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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 Dec 13 2005
Journal Name
Iraqi Journal Of Laser
Clinical Observation and Performance of High Power Diode Laser in the Treatment of Oral Lesions
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In this work, oral lesions belong to 17 patients, 7 males and 10 females. Their ages range between 15 and 45 years. Follow up was conducted after one day, 7 days, 14 days, one month, and finally 3 months postoperatively. The study lasted for 1.5 year. Surgical diode laser with wavelength of 810 ± 20 nm, with two power levels of 10 and 15 W were used in contact and in non-contact mode via optical fiber. The postoperative outcome revealed; greater haemostatic capability, dry, sealed wound and noticeable lack in pain sensation

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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
Sun Nov 26 2017
Journal Name
Journal Of Engineering
Reservoir Characterizations and Reservoir Performance of Mishrif Formation in Amara Oil Field
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Mishrif Formation is the main reservoir in Amara Oil Field. It is divided into three units (MA, TZ1, and MB12). Geological model is important to build reservoir model that was built by Petrel -2009. FZI method was used to determine relationship between porosity and permeability for core data and permeability values for the uncored interval for Mishrif formation. A reservoir simulation model was adopted in this study using Eclipse 100. In this model, production history matching executed by production data for (AM1, AM4) wells since 2001 to 2015. Four different prediction cases have been suggested in the future performance of Mishrif reservoir for ten years extending from June 2015 to June 2025. The comparison has been mad

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Investigate the effectiveness of investment in the electricity sector And its role in achieving sustainable development
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The provision of electric power is necessary for the advancement of the country's economy. It is the main engine of the economy and its various activities. It is an indicator of social welfare and it is considered as the basic pillars for achieving sustainable development (economic, social, environmental and institutional) by raising the levels of performance and meeting local needs. The problem of research was the absence of a program to audit the performance of the electricity sector contributes to ensure the application of sustainable development. The research was based on the hypothesis that the preparation of a proposed program to audit the performance of the electricity sector contributes to the achievement of The researchers sough

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Publication Date
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of osteoporosis prevention instruction program on nursing college students’ knowledge at Baghdad University
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Objective(s): Assess the effectiveness of osteoporosis prevention instruction program on nursing college students’
knowledge at Baghdad University.
Methodology: A quasi-experimental design was used to assess the effectiveness of osteoporosis prevention
instruction program on nursing college students at University of Baghdad from April 2011 to September 2011. A
random sample consisted of (40) females students from first year of Nursing College \ Baghdad University. The data
was collected by using constructed questionnaire, which consists of three parts. Part one: consists of demographic
information and health characteristics .Part two: consists of students’ daily life behaviors which include, dietary
behaviors, an

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Stator Faults Diagnosis and Protection in 3-Phase Induction Motor Based on Wavelet Theory
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Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
A turbidimetric method for the quantitative determination of cyproheptadine hydrochloride in tablets using an optoelectronic detector based on the LEDs array
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Scopus (17)
Crossref (3)
Scopus Crossref
Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
A turbidimetric method for the quantitative determination of cyproheptadine hydrochloride in tablets using an optoelectronic detector based on the LEDs array
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Scopus (17)
Crossref (3)
Scopus Crossref