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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 Dec 01 2020
Journal Name
Baghdad Science Journal
Determination of Phosphodiesterase Type 5 Enzyme (PDE-5) Inhibitors and Analogues as Adulterants in Selected Herbal Products using Gas Chromatography–Electron Impact-Mass Spectrometer (GC-EI-MS)
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       Sildenafil, tadalafil, and vardenafil are phosphodiesterase type 5 enzyme (PDE-5) inhibitors used for the treatment of male erectile dysfunction. This present study aims to investigate 55 herbal products indicated for men’s sexual health from the Malaysian market for adulteration of PDE-5 inhibitors and analogues. The screening and identification of 20 PDE-5 inhibitors and analogues in herbal products of various forms (powder, capsules, tablets, and pastels) were conducted using gas chromatography–electron impact-mass spectrometer (GC-EI-MS). The analysis has shown that 19 herbal products were adulterated with PDE-5 inhibitors and analogues. Unique ion fragmentations and the presence of molecular

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Modeling and analysis of thermal contrast based on LST algorithm for Baghdad city
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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
The Importance and Interaction Indices of Bi-Capacities Based on Ternary-Element Sets
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Grabisch and Labreuche have recently proposed a generalization of capacities, called the bi-capacities. Recently, a new approach for studying bi-capacities through introducing a notion of ternary-element sets proposed by the author. In this paper, we propose many results such as bipolar Mobius transform, importance index, and interaction index of bi-capacities based on our approach.

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Gas Sensor Application of New Composite Based on MWCNTs:CoPc:Metal Oxide
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The synthesis of new substituted cobalt Phthalocyanine (CoPc) was carried out using starting materials Naphthalene-1,4,5, tetracarbonic acid dianhydride (NDI) employing dry process method. Metal oxides (MO) alloy of (60%Ni3O4 40%-Co3O4 ) have been functionalized with multiwall carbon nanotubes (F-MWCNTs) to produce (F-MWCNTs/MO) nanocomposite (E2) and mixed with  CoPc to yield (F-MWCNT/CoPc/MO) (E3). These composites were investigated using different analytical and spectrophotometric methods such as 1H-NMR (0-18 ppm), FTIR spectroscopy in the range of (400-4000cm-1), powder X-rays diffraction (PXRD, 2θ o = 10-80), Raman spectroscopy (0-4000 cm-1), and UV-Visib

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Determination of Doxycycline Hyclate by Batch and Reverse Flow Injection Analysis Based on the Oxidative Coupling Reaction with 3-Methyl-2-benzothiazolinone Hydrazone hydrochloride (MBTH)
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New, simple and sensitive batch and reverse FIA spectrophotometric methods for the determination of doxycycline hyclate in pure form and in pharmaceutical preparations were proposed. These methods based on oxidative coupling reaction between doxycycline hyclate and 3-methylbenzothiazolinone-2-hydrazone hydrochloride (MBTH) in the presence ammonium ceric sulfate in acidic medium, to form green water-soluble dye that is stable and has a maximum absorbance at 626 nm. A calibration graph shows that a Beer's law is obeyed over the concentration range of 1-80 and 0.5-110 ?g.mL-1 of DCH for the batch and rFIA respectively with detection limit of 0.325 ?g.mL-1 of DCH for r-FIA methods. All different chemicals and physical experimental paramete

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Publication Date
Mon Jun 22 2026
Journal Name
Al–bahith Al–a'alami
The Impact of Means of Communication on Electoral Behavior and its Relationship to the Political Disparity of the Family (A Field Study of an Audience of the University of Baghdad’s Students)
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Iraq has seen many changes at the social, economic and political levels. This led to cause many shifts in the structure of its society and imposed great challenges reflected in the behavior and awareness of that society in general and youth in particular.

Those changes made the Iraqi society undergoing the transformation of value and culture aspects formed a political awareness that caused cultural and political diversity within the family and society. A greater openness to the outside world caused by the communication revolution, as the world has witnessed during the past two decades, has helped in making that change. Iraq had its share of media and political openness, which were included after the US occupation in 2003. As a re

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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
DAMAGE DETECTION AND LOCATION FOR IN AND OUT-OFPLANE CURVED BEAMS USING FUZZY LOGIC BASED ON FREQUENCY DIFFERENCE
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In this study, structures damage identification method based on changes in the dynamic characteristics
(frequencies) of the structure are examined, stiffness as well as mass matrices of the curved
(in and out-of-plane vibration) beam elements is formulated using Hamilton's principle. Each node
of both of them possesses seven degrees of freedom including the warping degree of freedom. The
curved beam element had been derived based on the Kang and Yoo’s thin-walled curved beam theory
in 1994. A computer program was developing to carry out free vibration analyses of the curved
beam as well as straight beam. Comparing with the frequencies for other researchers using the general
purpose program MATLAB. Fuzzy logic syste

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Publication Date
Wed Jan 01 2020
Journal Name
Says Rev Pharm
Healing of apical periodontitis after minimally invasive endodontics therapy using Er,Cr:YSGG laser: A prospective clinical study
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Publication Date
Mon Jun 22 2026
Journal Name
Journal Of Studies And Researches Of Sport Education
The effectiveness of the use of yoga exercises and its impact on the reactions of the two Alvesologih nervous and respiratory systems in the correction of antenna pistol shooting accuracy
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Publication Date
Wed Mar 16 2016
Journal Name
The Iraqi Journal Of Agricultural Sciences
PERFORMANCE EVALUATION OF FIELD AND GENETIC FOR SOME SIXTH RADIO GENERATION MUTANTS IN TOMATO
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The study was conducted at the fields of the Department of Horticulture and Landscape Gardening, College of Agriculture, University of Baghdad " Abu Ghraib" during the growing seasons 2013-2014 to Evaluate the Vegetative growth , yield traits and genetic parameter of some tomato mutants. Results showed significantly increased of plant height in M6-2 mutant 245cm in Comparison with M6- 3 130 cm . M6-4 mutant significantly increasing of floral clusters 13 . Mutant M6-3 showed significantly increasing the average of, fruit weight 125.9g and plant yield 7.17 kg.plant-1 as comparison with M6-2 which showed decreasing of average of fruit weight and plant yield 79.40g and 4.38 kg.plant-1 respectively. Also results showed the highest Genetic variat

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