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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
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
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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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
Fri Jun 29 2018
Journal Name
Journal Of The College Of Education For Women
Audio Classification Based on Content Features
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Audio classification is the process to classify different audio types according to contents. It is implemented in a large variety of real world problems, all classification applications allowed the target subjects to be viewed as a specific type of audio and hence, there is a variety in the audio types and every type has to be treatedcarefully according to its significant properties.Feature extraction is an important process for audio classification. This workintroduces several sets of features according to the type, two types of audio (datasets) were studied. Two different features sets are proposed: (i) firstorder gradient feature vector, and (ii) Local roughness feature vector, the experimentsshowed that the results are competitive to

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Publication Date
Sun Oct 01 2023
Journal Name
Baghdad Science Journal
Watermark Based on Singular Value Decomposition
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Watermarking operation can be defined as a process of embedding special wanted and reversible information in important secure files to protect the ownership or information of the wanted cover file based on the proposed singular value decomposition (SVD) watermark. The proposed method for digital watermark has very huge domain for constructing final number and this mean protecting watermark from conflict. The cover file is the important image need to be protected. A hidden watermark is a unique number extracted from the cover file by performing proposed related and successive operations, starting by dividing the original image into four various parts with unequal size. Each part of these four treated as a separate matrix and applying SVD

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Publication Date
Tue Mar 01 2022
Journal Name
Journal Of Osseointegration & Oral Rehablitation
Evaluation of marginal bone loss around SLActive implants by CBCT using different implant dimensions and surgical approaches: A clinical and radiological prospective study
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Aim: The reduction in the amount of marginal bone is the most important demand for the long term success of dental implants. This prospective clinical study was aimed to investigate the marginal bone loss of early loaded SLActive implants with different dimensions and surgical approaches. Materials and methods Fifteen patients aged from 18 to 60 years were divided into 2 groups (flapped and flapless approach) that underwent delayed implant placement protocol with SLActive implants. The marginal bone level was estimated by cone-beam computed tomography during three different periods: preoperatively, 8 weeks after surgery and 24 weeks after loading of the prosthesis. Results: The mean value of marginal bone level was not significantly chan

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Publication Date
Thu Apr 06 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Impact of a Scenario-Based Learning Model in Mathematics Achievement and Mental Motivation for High School Students
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Publication Date
Tue Aug 19 2025
Journal Name
Scientific Reports
Predictive modeling of asthma drug properties using machine learning and topological indices in a MATLAB based QSPR study
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Publication Date
Fri Jun 19 2026
Journal Name
Iraqi Journal Of Mechanical And Material Engineering
THE INFLUENCE OF FRICTION FACTOR ON THE COMBINED CONVECTIVE AND RADIATIVE HEAT TRANSFER IN A RECTANGULAR DUCT WITH INTERIOR CIRCULAR CORE
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Publication Date
Thu Jun 08 2023
Journal Name
University Of Thi-qar Journal Of Agricultural Research
A review: Machine relationship with the tractor and its effect on the productivity and compaction of agricultural soil
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The influence of process speed (PS) and tillage depth (TD) , on growth of corn (Zea mays L) yield, for Maha cultivar, were tested at two ranges of PS of 2.483 and 4.011 km.hr-1, and three ranges of TD of 15,20 and 25cm. The experiments were conducted in a factorial experiment under complete randomized design with three replications. The results showed that the PS of 2.483 km.hr-1 was significantly better than the PS of 4.011km.hr-1 in all studied conditions. The , slippage ratio (SR) and the machine efficiency (ME), the physical soil characteristics represented by the soil density and porosity (SBD and TSP), and the plant characteristics represented the roots dry weight, PVI and the crop productivity (CP), except adjective of the fu

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