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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
Thu Jan 01 2015
Journal Name
Journal Of Traumatic Stress Disorders &amp; Treatment
Randomised Controlled Study Comparing Two Psychological Therapies for Posttraumatic Stress Disorder (PTSD): Emotional Freedom Techniques (EFT) vs. Narrative Exposure Therapy (NET)
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Publication Date
Sat Sep 23 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients
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Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen

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Publication Date
Thu Dec 25 2025
Journal Name
World's Veterinary Journal
Effects of Bromelain Loaded with Gold Nanoparticles on Histopathological and Immunohistochemical Parameters in Albino Mice with Testicular Damage
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Carbon tetrachloride (CCl4) has been demonstrated to induce testicular damage via oxidative stress. Bromelain (Br), a proteolytic enzyme known for its biological activities and pharmacological properties, exhibits limited absorption owing to its low solubility and bioavailability. The present study aimed to investigate the histological and immunohistochemical effects of bromelain conjugated with gold nanoparticles (AuNPs) on the testis histology of albino mice treated with CCl4. Thirty-five male albino mice (Mus musculus), with an average age of 9 weeks, were randomly divided into five groups, each containing seven mice. The experiment was prolonged for four weeks. The first group (G1) was the control group, the second group (G2) re

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Publication Date
Tue Sep 30 2025
Journal Name
Gsc Advanced Research And Reviews
A comprehensive review of metal-organic framework based biosensors for detection of reactive oxygen species and hydrogen peroxide in biomedical applications
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Metal-organic frameworks (MOFs) have emerged as revolutionary materials for developing advanced biosensors, especially for detecting reactive oxygen species (ROS) and hydrogen peroxide (H₂O₂) in biomedical applications. This comprehensive review explores the current state-of-the-art in MOF-based biosensors, covering fundamental principles, design strategies, performance features, and clinical uses. MOFs offer unique benefits, including exceptional porosity (up to 10,400 m²/g), tunable structures, biocompatibility, and natural enzyme-mimicking properties, making them ideal platforms for sensitive and selective detection of ROS and H₂O₂. Recent advances have shown significant improvements in detection capabilities, with limit

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Publication Date
Thu May 05 2022
Journal Name
Al-kindy College Medical Journal
Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up: Utility of Immediate Post Placental Insertion of Intrauterine Device During Cesarean Delivery
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Background: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq.

Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women.

Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospita

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Publication Date
Wed Jun 24 2026
Journal Name
Journal Of Studies And Researches Of Sport Education
The impact of training on the development of the composite efficiency Alibd your faith and endurance of the effectiveness of the 100-meter run
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Is the efficiency of physical and your endurance is of great importance for some activities and field, as it whenever the situation has improved student career was able to perform physical exertion more with energy saving efforts, so the identification of physical aptitude and endurance private students, was based on that there are positively correlated the carrying of training and pregnancy fact on the shoulders of the student. In other words, physical aptitude and endurance in your control level that can be shown by the student during the performance of training and competitions. Therefore, lies the importance of research to test physical aptitude and endurance your help to reveal the career of the body in the light of their relationship

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Publication Date
Tue Apr 30 2024
Journal Name
Iraqi Journal Of Science
Topology-Based Modularity and Modularity Density for Detecting Protein Complexes: A Comparative Study
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     Binary relations or interactions among bio-entities, such as proteins, set up the essential part of any living biological system. Protein-protein interactions are usually structured in a graph data structure called "protein-protein interaction networks" (PPINs). Analysis of PPINs into complexes tries to lay out the significant knowledge needed to answer many unresolved questions, including how cells are organized and how proteins work. However, complex detection problems fall under the category of non-deterministic polynomial-time hard (NP-Hard) problems due to their computational complexity. To accommodate such combinatorial explosions, evolutionary algorithms (EAs) are proven effective alternatives to heuristics in solvin

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Deep Learning-Based Segmentation and Classification Techniques for Brain Tumor MRI: A Review
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Early detection of brain tumors is critical for enhancing treatment options and extending patient survival. Magnetic resonance imaging (MRI) scanning gives more detailed information, such as greater contrast and clarity than any other scanning method. Manually dividing brain tumors from many MRI images collected in clinical practice for cancer diagnosis is a tough and time-consuming task. Tumors and MRI scans of the brain can be discovered using algorithms and machine learning technologies, making the process easier for doctors because MRI images can appear healthy when the person may have a tumor or be malignant. Recently, deep learning techniques based on deep convolutional neural networks have been used to analyze med

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Publication Date
Mon Mar 09 2026
Journal Name
Journal Of Asian Architecture And Building Engineering
Visual storytelling and place-based learning: a generative approach to architectural cultural awareness
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In architectural learning, it is difficult to stimulate cultural awareness through the traditional education approaches, which results in historic places being neglected as knowledge sources. This research explores the premise that sketch-based visual storytelling may act as a generative approach to connect cognition, emotion, and behavior in historical contexts. The study adopts a qualitative methodology to explore a learning experience comprising two phases: the first is a formal educational setting, and the second is a historical and cultural context, aiming to investigate the role of sketch-based storytelling in enhancing cultural awareness. MAXQDA was employed to code the students’ storyboards on three levels of cultural awareness, m

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Publication Date
Mon Dec 16 2024
Journal Name
Light & Engineering
The Design and Experimental Realization of a Laser-Based Heating System Using Recycled Laser Module
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Laser is a powerful device that has a wide range of applications in fields ranging from materials science and manufacturing to medicine and fibre optic communications. One remarkable

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