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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 Nov 14 2024
Journal Name
Journal Of Emergency Medicine, Trauma And Acute Care
Isolation, optimization, and redesigning of phages of methicillin-resistant Staphylococcus aureus from clinical hospital isolates in Baghdad
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Background: A global health concern is methicillin-resistant Staphylococcus aureus (MRSA). The use of bacteriophages is one of the many novel control strategies against MRSA that are frequently sought. However, it is quite challenging to isolate enough lytic anti-MRSA phages. In order to extract, optimize, and remodel anti-MRSA phages, this study sought novel approaches.

Methods: Two ATCC MRSA strains and nine clinical MRSA isolates were used to isolate wild anti-MRSA phages from hospital settings, dirt, and sewage. The wild phages were optimized using plaque-based biokinetic techniques. Usi

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Publication Date
Wed Oct 30 2024
Journal Name
Iraqi Journal Of Science
Effectiveness of Eucalyptus camaldulensis Leaves Oil in Upregulating exoU expression in Pseudomonas aeruginosa
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Results of the current study demonstratedthat out of eighty-three isolatesof Pseudomonas aeruginosa,only twenty-five isolateswere resistant to five different antibiotics (of different classes) that were consequentlyconsideredmultidrug resistant isolates.These isolates developed variable susceptibility toward Eucalyptuscamaldulensisleavesoil (ECO). GC-MS analysis of ECOrevealed that the aromatic oil eugenol is the major constituent.However, the most frequent MIC was 0.39 µg/ml, while the lowest frequent MIC was 3.125 µg/ml.Moreover, this oil at ½ MIC (0.195µg/ml) increased the gene expression of exoU. Itis concluded from the outcomes of the studythat ECOmay cause severe damagewhen used to treat infections caused by P. aeruginosa.

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Publication Date
Sat Dec 30 2023
Journal Name
Al-mustansiriyah Journal Of Science
Study of Phenotypic and Genotypic Factors of Staphylococcus aureus Clinical Local Isolates
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The isolates of Staphylococcus aureus were isolated from patients with various infections in hospitals, the isolates were identified and accurately diagnosed by phenotypic examination and biochemical tests, as well Vitek-2, and then genetic detection and diagnosis of many of the pathogenic factors associated with Staphylococcus aureus using conventional polymerase chain reaction (PCR) and testing for association by antibiotic resistance and production of some toxins by Staphylococcus aureus. After performing analysis of statistical, it was set up that the correlation coefficient of the PCR technique using virulence genes, sensitivity test to antibiotics and other virulence factors were significant at p < 0.05, but was insignificant with the

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Publication Date
Tue Jan 01 2019
Journal Name
Biochemical And Cellular Archives
Effect of HPV infection on the expression of fibronectin in a group of Iraqi women with cervical carcinoma
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: Cervical malignancy positioned as the fourth most prevalent disease among women around the world. HPVs especially HPV16 are the causative agent of cervical cancer, responsible of about 5% of all human cancers worldwide. Some researchers found that the fibronectin is repressed by the papillomavirus (HPV) type 16 E7 oncoprotein in both HPV-positive nontumorigenic and tumorigenic cell lines, while others found that the HPV oncoprotein increase the levels of fibronectin. The aim is to study the effect of HPV infection on Fibronectin expression and their correlation onthe development of Cervicalcancinoma. The current retrospective study enrolled paraffinized blocks of two groups. The research included 30 cervical carcinomatous tissues as well

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Publication Date
Thu Oct 01 2020
Journal Name
Iraqi Journal Of Biotechnology,
Isolation and Identification of Multidrug Resistance Among Clinical and Environmental Pseudomonas aeruginosa Isolates
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Pseudomonas aeruginosa is the most common opportunistic pathogen causing morbidity and mortality in hospitalized patients due to its multiple resistance mechanisms. Therefore, as a therapeutic option becomes restricted, the search for a new agent is a preference. So P. aeruginosa is an extremely versatile Gram-negative bacterium capable of thriving in a broad spectrum of environments, and this performs main problems to workers in the field of health. One hundred and fifty samples were collected from different sources from Baghdad hospitals, divided into two main groups: clinical (100) specimens and (50) samples as an environmental, collected from October 2019 to the March 2020. All of these samples were cultured by specific and differential

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Publication Date
Wed Jan 07 2015
Journal Name
World Journal Of Experimentalbiosciences
Biofilm formation and antibiotic susceptibility for clinical and environmental isolates of Pseudomonas aeruginosa
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Pseudomonas aeruginosa is emerging opportunistic clinical pathogens. Clinical isolates of P. aeruginosaresist wide spectrum of antibiotics and form biofilm. The comparison study between clinical and environmental of P. aeruginosa in terms of biofilm formation and antibiotic resistance is very scanty. Thus, in current study microtiter plate technique was used to measure the biofilm formation by several clinical and environmental isolates. Moreover, the antibiotic susceptibility of these bacteria was evaluated by VITIK 2 techniques. The relationship between the antibiotic susceptibility and biofilm formation was evaluated for clinical and environmental isolates. Clinical and environm

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Publication Date
Tue Aug 15 2023
Journal Name
Al-academy
The effectiveness of modern technologies used in television news bulletins And its role in facilitating the presenter's work
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The impact of television has made it an essential technology that can't be dispensed with in all circumstances and situations, measuring the society's need for it. Some argue that there is no stronger media than television in introducing people of the world to each other, as it has the most powerful impact and attracts millions of viewers.
Television is deemed as the most effective tool of media as it is designed to capture both sound and image. The image, in itself, has the ability to engage and interact with our thoughts. In light of the aforementioned, it is noticeable that this interactive medium (television) has significantly evolved over the years, thanks to modern technologies that have been introduced over time. These advancem

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Publication Date
Mon Mar 15 2021
Journal Name
Route Educational & Social Science Journal
THE EFFECTIVENESS OF POLITICAL IDEOLOGY IN THE DESIGNS OF INTERNATIONAL MAGAZINE COVERS
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Raghad Fattah RADHI

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Engineering
A Review on Expansive Soils Stabilized with Different Pozzolanic Materials
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Soils that cause effective damages to engineer structures (such as pavement and foundation) are called problematic or difficult soils (include collapsible soil, expansive soil, etc.). These damages occur due to poor or unfavorited engineering properties, such as low shear strength, high compressibility, high volume changes, etc. In the case of expansive soil, the problem of the shrink-swell phenomenon, when the soil reacts with water, is more pronounced. To overcome such problems, soils can be treated or stabilized with many stabilization ways (mechanical, chemical, etc.). Such ways can amend the unfavorited soil properties. In this review, the pozzolanic materials have been selected to be presented and discussed as chem

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Publication Date
Mon Dec 09 2019
Journal Name
Periodicals Of Engineering And Natural Sciences
The philosophy of the workplace spirituality in the third millennium organizations: A field study at the ministry of health center
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Purpose: The research aims to build an integrated knowledge framework for the basic research topic. The spirituality of the workplace is through access to the most important scientific proposals on these topics. In management thought framing, the knowledge within them in a serious attempt is to provide the appropriate answers about the intellectual dilemma of research by diagnosing the nature of the relationship with the influential elements and its historical development . Methodology: The study is relied on the analytical survey method. The research sample targeted (88) managers in the center of the Iraqi Ministry of Health exclusively from the researched senior leaders (general manager, assistant general manager, and head of department),

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