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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 Jun 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Effectiveness of Monetary Policy in Neutralizing Oil Price Fluctuations on the Gross Domestic Product in Iraq for the Period (1990-2019)
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The research aimed to measure the reality of monetary policy and its role in neutralizing the impact of fluctuations in total domestic oil prices, through the most important monetary policy variable (money supply). An example of this is using a simple technique in the previous example, turning it into a straightforward user interface by (Judd and Kunee). After estimating the impact of the policy with the domestic gross domestic oil prices in Iraq, the effect of fluctuations in the domestic gross domestic oil prices in the simple regression model, while the morale of oil prices was not proven with a negative sign, while the morale of money supply and their impact on the increase of the domestic was proven in the multiple regressio

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Publication Date
Mon Apr 24 2017
Journal Name
Spe Kingdom Of Saudi Arabia Annual Technical Symposium And Exhibition
Optimization of Infill Drilling in Whicher Range Field in Australia
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Abstract<p>Now that most of the conventional reservoirs are being depleted at a rapid pace, the focus is on unconventional reservoirs like tight gas reservoirs. Due to the heterogeneous nature and low permeability of unconventional reservoirs, they require a huge number of wells to hit all the isolated hydrocarbon zones. Infill drilling is one of the most common and effective methods of increasing the recovery, by reducing the well spacing and increasing the sweep efficiency. However, the problem with drilling such a large number of wells is the determination of the optimum location for each well that ensures minimum interference between wells, and accelerates the recovery from the field. Detail</p> ... Show More
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Publication Date
Mon Oct 30 2023
Journal Name
Iraqi Journal Of Science
On a Subclass of Meromorphic Univalent Functions With Fixed Second Coefficientsassociated with q-Differed Operator
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The main object of this article is to study and introduce a subclass of meromorphic univalent functions with fixed second positive defined by q-differed operator. Coefficient bounds, distortion and Growth theorems, and various are  the obtained results.

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Two Educational Models in Acquiring Historical Concepts and Orientation of Fourth Grade Students in History
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The study focuses on Kamez model and the Claus Meyer model of instructional design, which are models that provide the learner with educational experiences to suit the logical information of the learner and the variety of instructional models. Research Objective: The present research aims to identify Limitations of the study. The current research is determined by ((fourth grade preparatory students, the book of the date of the fourth preparatory course)) Chapter II includes Arabic and foreign studies on the model of Kemp and Claus Mayer in the acquisition of concepts and direction towards the material. Chapter III Experimental Design: The researcher adopted an experimental design with two experimental groups and a control group. The resea

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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
Thu Oct 14 2021
Journal Name
Kufa Medical Journal
The Relationship between Knowledge and Practice in Clinical Breast Examination among Women in Baghdad, Iraq
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Aim: This study aims to determine both the level  of knowledge, attitude, and practice  in clinical breast examination in women and the relationship between knowledge and practice.Data collection was performed within a three-month period starting from February 2019 on.  Subjects and Method: A cross-sectional analytical study included 657 non-randomly selected women visiting primary health care centers in Baghdad city with an average of age between (20-59) years old.  Results: Only 51.8% ever heard of clinical breast examination. The mean knowledge score for clinical breast examination was (51.2±44). Only 5.5% of women performed regular clinical breast examinations. Participants who adequately practice clinical breast examinatio

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical significance of Osteoprotegerin, Vitamin D, Obestatin and some biochemical variables in Kidney failure Patients
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Chronic kidney disease (CKD) is described as an abnormalities of renal function, existing for a long period of time. By reason of the early grades of Chronic kidney disease can be experiences no symptoms, its premature identification is strenuous. initial stage CRD can cause various complications, such as anemia, matabolyic disorders of bone mineral. The study was done to assess the effect the chronic renal disease stage on the Osteoprotegerin, 1,25 dihydroxyvitamin D, Obestatin levels and some biochemical parameters in patients not undertaken dialysis therapy. In this case-control study fifty-five patients with Kidney failure and fourty healthy people were examined. Circulating concentrations of Osteoprotegerin, 1,25 dihydroxyvitamin D

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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 Apr 06 2014
Journal Name
Journal Of Educational And Psychological Researches
Effectiveness of cooperative learning in at the implementation of floral material for celli graph and decoration
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The purpose of this resesrh know (the effectiveness of cooperative lerarning implementation of floral material for calligraphy and ornamentation) To achieve the aim of the research scholar put the two zeros hypotheses: in light of the findings of the present research the researcher concluded a number of conclusions, including: -
1 - Sum strategy helps the learner to be positive in all the information and regulations, monitoring and evaluation during the learning process.
2 - This strategy helps the learner to use information and knowledge and their use in various educational positions, and to achieve better education to increase its ability to develop thinking skills and positive trends towards the article.
In light of this, the

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Publication Date
Sun Jan 03 2016
Journal Name
Journal Of Educational And Psychological Researches
Test the effectiveness of Method EMDR
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Our country faced lots of crises specially Wars and still living under the traumatic events. This would result in psychological disorder specially the Acute Stress Disorder (ASD). That’s if not treated, it will turn to be over Post Traumatic Stress Disorder(PTSD). Also not mentioning the shortage of recourses speaks about war and crises. That treat with its inflections psychologically and sociologically theses cases if happened.

The importance of this study arise through it is objective to introduce a program for EMDR which give benefit for treat in health, social, educational institutes.

Aims:

The objective of this Study is the identification of a Test the effectiveness of Eye Movement Desensi

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