subband of the stationary wavelet transform. BlockShrink thresholding technique is applied to the hybrid transform coefficients. This technique can decide the optimal block size and thresholding for every wavelet subband by risk estimate (SURE). The proposed algorithm was executed by using MATLAB R2010aminimizing Stein’s unbiased with natural images contaminated by white Gaussian noise. Numerical results show that our algorithm co

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Image Watermarking based on Huffman Coding and Laplace Sharpening
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In this paper, an algorithm through which we can embed more data than the
regular methods under spatial domain is introduced. We compressed the secret data
using Huffman coding and then this compressed data is embedded using laplacian
sharpening method.
We used Laplace filters to determine the effective hiding places, then based on
threshold value we found the places with the highest values acquired from these filters
for embedding the watermark. In this work our aim is increasing the capacity of
information which is to be embedded by using Huffman code and at the same time
increasing the security of the algorithm by hiding data in the places that have highest
values of edges and less noticeable.
The perform

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Publication Date
Tue Oct 04 2022
Journal Name
Ieee Access
Plain, Edge, and Texture Detection Based on Orthogonal Moment
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Image pattern classification is considered a significant step for image and video processing.Although various image pattern algorithms have been proposed so far that achieved adequate classification,achieving higher accuracy while reducing the computation time remains challenging to date. A robust imagepattern classification method is essential to obtain the desired accuracy. This method can be accuratelyclassify image blocks into plain, edge, and texture (PET) using an efficient feature extraction mechanism.Moreover, to date, most of the existing studies are focused on evaluating their methods based on specificorthogonal moments, which limits the understanding of their potential application to various DiscreteOrthogonal Moments (DOMs). The

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