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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 Aug 30 2024
Journal Name
Iraqi Journal Of Science
Investigation of Flagellum genes FleN and FlgE and Gene Expression of FleN Gene in Pseudomonas Aeruginosa Clinical Isolates
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The opportunistic multidrug resistance pathogen Pseudomonas aeruginosa has one or several flagella, and the numbers of these sophisticated machines are regulated by the flagellar regulator gene FleN. The flagellar hook gene FlgE is important for its synthesis, motility and tolerance to antibiotics. Bacteriahave resistance to antibiotics, especially to cephalosporin beta-lactam antibiotics. For the current study, 102 clinical specimens were collected and identified using routine laboratory tests and confirmed by Vitek-2 compact system.  A total of 33 isolates of P. aeruginosa were identified. The antibiotic susceptibility test was done by the Vitek 2 Compact system. Flagellar gene detected by conventional PCR revealed that the FleN

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Publication Date
Tue Dec 30 2008
Journal Name
Al-kindy College Medical Journal
Clinical Evaluation of the Levels of CEA,CA15-3 and AlphaFeto Protein in Malignant and Benign Pleural Effusion
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Background: Pleural effusion is a common clinical
problem.
Objective: The aim of the study was to evaluate the
diagnostic utility of Carcino embryonic antigen
(CEA), CA 15- 3, and alpha-feto protein ( AFP ) as
a tumor markers in serum and pleural effusion and
evaluate the value of combining them as a diagnostic
tools that are complementary to cytology in the
diagnosis of malignancies .
Methods: Forty patients (18 malignant and 22 benign
pleural effusion) were included in this study .The
serum and effusion levels of CEA, CA 15 – 3 and
AFP were measured using immunoradiometric assay
Results: from the 40 effusions studied 26 were
exudates and 14 were transudates. The level of
pleural effusions

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Publication Date
Mon May 01 2023
Journal Name
Rimak International Journal Of Humanities And Social Sciences
THE EFFECT OF ARRANGING WOMEN'S ISSUES IN THE IRAQI ELECTRONIC NEWSPAPERS' WEBSITES ON THE COGNITIVE LEVEL OF IRAQI UNIVERSITY FEMALE TEACHERS A FIELD STUDY OF A SAMPLE OF FEMALE TEACHERS AT THE UNIVERSITY OF BAGHDAD
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Women are considered the real power to build societies, as they are half of society, and it is their responsibility to raise generations، as human history testifies to the recording of great names with their giving and achievement in various scientific, social and humanitarian disciplines. Because of the importance of women in our lives, society must give them special care, whether at home or within the community structure to which they belong, so that they contribute to the image that brings about a transformation in the public scene, as well as providing them with support to take charge of bringing about change themselves, and this explains the interest of the press at all levels. Women's issues and topics through various journal

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Publication Date
Sun Dec 01 2013
Journal Name
Diyala Journal Of Engineering Sciences
Design and Simulation of parallel CDMA System Based on 3D-Hadamard Transform
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Future wireless systems aim to provide higher transmission data rates, improved spectral efficiency and greater capacity. In this paper a spectral efficient two dimensional (2-D) parallel code division multiple access (CDMA) system is proposed for generating and transmitting (2-D CDMA) symbols through 2-D Inter-Symbol Interference (ISI) channel to increase the transmission speed. The 3D-Hadamard matrix is used to generate the 2-D spreading codes required to spread the two-dimensional data for each user row wise and column wise. The quadrature amplitude modulation (QAM) is used as a data mapping technique due to the increased spectral efficiency offered. The new structure simulated using MATLAB and a comparison of performance for ser

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Synthesis and Characterization of New phenolic Schiff bases Derivatives Based on Terephthaladehyde
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A variety of new phenolic Schiff bases derivatives have been synthesized starting from Terephthaladehyde compound, all proposed structures were supported by FTIR, 1H-NMR, 13C-NMR, Elemental analysis, some derivatives evaluated by Thermal analysis (TGA).

