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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 Oct 02 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Clinical Approach and Treatment of Benign and Malignant Parotid Masses
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Background: Parotid gland tumors account for 80% of all salivary gland neoplasms, 20% of these are malignant, but in daily clinical practice most parotid masses are operated on before obtaining the final histological diagnosis. This clinical setting further complicates the critical point of parotid surgery, which is the management of the facial nerve. Materials and methods: 45 patients underwent parotidectomy for benign and malignant neoplasms. A complete history is collected from the patients with the duration and the site of the tumor, the facial nerve examined and its associations, a medical consultation done for opinion and management. Clinical examination with facial nerve was mandatory to avoid any mistakes that may occur. The most si

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The relationship between organizational justice and empowerment and their impact on achieving organizational commitment (field study in the Department of Labor and Vocational Training)
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The research has deal with the relationship between organizational justice and empowerment and their impact on the achievement of organizational commitment in the office of Labour and Vocational Training. To study the research problem which is represented a sense that employees with low levels of organizational justice and empowerment and the reflection on the organizational commitment of the employees, so that Has been collecting data and information relating to research by designing a questionnaire, were distributed to a sample of (50) people in the office mentioned, and the results of the study to confirm the research hypotheses. and the key results of the research was the presence of correlation relationships and the effect o

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Evaluate the implementation of the investment plan projects A study on the field of the plan projects for the period 2013-2016
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The main problem of this research is the delay of implementation of the investment plan projects for the period (2013-2016) and the weakness of the staff ability in the ministries and they don’t have the sufficient experience to carry out the implementation process.

Therefore, the research aims to evaluate the implementation of programs and projects of the investment plan in a manner consistent with the objectives set for them without any wasteful of efforts, time and money. And then identify the problems and obstacles to determine the deviations of the implementation of the specific for each sector according to the criteria of evaluation and the form of cost, quality, time and implementation.<

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Publication Date
Mon Dec 25 2017
Journal Name
Biomedical And Pharmacology Journal
Evaluation of Crestal Bone Loss and Alkaline Phosphatase Level in Saliva According To Different Flap Designs in Single-Tooth Dental Implant Surgery (A Clinical Comparative Study)
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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Random Number Generation for Quantum Key Distribution Systems Based on Shot-Noise Fluctuations in a P-I-N Photodiode
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A simple setup of random number generator is proposed. The random number generation is based on the shot-noise fluctuations in a p-i-n photodiode. These fluctuations that are defined as shot noise are based on a stationary random process whose statistical properties reflect Poisson statistics associated with photon streams. It has its origin in the quantum nature of light and it is related to vacuum fluctuations. Two photodiodes were used and their shot noise fluctuations were subtracted. The difference was applied to a comparator to obtain the random sequence.

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Publication Date
Thu Nov 02 2023
Journal Name
Journal Of Engineering
Improving Voltage Stability in Kurdistan Power System in Areas with Deficit Power Production by Rescheduling the Active Power Based on PSS/E Simulation
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This paper aims to improve the voltage profile using the Static Synchronous Compensator (STATCOM) in the power system in the Kurdistan Region for all weak buses. Power System Simulation studied it for Engineers (PSS\E) software version 33.0 to apply the Newton-Raphson (NR) method. All bus voltages were recorded and compared with the Kurdistan region grid index (0.95≤V ≤1.05), simulating the power system and finding the optimal size and suitable location of Static Synchronous Compensator (STATCOM)for bus voltage improvement at the weakest buses. It shows that Soran and New Koya substations are the best placement for adding STATCOM with the sizes 20 MVAR and 40 MVAR. After adding STATCOM with the sizes [20MVAR and 40MV

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Influence of behavioural implication of information on the selection of accounting methods and their reflection on investor's decisions field study on Iraq stock exchange
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The research aims to highlight on the behavioural approach in accounting, and clarify the behavioural implications of the main activities of accounting, and clarify the concept of information inductance within the framework of the behavioural approach and its impact on preparing financial statements. And that the impact of financial information on the behaviour of investment decision-makers, and to achieve the goals of the research, the researcher prepared a questionnaire according to Likert five-step scale, and he took into consideration in preparing it in line with the characteristics of the study community, and that the target community for this questionnaire is the investors in the Iraq Stock Exchange. The researcher reached

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
HRM Management Approaches, With a Focus on Employee Centric Approach: A Case Study In The Rafidain Bank In Iraq
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This research attempts to shed light on a topic that is considered one of the most important topics of HRMs management, which is the Employee centric approach by examining its philosophy and understanding . To achieve the goal, the research relied on the philosophical analytical method, which is one of the approaches used in theoretical studies. The research reached a set of conclusions, the most important of which are the theoretical studies that addressed this entry in the English language and the lack of it in the Arabic language, according to the researcher's knowledge. The research reached a set of recommendations, the most important of which was that this approach needs more research, analysis and study at the practical and th

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Publication Date
Mon Jan 01 2018
Journal Name
Current Research In Microbiology And Biotechnology
Detection of some Physiological and Immunological parameters in Iraqi clinical and subclinical hypothyroid patients: Relationship study
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The present study was performed to evaluate the level of some risk factors (biochemical and immunological) in hypothyroid Iraqi patients considering the different thyroid functional states (hypothyroidism and subclinical hypothyroidism).The study includes 82 patients clinically diagnosed with hypothyroidism. Three study groups have been investigated: (47 clinical hypothyroid patients, 12 subclinical hypothyroid patients 23 healthy individuals) of different ages. This study, show that the proportion of females (83.3 %), (87.2%) in subclinical and clinical hypothyroidisim respectively higher than the proportion of males (16.7%),(12.8%) in subclinical and clinical hypothyrodism respectively of the total patients.The majority of subclinical hyp

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Publication Date
Tue May 31 2022
Journal Name
Journal Of Positive School Psychology
A GENRE-BASED ANALYSIS OF POLITICAL SPEECHES IN THE UN GENERAL ASSEMBLY
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