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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 Jul 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using of costs based on activity that focused on performance in Reduce Costs and their reflection to improve competitive advantage: An applied research in wasitTextile and Knitting factory
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The research aims mainly to the role of the statement style costs on the basis of activity based on performance (PFABC) to reduce production cost and improve the competitive advantage of economic units and industrial under the modern business environment dominated by a lot of developments and changes rapidly, which necessitates taking them and criticize them to ensure survival and continuity.  The research problem is the inability of traditional cost methods of providing useful information to the departments of units to take many administrative decisions, particularly decisions related to the product and calculating the costs of the quality of the sound and the availability of the need and the ability to replace methods capa

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Publication Date
Wed Jan 01 2025
Journal Name
International Journal Of Body, Mind And Culture
Effectiveness of the Benson Relaxation Technique in Reducing Pain During Femoral Artery Sheath Removal Following Percutaneous Coronary Intervention: A Randomized Controlled Trial
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Objective: This study aimed to evaluate the effectiveness of the Benson Relaxation Technique (BRT) in reducing pain during femoral artery sheath removal after percutaneous coronary intervention (PCI). Methods and Materials: A randomized controlled trial was conducted at three cardiac centers in Iraq. A total of 58 patients undergoing therapeutic PCI were randomly assigned into two groups: intervention (n=27) and control (n=31). The intervention group received BRT for 10 minutes before and after sheath removal. Pain was assessed using the Visual Analogue Scale (VAS) immediately after the procedure. Demographic data and clinical variables were collected. Data were analyzed using SPSS v26 and non-parametric tests (Mann-Whitney U, Krus

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Experimental Study on Heat Transfer and Friction Factor Characteristics of Single Layer Graphene Based DI-water Nanofluid in a Circular Tube under Laminar Flow and Different Heat Fluxes as Boundary Conditions
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An experimental study was performed to estimate the forced convection heat transfer performance and the pressure drop of a single layer graphene (GNPs) based DI-water nanofluid in a circular tube under a laminar flow and a uniform heat flux boundary conditions. The viscosity and thermal conductivity of nanofluid at weight concentrations of (0.1 to 1 wt%) were measured. The effects of the velocity of flow, heat flux and nanoparticle weight concentrations on the  enhancement of the heat transfer are examined. The Nusselt number of the GNPs nanofluid was enhanced as the heat flux and the velocity of flow rate  increased, and the maximum Nusselt number  ratio (Nu nanofluid/ Nu base fluid)   and thermal performance factor

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
design Electronic cost accounting system for the Iraqi Airways Company
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The research Was based to on a real problem and realistically of represented by that  Iraqi Airways company does not have the electronic cost accounting system and therefore  be the process of  the pricing various services provided by a company sample research respecting  air transport and air cargo and aviation fuel and services and catering are not properly especially in the presence of new data from the new companies entering competition in Iraqi aviation industry and therefore does not provide price flexibility in order to compete in getting market share, And then research this problem addressed through design an electronic cost Accounting system covers all the costs incurred by the compan

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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Social Safety Nets and Sustainable Development in Fragile Environments: A Field Social Study of Slums in the City of Baghdad/Al-Karkh: هبة صالح مهدي, عدنان ياسين مصطفى
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Almost human societies are not void of poverty, as the latter accompanied the emergence of humanity, and it, thus, represents an eternal problem. To advance an individual's reality and raise the level of the poor social classes, social security networks have been established. Such networks operate in society following social systems and laws to provide food, and material support. Besides, such networks help to rehabilitate the individual academically and vocationally. They empower vulnerable groups through the establishment of courses and workshop, provide (conditional) subsidies related to the health and educational aspects in order to achieve the sustainable development goals of (2030), and apply developmental roles of social safety ne

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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
Mon Jun 22 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison of enamel color alteration between bonded and free unbonded surfaces of maxillary anterior teeth after fixed orthodontic therapy (A prospective clinical study)
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Background: The purpose of this study is to compare the color changes between the bonded middle third and the unbonded gingival and incisal thirds, fallowing fixed orthodontic treatment Material and method: The color parameter l, a, b has been recorded for each thirds in upper anterior teeth by mean of easy shad device. The has been calculated for gingival, middle and incisal thirds for the upper anterior teeth in 34 patient, 17 males and 17femals, those subject undergone fixed orthodontic treatment Results: The in middle bonded third is highly significant higher than that in incise and gingival thirds p<0.01 because the middle third isn’t expose to oral fluid and dental brushing since it covered by the bracket. Also there

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Publication Date
Wed Jan 01 2025
Journal Name
مجلة العراقية للبحوث الانسانية والاجتماعية والعلمية
Detection of fimH, mrkD and mrkC genes in biofilm-forming Klebsiella pneumoniae isolated from different clinical cases"
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Publication Date
Sat Jul 01 2023
Journal Name
International Journal Of Current Medical And Applied Science
Evaluation of Postgraduate Clinical Educational Environment in The Context of Iraqi Medical Education.
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Background: A carefully planned clinical medical education is critical for the provision of supportive clinical educational environment. The latter will ensure effective teaching, active learning and good attitudes and performance at the bedside. The aim of this study was to evaluate clinical learning environment at AL-Diwaniyah Teaching Hospital. Materials and Methods: A descripitive cross-sectional study involved resident doctors from Internal Medicine and Surgery departments who had six months or more residency training in the respective departments. Data were collected using the Postgraduate Hospital Educational Environment Measure. Data where analyzed using the Statistical Package for Social Sciences version 21.0 and presented us

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Mechanical Engineering Research And Developments
Real-time control of robotic hand by human hand at low cost
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