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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 Nov 28 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Comparative Efficacy of Biologics vs. Conventional Therapies in Psoriasis: A Meta-Analysis of a Decade of Progress From 2015 to 2025
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Background: The treatment of moderate-to-severe psoriasis has advanced significantly with the use of biologic treatments. Objective: To compare the effectiveness, safety, and impact on quality of life of biologic therapies versus conventional systemic therapies for moderate-to-severe psoriasis, using evidence from 2015 to 2025, focusing on the implications for understudied regions such as Iraq and the Middle East. Methods: Data was collected using "Embase," "MEDLINE," "PubMed," and "Cochrane Central Register." The study includes 45 randomized controlled trials. Additionally, 25 key real-world evidence studies were included for qualitative synthesis to provide context on long-term drug survival, quality of life, and regional applicab

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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of Teaching Program Based on The Theory of Multiple Intelligence in the Development of Literary Thinking Among Students
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The research aims to know the effectiveness of a training program based on multiple intelligence theory in developing literary thinking among students of the Arabic Language Department at Ibn Rushd School of Humanities and to achieve the goal of research, the Safaris Research Institute, and the research community of Arabic language students in the Faculty of Education the third section of Arabic Language: The research sample consists of (71) students. Divided into (35) students in the experimental group and (36) students in the control group, the researcher balanced between the two groups with variables (intelligence, testing of tribal literary thinking, and time age in months), and after using the T-test for two independent samples, the

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Publication Date
Mon Jan 02 2012
Journal Name
Journal Of Biotechnology Research Center
The Prophylactic Role of Lipopolysaccharide of Pseudomonas aeruginosa Against Corneal Infection
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Publication Date
Fri Jul 11 2025
Journal Name
Scientific Reports
Molecular docking study and pharmacokinetic insights of rifampicin in pure and capsule dosage forms
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To detect the amount of Rifampicin in bulk and medicinal dosage formulations, an accurate, and cost-effective UV spectrophotometric technique has been developed using the area under the peak to estimate the presence of Rifampicin. This range of wavelengths (300–356) nm was chosen. The method showed linearity in the 2-22 μg/mL range, with R2 being 0.9996. The developed method' linearity, detection limit, quantification limit, precision, repeatability, and accuracy were all statistically and experimentally validated. The suggested methodology can be used for routine quality control analysis of Rifampicin in pure form and in capsule dosage form, as demonstrated by the satisfactory recovery percentage results. This study explores the struct

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Publication Date
Fri Jul 11 2025
Journal Name
Scientific Reports
Molecular docking study and pharmacokinetic insights of rifampicin in pure and capsule dosage forms
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To detect the amount of rifampicin in bulk and medicinal dosage formulations, an accurate and costeffective UV spectrophotometric technique has been developed using the area under the peak to estimate the presence of rifampicin. This range of wavelengths (300–356 nm) was chosen. The method showed linearity in the 2–22 μg/mL range, with R2 being2 0.9996. The developed method’s linearity, detection limit, quantification limit, precision, repeatability, and accuracy were all statistically and experimentally validated. The suggested methodology can be used for routine quality control analysis of rifampicin in pure form and in capsule dosage form, as demonstrated by the satisfactory recovery percentage results. This study explores the str

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Publication Date
Wed Aug 15 2018
Journal Name
Online Journal Of Veterinary Research
Prevalence and type of fungi in milk fromgoats with sub clinical mastitis
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Publication Date
Wed Jun 01 2016
Journal Name
Drug Design, Development And Therapy
Prophylactic effects of Clausena excavata Burum. f. leaf extract in ethanol-induced gastric ulcers
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Publication Date
Wed Jan 18 2017
Journal Name
International Journal Of Pharmacy Practice
Antimicrobial utilization in an Iraqi province: a comprehensive evaluation of antibiotic source and cost
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Publication Date
Tue Jan 28 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Human Resources Accounting And its Reflection on Quality Cost
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The development of human resources training programs can assist in agreat deal in creating products of high quality with quantitive advantage for the economicunit;through the sale of products by prices higher of the peer products price in the arket,or decreasing production costs which lead into increusing the unet  profits. for these reasons, the human resources have got great importance for their great role in  any economy,and they havestarled to consentrate on accounting these resource.From this point of view, this research has handied human resources accounting and their effect on quality costs.  In(MID-Refinery Company),quality costs are determined ,then we have larified the reality of training and development in the o

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Publication Date
Tue Jun 03 2025
Journal Name
Journal Of Biotechnology Research Center
The Link between NAFLD and Colorectal Cancer: Insights from Liver Function Enzymes and Serum Biomarkers in a Case-Control Study
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Background: Colorectal cancer (CRC) is a major killer, and nonalcoholic fatty liver disease (NAFLD) affects almost one-quarter of the global population. The aim of the study is to Investigate the correlation between nonalcoholic fatty liver disease (NAFLD) and an increased risk of colorectal cancer (CRC), as well as the relationship between liver function enzymes and specific serum biomarkers in CRC patients with NAFLD. Methods: A case-control study involving 60 participants was conducted from February to August 2022. The patients with colon cancer were examined at Baghdad Medical City's Al-Amal Hospital for Radiation and Nuclear Medicine and Oncology Teaching Hospital, and blood samples were taken. Thirty patients with NAFLD who ha

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