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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
Mon Jan 13 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Environmental Cost Management And The Role Of Sustainable Environmental Development: بالتطبيق في مصنع اسمنت باجل
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The environmental cost management focus on continuous improvement of processes and the various activities of the organization in order to improve the environmental performance by producing an environmentally friendly products lead to a competitive advantage for the organization and supports the activities of their sustainability.

  The study was carried out in Bagel cement factory, one of the pioneer projects in Yemen in manufacturing field, The study found the need to develop a separate section for environmental management in order to put plans and environmental policies and the introduction of a special division in the Department of costs cares about Management practices cost and measure environmental costs, also give solu

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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Engineering
Adsorption of Chromium (Vi) from Aqueous Solutions using Low Cost Adsorbent: Equilibrium and Regeneration Studies
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The adsorption of Cr (VI) from aqueous solution by spent tea leaves (STL) was studied at different initial Cr (VI) concentrations, adsorbent dose, pH and contact time under batch isotherm experiments The adsorption experiments were carried out at 30°C and the effects of the four parameters on chromium uptake to establish a mathematical model description percentage removal of Cr (VI). The
analysis results showed that the experimental data were adequately fitted to second order polynomial model with correlation coefficients for this model was (R2 = 0.9891). The optimum operating parameters of initial Cr (VI) concentrations, adsorbent dose, pH and contact time were 50 mg/l, 0.7625 g, 3 and 100 min, respectively. At these conditions, th

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of the effectiveness of using platelet rich fibrin (PRF) as a sole grafting material and membrane in augmentation of dehiscence and fenestration defects encountered during dental implant surgery
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Background: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Physical Education Program on the Domains of the University Students, Attitudes toward Physical Fitness
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Objectives: To determine the effectiveness of physical education program on the domains of the university
students attitudes of physical activity and health, physical activity and mental health, physical activity and nutrition
toward physical fitness.
Methodology: A quasi-experimental design is carried out throughout the present study with the application of
test-retest approach through the period from February 3rd 2013 to June 30th 2013. The study is conducted on
purposive sample of(40) Undergraduate Students at the College of Science University of Baghdad . The sample is
Consisted of (20) males and (20) females. Questionnaire of two main parts, Personal and demographic
information and students' attitudes about phys

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Publication Date
Fri Apr 01 2016
Journal Name
Al–bahith Al–a'alami
Journalism of Paper Newspapers in Light of the Competition of the Electronic Press / (A Field Study of Yemeni Daily Newspapers)
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The researcher seeks to get scientific facts through knowing the relationship between the priorities of Yemeni audience in follow-up paper daily newspapers compared to surfing publics the online journalism sites and the nature of information obtained from online journalism sites and printed paper newspapers and the impact of the daily newspapers in the priority of issues and political events among a sample of a group of Yemeni readers in order to identify the extent to keep up the paper daily newspapers of the development in the field of online journalism and the extent of reading paper newspapers under the intense competition by online journalism sites, and are paper newspapers able to keep pace with the actual developments provided by

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Efficiency of Human Resources Information System and Its Impact on The Level Effectiveness of Employees Performance Appraisal System / Practical Research on Ministry of Higher Education and Scientific Research
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Abstract

The research aims to determine the role of the efficiency of Human Resources Information System in the effectiveness of Employees Performance Appraisal System in the Ministry of Higher Education and Scientific Research / Center for the ministry, it was touching the researchers need the ministry to devise methods that employ outputs Human Resources Information System in the organization surveyed for the development of methods and levels of process evaluate the performance of its employees, in order to identify the extent of the role played by human resources information system in the process of assessing the performance of employees, we raised the question of the President as follows:

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an educational program on nurses' knowledge regarding management of extravasation vesicant intravenous chemotherapy at oncology centers in Baghdad city
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Objectives: to determine the effectiveness of an Education Program on Nurses' Knowledge regarding management of extravasation vesicant intravenous chemotherapy

Methodology: quiz-experimental study (single-group pretest-posttest1 and posttest2) was directed in Amal oncology center and national oncology center in Baghdad city from 13th, December 2018 to the 7 of February 2019. The program and tool have been created by the researcher for the purpose of the study. A non- probability purposive sample of (40) nurses who employed in Baghdad oncology centers. Validity and reliability of the instrument were determined through a pilot study. Data were analyzed through the use of Statistical Pack

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of the Health Action Process Approach on Promoting the Health Behaviors of Male High School Students in Al-Rusafa District
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Objectives: The study aimed to evaluate health behavior, evaluate Health Action Process Approach, determine the effectiveness of the Health Action Process Approach based the application of program on students’ engaging in regular physical exercise.

Methodology: The research design for this study was a quasi-experimental. The study sample included high school male students, the final sample size was(160 ) Non-probability sampling (convenience sample) are chosen, (80) students study group and (80) students control group.

Results: The results show there was no statistically significant difference in the HAPA constructs among family's socioeconomic class groups and less tha

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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of An Instructional Program on Pulmonary Tuberculosis Patients Quality of Life Concerning General Health-Related among sample in Baghdad City
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Objective(s): This research aims at evaluating the quality of pulmonary tuberculosis patients life before and after applying the suggested instructional program, and to find out relationships among distribution of an overall assessment quality of life improvement and socio-demographic characteristics variables. Methodology: Self controlled design studying effectiveness of applying instructional program on quality of life for pulmonary tuberculosis patients among sample size (65) patients from primary health care centers/AL-Sadur City sector-the consultation clinic of chest and respiratory diseases at AL

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Education Program on Nurses- Midwives' knowledge toward Postpartum Hemorrhage at Delivery Room of Maternity Hospitals in Baghdad City
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 Objectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May 

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