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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
Sat Nov 03 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Short Wave Diathermy and Therapeutic Ultrasound on The Management of Patients With Knee Osteoarthritis
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Objective : The present study is aimed to evaluate the effectiveness of short wave diathermy and
ultrasound therapy for the management of patients with knee osteoarthritis
Methodology : all patients who referred to the Medical Rehabilitation Unit in Baghdad Teaching
Hospital and Sadr A!-Qanat Center. The period of the study was from October 2004 to April 2005, total
number of patients was 24 (9 male and 15 female). Age range of patients was 42-70 years. Complete
clinical and radiological examinations were achieved on all patients and referred to the Medical
Rehabilitation Unit for physiotherapy. Short wave diathermy and ultrasound therapy were applied on
all patients.
Results : Demographic distribution revealed th

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instructional Intervention on Medical and Health Information of Patients with Diabetes Mellitus Type II
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Objective: The objectives of the present study were to evaluate the effectiveness of the instructional intervention
about medical and health knowledge of patients with diabetes mellitus type II.
Methodology: A Quasi- experimental study was carried out in National Center for Diabetes Mellitus/ Almustansria
University, started from 4th January 2012, to 1st April 2012. Non-probability (purposive sample) of (50) diabetes
mellitus type II, who visit National Center for Diabetes Mellitus/ Almustansria University. The study sample is
divided equally into (25) study and (25) control groups. The study group received the instructional intervention.
While the control not exposed to the instructional intervention. The data are coll

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Publication Date
Thu May 29 2025
Journal Name
Bmc Public Health
Coping skills and associated sociodemographic, clinical, and psychological factors among women with breast cancer in Iraq: a cross-sectional study”
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Background: Coping skills play a vital role in managing the physical and psychological effects of breast cancer (BC). Despite improvements in early detection and treatment, Breast cancer survivors continue to face long-term challenges after diagnosis. Therefore, this study aims to evaluate the coping skills employed by breast cancer women in Iraq and to identify the sociodemographic, clinical, and psychological factors associated with these coping skills. Methods: A cross-sectional study was conducted among 244 breast cancer women in The Medical City Teaching Oncology Hospital, Baghdad, Iraq, from August 2023 to October 2023, coping skills and psychological factors were assessed using the BRIEF COPE-28, and Hospital Anxiety Depression scale

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
Clinical and Doppler Study of Restrictive Filling Pattern in Patients with Dilated Cardiomyopathy
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Background: Dilated cardiomyopathy (DCM) is a well-recognized cause of cardiovascular morbidity and mortality.Objectives: To evaluate the prognostic implications of the restrictive left ventricular filling pattern (RFP) in dilated cardiomyopathy.Methods: Patients with DCM admitted to Ibn AL-Bitar Hospital for Cardiac Surgery, Baghdad-Iraq, from May 2006 to August 2008, underwent a full clinical evaluation and Doppler echocardiography study. Patients were classified into three groups: Group I had persistent restrictive filling pattern; Group II had reversible restrictive filling pattern; and Group III had nonrestrictive filling pattern. Results: The current study was conducted on a total number of 80 patients with DCM, fifty (62.5 %) were

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Publication Date
Tue Feb 26 2019
Journal Name
Journal Of Contemporary Medical Sciences
Demographic and clinical profiles of female patients diagnosed with breast cancer in Iraq
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Objective To highlight the main demographic characteristics and clinical profiles of female patients registered with breast cancer in Iraq; focusing on the impact of age.Methods This retrospective study enrolled 1172 female patients who were diagnosed with breast cancer at the Main Center for Early Detection of Breast Cancer/Medical City Teaching Hospital in Baghdad. Data were extracted from an established information system, developed by the principal author under supervision of WHO, that was based on valid clinical records of Iraqi patients affected by breast cancer. The recorded information regarding clinical examination comprised positive palpable lumps, bloody nipple discharge, skin changes, bilateral breast involvement, tumor

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
Divorce and its effects on women rights - A field study in Baghdad city / ALMADAIN COURT
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The problem of divorce from the phenomena that characterized the nature of privacy,
although their impact beyond the individual to include the community as a whole, the parties
to the relationship affected by divorce caused them harm moral and material for a long time,
resulting imbalance in the personal relationship and family and social relations because of the
high divorce rates, particularly in Iraq high rates of 28690 thousand cases in 2004 to 59 515
thousand cases in 2011 and an increase of more than (100%) during the period above, and this
rise caused by aggravation of many of the problems led the reasons for social, economic and
incompatibility spouses, health and lack of reproduction, not spending The wife a

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Teaching Strategy Based on the Cognitive Model of Daniel in the Development of Achievement and the Motivation of learning the School Mathematics among the Third Intermediate Grade Students
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This research aims to examine the effectiveness of a teaching strategy based on the cognitive model of Daniel in the development of achievement and the motivation of learning the school mathematics among the third intermediate grade students in the light of their study of "Systems of Linear Equations”. The research was conducted in the first semester (1439/1440AH), at Saeed Ibn Almosaieb Intermediate School, in Arar, Saudi Arabia. A quasi-experimental design has been used. In addition, a (pre & post) achievement test (20 Questions) and a (pre & post) scale of learning motivation to the school mathematics (25 Items) have been applied on two groups: a control group (31Students), and an experimental group (29 Students). The resear

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Publication Date
Wed Jun 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
Cost of human resources from a behavioral perspective
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Purpose/objective:

1 - To explain the financial impact of the activities and areas of human resources management and the adoption of the methodology for estimating costs on the basis of conduct and statement of how to assess costs and benefits of human resource activities.

2 - Measuring  human capital, and its impact on the financial statements.

 

Design/methodology/approach:

 Concentrated dimensions of the research paper's lack of financial statements prepared by the organizations for information mandated human resource its components of the three (attraction - development

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Crossref
Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical Evaluation of Melatonin Alone and in Combination with Pizotifen in the Prophylaxis of Migraine
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The treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release.  In the view of the involvement of serotonin in the pathophysiology of migraine a

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Crossref
Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Education Program on Secondary School Teachers Psycho-Social Changes with Menopause in Baghdad City
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Objective: To assess the effect of education program on psychological and social changes of secondary school teachers with menopause.

Method: A quasi-experimental design is carried out with the application of a pre- post –test for menopause secondary school teacher's bio-psychosocial changes. Non-probability sample consists of (60 female teachers) (40) teachers from Al- Rusafa first Education Directorate secondary schools, and (20) teachers from Al- Karkh third Education Directorate secondary schools. The sample was exposed to pretest, educational program, and posttest. Data were collected through the utilization of the study instrument (the questionnaire) and application of bio-psychosocial ed

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