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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
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 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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Publication Date
Thu Jan 15 2026
Journal Name
Biomed Visions Journal
Developing Pharmacy Education: Review of Virtual Reality Technology in Improving Clinical Training and Learning Skill Development
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Incorporating modern technology into education is becoming imperative. Numerous pharmacy institutions are incorporating virtual reality (VR) technology training into their curricula to enhance educational experience. This review examines the current state, historical evolution, and application of VR programs in pharmacy education and training. The review also provides details about the main challenges and limitations associated with the use of this technology. The VR technology, including virtual laboratories and simulations, significantly improves clinical training and educational outcomes. The utilization of VR in clinical teaching encounters numerous barriers, including ethical concerns and technological constraints, as well as other res

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Disc Battery-The escalating risk of ingestion by children in IraqAnd subsequent clinical events and complications.
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Background: Disc battery ingestion is a common
serious problem in Iraq. It increase in the last years
because of the increase in number of electronic toys
that uses these batteries. These batteries contains
many types of irritant chemicals that increases the
risk of it's ingestion.
Methods:We reviewed the medical records of
children aged between 1year and 7 years
old admitted to Surgical Specialty Hospital/Baghdad
Medical City due to disc battery ingestion from
January 2007 through December 2010). The diagnosis
of disc battery ingestion was based upon history,
clinical symptoms, and results of imaging studies.
The clinical data reviewed included sex, age, clinical
manifestation and duration of sy

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical Assessment and Cytomorphometric Analysis of Buccal Mucosal Cells in Behçet’s Disease Patients
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Background: Behçet’s disease (BD) is a disorder of systemic inflammatory condition. Its important features are represented by recurrent oral, genital ulcerations and eye lesions. Aims. The purpose of the current study was to evaluate and compare cytological changes using morphometric analysis of the exfoliated buccal mucosal cells in Behçet’s disease patients and healthy controls, and to evaluate the clinical characteristics of Behçet’s disease. Methods. Twenty five Behçet’s disease patients have been compared to 25 healthy volunteers as a control group. Papanicolaou stain was used for staining the smears taken from buccal epithelial cells to be analyzed cytomorphometrically. The image analysis sof

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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
Tue Jun 30 2009
Journal Name
Al-kindy College Medical Journal
Non-Metastatic Breast Cancer : Clinical Presentation and Patterns of Surgical Treatment
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Background : Breast cancer is the most common cancer of
women. When breast cancer is detected and treated early,
the chances for survival are better. Surgery is the most
important treatment for non-metastatic breast cancer.
Al-Kindy Col Med J 2008 Vol.5(1) 40 Original Article
Objectives : The aim of this study is to review different
clinical presentation and to evaluate types of surgical
procedures and complications in treatment of nonmetastatic breast cancer.
Method : During the period from Jun 1998 to May 2005,
93 patients with non-metastatic breast cancer were
diagnosed and treated surgically in 2 hospitals in Baghdad (
Hammad Shihab military hospital and Al-Kindy teaching
hospital).
Results : Wo

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Publication Date
Mon Jul 01 2024
Journal Name
World Neurosurgery
Orbital Rhabdomyosarcoma: Comprehensive Review of Epidemiology, Clinical Staging, and Treatment Outcomes
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Publication Date
Mon Nov 24 2025
Journal Name
2025 13th International Conference On Control, Mechatronics And Automation (iccma)
Modeling Twisting and Coiling Actuators with Regression-Based Learning: Application to Neck Rehabilitation
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Twisting and coiling actuators (TCAs) are lightweight artificial muscles that can produce large linear contractions while lifting heavy loads with low power. A TCA consists of two or more strings connected to a rotational motor and a load. When activated, the strings twist and coil, causing contraction. This study presents a data-driven framework for modeling TCA behavior using experimental data. Polynomial regression, Support Vector Regression (SVR), and symbolic regression were applied using the motor angle and payload weight as inputs. The models were evaluated under various loads and implemented in a neck-rehabilitation prototype. SVR showed the highest accuracy (RMSE: 6.17 mm upward, 4.98 mm downward); however, it lacks a closed-form e

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