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Publication Date
Thu Mar 01 2018
Journal Name
Journal Of Engineering
Implementation of Power System Stabilizer Based on Conventional and Fuzzy Logic Controllers
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To damp the low-frequency oscillations which occurred due to the disturbances in the electrical power system, the generators are equipped with Power System Stabilizer (PSS) that provide supplementary feedback stabilizing signals. The low-frequency oscillations in power system are classified as local mode oscillations, intra-area mode oscillation, and interarea mode oscillations. A suitable PSS model was selected considering the low frequencies oscillation in the inter-area mode based on conventional PSS and Fuzzy Logic Controller. Two types of (FIS) Mamdani and suggeno were considered in this paper. The software of the methods was executed using MATLAB R2015a package.

 

 

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Proposed Hybrid Cryptosystems Based on Modifications of Playfair Cipher and RSA Cryptosystem
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Cipher security is becoming an important step when transmitting important information through networks. The algorithms of cryptography play major roles in providing security and avoiding hacker attacks. In this work two hybrid cryptosystems have been proposed, that combine a modification of the symmetric cryptosystem Playfair cipher called the modified Playfair cipher and two modifications of the asymmetric cryptosystem RSA called the square of RSA technique and the square RSA with Chinese remainder theorem technique. The proposed hybrid cryptosystems have two layers of encryption and decryption. In the first layer the plaintext is encrypted using modified Playfair to get the cipher text, this cipher text will be encrypted using squared

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Publication Date
Thu Dec 31 2020
Journal Name
Pollution Research Journal
ANALYSIS OF THE HYDRAULIC CHARACTERISTICS OF AL MAHAWIL STREAM USING HECRAS: A FIELD STUDY
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A water resources management for earthen canal/stream is introduced through creating a combination procedure between a field study and the scientific analytical concepts that distinguish the hydraulic problems on this type of stream with using the facilities that are available in HECRAS software; aiming to point the solutions of these problems. Al Mahawil stream is an earthen canal which is subjected to periodic changes in cross sections due to scour, deposition, and incorrect periodic dredging processes due to growth of the Ceratophyllum plants and weeds on the bed and banks of the stream; which affect the characteristics of the flow. This research aims to present a strategy of water resources management through a field study that conducte

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Publication Date
Mon Jan 01 2024
Journal Name
Journal Of Applied Pharmaceutical Science
The role of angiotensin converting enzyme (insertion)/(deletion) and angiotensin II type 1 receptor (A1166C) gene polymorphisms in antiproteinuric effect of ACE inhibitors in type 2 diabetic Iraqi patients
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The angiotensin converting enzyme (ACE) I\D gene polymorphism influences the blood ACE enzyme activity. Renoprotective effect of ACE inhibitors (ACEIs) varies among patients due to genetic variation, particularly in Renin-Angiotensin-Aldosterone System genes. This study investigates the genetic variations of ACE I\D and AGT1RA1166C gene polymorphisms in the antiproteinuric effect of ACEI therapy in type 2 diabetes mellitus (T2DM) patients. This is a cross-sectional study that included 76 T2DM patients who are ACEI users, divided into two groups: T2DM without diabetic kidney disease (DKD) included 31 patients, and T2DM with DKD included 45 patients. Urine samples were taken for measurement of urine albumin and creatinine, then calcul

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Publication Date
Wed Mar 15 2023
Journal Name
Al-academy
Dramatic Dialogue And Its Effectiveness In Enhancing The Characteristics Of The Alienated Character In The Television Series
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Dialogue is one of the pillars of character building in the television series, through which it is possible to identify the most important characteristics and traits of the personality, in addition to its ability to reveal the most important problems at all levels. The following: (How does dialogue contribute to enhancing the traits of the alienated personality?). It therefore aims to identify the effectiveness of the dramatic dialogue in enhancing the traits of the alienated personality represented by (powerlessness, isolation, meaninglessness, objectification, non-standardization and rebellion). (The traits of the alienated character, and the second is the psychological function of the dramatic dialogue), to extract from them the main

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