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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 May 31 2023
Journal Name
Iraqi Geological Journal
Depositional and Stratigraphic Evolution of the Mishrif Formation in Eridu Oil Field, Southwestern Iraq
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This study is achieved in the local area in Eridu oil field, where the Mishrif Formation is considered the main productive reservoir. The Mishrif Formation was deposited during the Cretaceous period in the secondary sedimentary cycle (Cenomanian-Early Turonian as a part of the Wasia Group a carbonate succession and widespread throughout the Arabian Plate. There are four association facies are identified in Mishrif Formation according the microfacies analysis: FA1-Deep shelf facies association (Outer Ramp); FA2-Slope (Middle Ramp); FA3-Reef facies (Shoal) association (Inner ramp); FA4-Back Reef facies association. Sequence stratigraphic analysis show there are three stratigraphic surfaces based on the abrupt changing in depositional

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Publication Date
Tue Dec 31 2024
Journal Name
Iraqi Geological Journal
Petrophysical Characterization and Lithology of the Mishrif Formation in Ratawi Oil Field, Southern Iraq
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The Ratawi Oil Field (ROF) is one of Iraq's most important oil fields because of its significant economic oil reserves. The major oil reserves of ROF are in the Mishrif Formation. The main objective of this paper is to assess the petrophysical properties, lithology identification, and hydrocarbon potential of the Mishrif Formation using interpreting data from five open-hole logs of wells RT-2, RT-4, RT-5, RT-6, and RT-42. Understanding reservoir properties allows for a more accurate assessment of recoverable oil reserves. The rock type (limestone) and permeability variations help tailor oil extraction methods, extraction methods and improving recovery techniques. The petrophysical properties were calculated using Interactive Petroph

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Publication Date
Sat Jul 01 2006
Journal Name
Saudi Medical Journal
Treatment of alopecia areata by topical diclofenac sodium gel in comparison to benzoyl peroxide gel. A novel single blind therapeutic clinical trial
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KE Sharquie, AA Al-Nuaimy, WJ Kadhum, Saudi medical journal, 2006 - Cited by 3

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Instructional Program Concerning Healthy Lifestyle on Patients’ Attitudes after Percutaneous Coronary Intervention at Cardiac Centers in Baghdad City
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Abstract:

Objective: The study’s aim to evaluate the effectiveness of instructional program about healthy lifestyle on patients’ attitudes after undergoing percutaneous coronary intervention.

Methodology: Quasi-experimental design/ has been utilized for the current study starting from December 2018 to March 2020 to achieve the objectives of the study. Non-probability (purposive) sample of 60 patients was divided into intervention and control groups. Data were analyzed by the application of descriptive and inferential statistical methods.

Results: findings reported that before intervention both study and control groups demonstrated low total mean of score relat

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Publication Date
Mon Feb 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Educational Program on Nurses' Practices toward Chemotherapy-Induced Peripheral Neuropathy for Children at Hematology Center in Baghdad City
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Objectives: the study aims to assess nurses' practices toward chemotherapy-induced peripheral neuropathy (CIPN) for children at the hematology center, and to determine the effectiveness of the health education program on nurses' practices toward CIPN, and to find out the relationships between the effectiveness of Health education program and demographic characteristics of nurses.

Methodology: Use quasi-experimental design in the study (a design that divides the sample into two groups, a study group and a control group, with data collection in three stages). This study was conducted at a hematology center in Baghdad city for the period (from December 16th, 2019 to 8th May 202

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Publication Date
Mon Jan 01 2018
Journal Name
Indian Journal Of Public Health Research &amp; Development
Effectiveness of an education program on hemodialysis patients, knowledge towards dietary regimen at Al-Hussein Teaching Hospital in Al-Nasiriyha City
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Publication Date
Thu Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Female Students’ Practices toward Premenstrual Syndrome at Secondary Schools in Third Al- Rusafa Education Directorate
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Objective: Determination the effectiveness of educational program on female students’ practices toward premenstrual.

Methodology: A quasi-experimental design study was conducted involving (140) student purposely in four secondary schools at Al-sadder city (70) student for study group and (70) for control group. The prevalence of PMS selected through American College of Obstetricians and Gynecologists (ACOG) (2015) criteria to select PMS students before program. The education program were set in four steps, the first step (pre-test) is to assess the practices, before the implementation of the program, the second step is implementing the program, following two steps post-test  I and II betwe

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Publication Date
Mon Jan 01 2024
Journal Name
Research Journal Of Biotechnology
Gene expression of psID gene in Pseudomonas aeruginosa isolated from clinical cases
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Publication Date
Mon May 09 2022
Journal Name
مجلة كلية التربية الاساسية الجامعة المستنصرية
Detection of sul1 resistance gene in Acinetobacter baumannii from different Clinical cases
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Publication Date
Thu Nov 19 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
CFD Simulation of Velocity Distribution in a River with a Bend Cross Section and a Cubic Bed Roughness Shape
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