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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 Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Analytical Study Compared Between Poisson and Poisson Hierarchical Model and Applied in Healthy Field
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Through this research, We have tried to evaluate the health programs and their effectiveness in improving the health situation through a study of the health institutions reality in Baghdad to identify the main reasons that affect the increase in maternal mortality by using two regression models, "Poisson's Regression Model" and "Hierarchical Poisson's Regression Model". And the study of that indicator (deaths) was through a comparison between the estimation methods of the used models. The "Maximum Likelihood" method was used to estimate the "Poisson's Regression Model"; whereas the "Full Maximum Likelihood" method were used for the "Hierarchical Poisson's Regression Model

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Publication Date
Sun Sep 01 2019
Journal Name
Dental Hypotheses
Possible Role of Statins on the Inflammatory Biomarkers in Patients With Periodontal Disease: A Cross-Sectional Study
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The aim of the present study was to demonstrate the possible role of statins on the inflammatory biomarkers in patients with periodontal disease (PD) This cross-sectional study involved 74 patients with PD and/or dyslipidemia divided into Group A: 34 patients with PD (nonstatins users); Group B: 40 patients with PD (statins users); and Group C: 30 healthy controls. Total cholesterol (TC), triglyceride (TG) and high-density lipoprotein, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and malondialdehyde (MDA) were measured . Blood pressure prolife and indices of PD were evaluated in each group. Statistical analysis was conducted by using SPSS version 20.0.

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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
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
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Re-engineering management processes and its impact on the strategic decision-making process Field study on the College of Education / University of Mustansiriya / Iraq
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The aim of the research is to identify both the re-engineering of management processes and the strategic decision-making process in the research community and determine the nature of the correlation between the two variables and know the relationship between them to achieve the research goal. The researcher used a descriptive and analytical method. The research community consists of a group of professors and staff of the College of Education affiliated to the University of Mustansiriya in Baghdad, which their number were (45),  the researcher has distributed the forms to all members of the sample,  only (3) forms were excluded for invalidity and thus the number of forms approved in the analysis were (42) forms. The rese

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Publication Date
Wed Apr 01 2020
Journal Name
Al-rafidain Journal For Sport Sciences
The Effectiveness of UsingflippedclassroombyQuick Response Codes In Learning Someofskills In Artistic Gymnastics for men
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The study aimed to prepare quick response codes to learn some of the technical skills of the second graders in the Faculty of Physical Education and Sports Sciences. The experimental method was used in the design of the experimental and control experimental and control groups. The research sample was represented by second-graders in the College of Physical Education and Sports Sciences / University of Baghdad, and by lot, the second division (a) was chosen to represent the experimental group that applied the inverse method using the QR code, and the second division (g) to represent the control group and applied the traditional method. (10) Students per group. After the tribal tests, his main experiment was carried out for 10 weeks with one

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Publication Date
Wed Apr 01 2020
Journal Name
Al-rafidain Journal For Sport Sciences
The Effectiveness of UsingflippedclassroombyQuick Response Codes In Learning Someofskills In Artistic Gymnastics for men
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The study aimed to prepare quick response codes to learn some of the technical skills of the second graders in the Faculty of Physical Education and Sports Sciences. The experimental method was used in the design of the experimental and control experimental and control groups. The research sample was represented by second-graders in the College of Physical Education and Sports Sciences / University of Baghdad, and by lot, the second division (a) was chosen to represent the experimental group that applied the inverse method using the QR code, and the second division (g) to represent the control group and applied the traditional method. (10) Students per group. After the tribal tests, his main experiment was carried out for 10 weeks with one

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Publication Date
Sun Mar 10 2019
Journal Name
Al-mustansiriyah Journal Of Science
Effect of Inclined Magnetic Field on Peristaltic Flow of Carreau Fluid through Porous Medium in an Inclined Tapered Asymmetric Channel
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During this article, we have a tendency to show the peristaltic activity of magnetohydrodynamics flow of carreau fluid with heat transfer influence in an inclined tapered asymmetric channel through porous medium by exploitation the influence of non-slip boundary conditions. The tapered asymmetric channel is often created because of the intrauterine fluid flow induced by myometrial contraction and it had been simulated by asymmetric peristaltic fluid flow in an exceedingly two dimensional infinite non uniform channel, this fluid is known as hereby carreau fluid, conjointly we are able to say that one amongst carreau's applications is that the blood flow within the body of human. Industrial field, silicon oil is an example of carreau

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Publication Date
Sun Oct 01 2023
Journal Name
Optical Fiber Technology
A taper-in-etch based hybrid fiber Mach-Zehnder interferometer hydrogen sensor
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