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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
Sun Apr 19 2015
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Wireless Networks
Design and evaluation of distributed and dynamic mobility management approach based on PMIPv6 and MIH protocols
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Publication Date
Mon Jan 01 2024
Journal Name
Current Chemistry Letters
Synthesis and characterisation of novel metal-organic frameworks (MOFs) based on zirconium and bicinchoninic acid
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Metal-organic frameworks (MOFs) are a relatively new class of materials of unique porous structures and exceptional properties. Currently, more than 110,000 types of MOFs have been reported among the countless possibilities. In this study, we have synthesised a novel MOF using zirconium chloride as the metal source and 4,4'-dicarboxy-2,2'-biquinoline (bicinchoninic acid disodium salt) as the linker, which reacted in N,N-Dimethylformamide (DMF) solvent. Three preparation methods were employed to prepare five types of the MOF, and they were compared to optimize the synthesis conditions. The resulting MOFs, named Zr-BADS, were characterised using scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), microscopy, and

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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
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 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
Thu Feb 01 2018
Journal Name
Iet Signal Processing
Signal compression and enhancement using a new orthogonal‐polynomial‐based discrete transform
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Publication Date
Wed Mar 01 2023
Journal Name
Journal Of Engineering
A An Authentication and Access Control Model for Healthcare based Cloud Services
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Electronic Health Record (EHR) systems are used as an efficient and effective method of exchanging patients’ health information with doctors and other key stakeholders in the health sector to obtain improved patient treatment decisions and diagnoses. As a result, questions regarding the security of sensitive user data are highlighted. To encourage people to move their sensitive health records to cloud networks, a secure authentication and access control mechanism that protects users’ data should be established. Furthermore, authentication and access control schemes are essential in the protection of health data, as numerous responsibilities exist to ensure security and privacy in a network. So, the main goal of our s

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Publication Date
Sun Oct 04 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
Tue Jan 01 2019
Journal Name
Journal Of Southwest Jiaotong University
Multi -Focus Image Fusion Based on Stationary Wavelet Transform and PCA on YCBCR Color Space
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The multi-focus image fusion method can fuse more than one focused image to generate a single image with more accurate description. The purpose of image fusion is to generate one image by combining information from many source images of the same scene. In this paper, a multi-focus image fusion method is proposed with a hybrid pixel level obtained in the spatial and transform domains. The proposed method is implemented on multi-focus source images in YCbCr color space. As the first step two-level stationary wavelet transform was applied on the Y channel of two source images. The fused Y channel is implemented by using many fusion rule techniques. The Cb and Cr channels of the source images are fused using principal component analysis (PCA).

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Publication Date
Thu Dec 03 2015
Journal Name
Iraqi Journal Of Science
New multispectral images classification method based on MSR and Skewness implementing on various sensor scenes
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