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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
Sun Jan 01 2023
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF TARGET COST MANAGEMENT APPROACH IN REDUCING COSTS FOR THE ACHIEVEMENT OF COMPETITIVE ADVANTAGE AS A MEDIATOR: AN APPLIED STUDY OF THE IRAQI ELECTRICAL INDUSTRY
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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
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The reality of the application of cost accounting system in the contracting institutions in the kingdom of Saudi Arabia
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The study aimed to identify the reality of the application of cost accounting system in the contracting institutions in Saudi Arabia, and the extent of the reflection of the application of this system on the effectiveness and efficiency of the general performance of these institutions. Where the research community consists of the contracting institutions operating in the Saudi Arabia, and then a suitable random sample was selected from seventy one institutions. The researchers used the historical method to track the previous studies as well as the descriptive approach to conducting the field study. The study data were analyzed by SPSS statistical program.

The results of this study conclude that there is a

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Publication Date
Sun Sep 01 2019
Journal Name
Baghdad Science Journal
Detection a New Antiseptic Resistant Variant of qac Gene in Some Multi Drug Resistant Staphylococcus aureus Isolated from Different Clinical Sources
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The increasing use of antiseptic compounds creates selective pressure cause emergence of antiseptic resistance among Staphylococcus aureus .Resistance mechanism of antiseptic is driven mainly by multi drug resistant (MDR) efflux protein.Sixty five isolates of S.aureuswere collected from different clinical sources and subjected to 11 antibiotics most of them are recognized by efflux systems as extruded substrates. Range of efflux activity was estimated using cartwheel method. Simultaneous discrimination of antiseptic coding genes (qacA/B, smr and norA)as well as nuc and mecA genes among multidrug resistantS.aureus(MRSA) isolates was preformed using multiplex PCR assay

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Structured Educational Program on Nurses’ Practices Concerning Therapeutic Communication at Cardiac Care Units in Holy Karbala Governorate Hospitals
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Abstract
Objectives: This study aimed to evaluate the effectiveness of an educational program on nurses' practices concerning therapeutic communication.
Methodology: A quasi experimental design was carried out at Karbala Center for Cardiac Diseases and Surgery, Imam Hussein Medical City and Al-Handia General Hospital for period 10th June 2017 to the 15th of August 2018.
The program and instruments were constructed and developed by the researcher to measure the purpose of the study. Purposive sample comprised of (57) nurses were divided into two groups, study and control groups. The questionnaire consisted from two parts, first part is related to nurses' demographic characteristics and second part which include practices checkl

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instructional Health Educational Vascular Access on Hemodialysis Patients' Knowledge at Al-Hussein Teaching Hospital in AL-Nasiriyah City.
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Objectives: The study aims: (1) To determine effectiveness of instructional health education vascular access on hemodialysis patients' knowledge, (2) To find out the association between effects of instructional health education vascular access and demographic characteristics of (age, gender and educational level). Methodology: A quasi experimental study –control study design is carried out at AL-Hussein Teaching Hospital in AL-Nasiriyah City, from 3November,2015 to 2 June, 2016. A non-probability (Purposive sample) of (80) patients with vascular access devices on maintenance hemodialysis patients divided int

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Publication Date
Thu Jun 01 2023
Journal Name
Iraqi Journal Of Physics
Effect of Organic / Inorganic Gate Materials on the Organic Field-Effect Transistors Performance
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The choice of gate dielectric materials is fundamental for organic field effect transistors (OFET), integrated circuits, and several electronic applications. The operation of the OFET depends on two essential parameters: the insulation between the semiconductor layer and the gate electrode and the capacitance of the insulator. In this work, the electrical behavior of a pentacene-based OFET with a top contact / bottom gate was studied. Organic polyvinyl alcohol (PVA) and inorganic hafnium oxide (HfO2) were chosen as gate dielectric materials to lower the operation voltage to achieve the next generation of electronic applications. In this study, the performance of the OFET was studied using monolayer and bilayer gate insulators. To mo

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Publication Date
Thu Feb 13 2020
Journal Name
Thesis
IMPLICATION OF GEOMECHANICAL EVALUATION ON TIGHT RESERVOIR DEVELOPMENT / SADI RESERVOIR HALFAYA OIL FIELD
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IMPLICATION OF GEOMECHANICAL EVALUATION ON TIGHT RESERVOIR DEVELOPMENT / SADI RESERVOIR HALFAYA OIL FIELD

Publication Date
Thu Jun 01 2023
Journal Name
Iraqi Journal Of Physics
Effect of Organic / Inorganic Gate Materials on the Organic Field-Effect Transistors Performance
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The choice of gate dielectric materials is fundamental for organic field effect transistors (OFET), integrated circuits, and several electronic applications. The operation of the OFET depends on two essential parameters: the insulation between the semiconductor layer and the gate electrode and the capacitance of the insulator. In this work, the electrical behavior of a pentacene-based OFET with a top contact / bottom gate was studied. Organic polyvinyl alcohol (PVA) and inorganic hafnium oxide (HfO2) were chosen as gate dielectric materials to lower the operation voltage to achieve the next generation of electronic applications. In this study, the performance of the OFET was studied using monolayer and bilayer gate insulators.

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Publication Date
Wed Apr 05 2023
Journal Name
Journal Of Engineering
Construction Time-Cost Optimization Modeling Using Ant Colony Optimization
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In the field of construction project management, time and cost are the most important factors to be considered in planning every project, and their relationship is complex. The total cost for each project is the sum of the direct and indirect cost. Direct cost commonly represents labor, materials, equipment, etc.
Indirect cost generally represents overhead cost such as supervision, administration, consultants, and interests. Direct cost grows at an increasing rate as the project time is reduced from its original planned time. However, indirect cost continues for the life of the project and any reduction in project time means a reduction in indirect cost. Therefore, there is a trade-off between the time and cost for completing construc

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