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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 Jan 01 2026
Journal Name
Veterinary Medicine International
Comparative Effects of Intravaginal Progesterone Sponge Durations (Short vs. Long Duration) With or Without Probiotics on Vaginal Microbiota Balance and Reproductive Performance in Black Iraqi Goats
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Intravaginal progesterone sponges have been widely utilized to synchronize estrus in goats; however, extended use may be accompanied by vaginal microbial imbalance, vaginal discharge abnormalities, and diminished reproductive performance. Intravaginal probiotics have been suggested as an alternative to antibiotics for addressing vaginal dysbiosis, but their effects across varying synchronization durations have not been thoroughly studied in goats. The current study was conducted to assess the effect of intravaginal probiotic use in association with various progesterone sponge durations on vaginal microbiota and reproductive effciency in Black Iraqi goats. Forty-four adult goats (2–5 years) were randomly assigned to four groups (n = 11) fo

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Publication Date
Thu May 11 2017
Journal Name
Journal Of Language Teaching And Research
Subjectless Sentences vs. Subjectless Clauses
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BN Rashid, Journal of Language Teaching and Research, 2017 - Cited by 1

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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Economics And Administrative Sciences
Estimating Demand for Imported Food Categories in Iraq
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Iraq is highly dependent on international markets to provide food for its residents. As imported food prices are highly dependent on crude oil prices in global markets, any shock in oil prices will have an impact on food consumption in the country. As a result, it is essential to study the demand for imported food at every time period. To the best of our knowledge as researchers, as not even a single study is available in the literature, this paper is considered the first to study the demand for imported food groups in Iraq. Therefore, the main objective of this research is to estimate demand elasticities for several imported food categories in Iraq. This study uses an Almost Ideal Demand System model to analyze the demand for imported f

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Publication Date
Wed Apr 01 2026
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Sequencing of Catalytic Serine Protease, Linker, and Activation Peptide Domains-Coding Regions of the F9 Gene in Iraqi Hemophilia B Patients
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Background: Hemophilia B is an X-linked recessive disorder caused by mutations in the F9 gene, causing bleeding tendency predominantly in males. The mutational spectrum of the F9 gene has not been adequately studied in Iraq. Objectives: To detect the disease-causing variants of exons 6, 7, and 8 and immediate introns of F9 gene using Sanger sequencing among Iraqi hemophilia B patients and to correlate them with phenotypes. Methods: Forty Iraqi hemophilia B patients were recruited for this cross-sectional study from The Hereditary Bleeding Disorder Ward in the Children Welfare Teaching Hospital, Medical City, Baghdad, between November 2021 and April 2022 using a consecutive sampling technique. Peripheral blood samples were used for sequencin

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Publication Date
Tue Mar 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Formation Evaluation for Nasiriyah Oil Field Based on The Non-Conventional Techniques
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The unconventional techniques called “the quick look techniques”, have been developed to present well log data calculations, so that they may be scanned easily to identify the zones that warrant a more detailed analysis, these techniques have been generated by service companies at the well site which are among the useful, they provide the elements of information needed for making decisions quickly when time is of essence. The techniques used in this paper are:

  • Apparent resistivity Rwa
  • Rxo /Rt

   The above two methods had been used to evaluate Nasiriyah oil field formations (well-NS-3) to discover the hydrocarbon bearing formations. A compu

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of COX-2 Inhibitors Selectivity on Lipid Profile in Hyperlipidemic and Normolipidemic Type 2 Diabetics
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Development of NSAIDS based on inhibiting cyclooxygenase activity. However, the different physiological consequences arrised by appearance of new drugs with different selectivity to COX-2 enzyme upon their administration with their relevant affects on some cardiovascular risk factors. To study the potential effects of relatively  diclofenac and highly specific  celecoxib COX-2 inhibitors on lipid profile and serum C-reactive protein in type 2 diabetes, whom have hyperlipidemia to be compared by their effects with normolipidemic patients. A total number of 34 type 2 diabetics (14 normolipidemics and 20 hyperlipidemics) treated with either diclofenac 100mg/day or celecoxib 200mg/day for eight weeks. Analysis  of results indi

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Publication Date
Sun Mar 10 2024
Journal Name
Journal Of Sport And Health Research
The effectiveness of a rehabilitation program with aqueous media on the egree of pain and balance for those suffering from sacroiliitis in football players
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Abstract in English  The aim of this study is to identify the effectiveness of rehabilitation exercises in conjunction with aquatic therapy for those suffering from sacroiliitis in football players. The researcher used the experimental approach, using the experimental design (pre-measurement, post-measurement). Similar to the objectives and procedures of the research, the researcher assumed the following: the existence of significant differences. Statistics between pre- and post-measurements in variables in favor of post-measurement for the following variables (degree of pain and level of balance). The experimental approach was used with a pre- and post-measurement design on one group of football players with sacroiliitis, nu

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Language Teaching And Research
Islamification vs. Islamophobia: A Message to the Youth in the Occident: Critical &amp; Rhetorical Inquiries
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Drawing upon the recent theoretical framework of Burkean concept of identification (ID), the current study aims at probing the interaction of content and form in two letters penned by Iran’s Supreme Leader and addressed to the Youth on Jan. and Nov. 2015. To this end, the study seeks (i) to determine a role ID takes in the conveyance of intended assumptions to the targeted readers; and (ii) to observe if the writer’s objectives, i.e. to identify himself with the readers and to realize his politically-religiously-infused creeds, result in success or failure; moreover, (iii) it seeks to determine how he achieved his end to attenuate the impacts of blazing inferno of Islamophobia and anti-Islam sentiments in his addressees. The who

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Publication Date
Sat Feb 01 2025
Journal Name
Saudi Medical Journal
Spectrum and classification of ATP7B variants with clinical correlation in children with Wilson disease
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Publication Date
Wed Sep 23 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Oral Health in Hypertensive Patients Treated with HMG-CoA Reductase Inhibitors (Statins)
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Background: Hypertension is a chronic medical condition in which the blood pressure in the arteries is elevated, it's classified as either primary (essential) hypertension or secondary hypertension, and it increases the risk of ischemic heart disease, peripheral vascular disease and other cardiovascular diseases. Several classes of medications collectively referred to as antihypertensive drugs like beta blockers, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, renin inhibitors and statins (HMG-CoA) reductase inhibitor. Statin medication may have some beneficial effects when subjects have dental plaque or signs of periodontitis as gingival bleeding. The purpose of this study were to as

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