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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 Oct 01 2023
Journal Name
Bulletin Of Electrical Engineering And Informatics
A novel data offloading scheme for QoS optimization in 5G based internet of medical things
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The internet of medical things (IoMT), which is expected the lead to the biggest technology in worldwide distribution. Using 5th generation (5G) transmission, market possibilities and hazards related to IoMT are improved and detected. This framework describes a strategy for proactively addressing worries and offering a forum to promote development, alter attitudes and maintain people's confidence in the broader healthcare system without compromising security. It is combined with a data offloading system to speed up the transmission of medical data and improved the quality of service (QoS). As a result of this development, we suggested the enriched energy efficient fuzzy (EEEF) data offloading technique to enhance the delivery of dat

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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Effectiveness of public expenditure in correcting the Imbalance of Trade Structure in Iraq after year 2003
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This research aims to focus on the reality of the imbalance of the balance of trade structure in order to improve it and determine the size of the imbalance as a result of dependence on one commodity, namely crude oil in the structure of exports versus the diversity of the structure of imports of various goods and goods.

    In order to achieve that goal, a deductive approach was adopted, which included a shift from general theory data to special applications.

   We have reached through the research to a number of conclusions, most notably the effectiveness of public spending in correcting the imbalance of the balance of trade structure during the study pe

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Publication Date
Fri Sep 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Applied Spatial Data Analysis Technique on Petrophysical Properties of MA Unit of Mishrif Formation / Noor Field
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Noor oil field is one of smallest fields in Missan province. Twelve well penetrates the Mishrif Formation in Noor field and eight of them were selected for this study. Mishrif formation is one of the most important reservoirs in Noor field and it consists of one anticline dome and bounded by the Khasib formation at the top and the Rumaila formation at the bottom. The reservoir was divided into eight units separated by isolated units according to partition taken by a rounding fields.

In this paper histograms frequency distribution of the porosity, permeability, and water saturation were plotted for MA unit of Mishrif formation in Noor field, and then transformed to the normal distribution by applying the Box-Cox transformation alg

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Publication Date
Thu Jun 30 2022
Journal Name
International Review Of Mechanical Engineering (ireme)
Field Study of Absorbent Media Effect on the Yield of Solar Desalination for Iraqi Marsh Water
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Fresh water production from saline or waste water utilizing solar stills is the secured future approach in water industry with low cost and no environmental pollution accompanied with low productivity. In this work, the effect of inserting different available materials in a passive Single Slope Solar SSS stills on their productivity is accomplished. Side by side tests are performed on a conventional still, and three SSS stills inserted with carbon filter media, Copper wire mesh, and Cellulose sheets. All these stills are symmetrical in dimensions with 0.5 m2 base area tested for 20mm water level. The stills have been manufactured, instrumented, and tested in July 2021 under DhiQar-Iraq climate conditions (latitude 31.2° N, longitude 46.34

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Publication Date
Tue Mar 04 2008
Journal Name
Journal Of Baghdad College Of Dentistry
Twelve months clinical comparison between modified Widman flap with or without enamel matrix derivative for the treatment of infrabony defects
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Publication Date
Thu Oct 21 2021
Journal Name
Physical Review E
Lattice Boltzmann method with moment-based boundary conditions for rarefied flow in the slip regime
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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Educational Program on Nurses Knowledge toward Nursing Management for Patients Undergoing Percutaneous Coronary Intervention in Cardiac Center at Al-Dewaniyah City
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Objectives: The study aims to evaluate the effectiveness of the educational program on nurses’ knowledge towards nursing management for patients undergoing percutaneous coronary intervention (PCI), as well as to find out the relationship between nurses' knowledge and some of their demographic characteristics (age, gender, level of education, and years of experience in cardiac units).

Methodology:  A Quasi-experimental as one group (pre and post test) study was conducted at the Heart Center in Al-Diwaniyah city for the period from December 7, 2019 to February 23, 2020. A sample of (40) nurses working in the heart center was chosen from different nursing addresses. The sample covered one gro

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Publication Date
Wed Apr 06 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Management using the Six Sigma approach to cost rationalization of activities : Application in the Iraqi mechanical carpet factory
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The textile industries play a prominent role in reviving the national economy, but they are currently suffering from several problems, including the high costs of their activities, the low quality of their production processes, and accordingly, the hexagonal diffraction approach came to help analyze production activities to determine which of them are the most expensive and do not have a benefit or cost greater than Its benefit as a result of waste and losses that accompany its implementation. And by applying to the Iraqi mechanical carpet factory, the research reached several conclusions, the most important of which is the presence of several sources of waste and loss, such as activities and operations that do not add value, whi

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Publication Date
Sun Mar 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
The effectiveness of the organization in the philosophy of the most prominent theoreticianAdministrative thought
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بناء على ما تقدم يتضح ان القطاع العام والقطاع الخاص ليسا موقفا ايدولوجيا انتقائيا، وانما هو انبثاق من العمود الفقري للصيرورة الرأسمالية القائمة على تقديس الملكية الخاصة، وان الادوار التي يمكن ان يلعباها ليسا منعزلين عن الحركة العامة للاقتصاد في كليته، وليس هما ابنا السياسات الاقتصادية، والبناء الفوقي بقدر ماهما نتاج الحركة الموضوعية وصيرورة التطور الاجتماعي معبرا عنها في تطور علاقات الانتاج وقوى الانتا

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Publication Date
Mon Oct 14 2019
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Short Term Effectiveness of Gamma Knife Radiosurgery in the Management of Brain Arteriovenous Malformation
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AIM: To evaluate the short-term effectiveness of Gamma knife radiosurgery as a modality of treatment of brain arteriovenous malformation. METHODS: Sixty-three patients with arteriovenous brain malformations underwent Gamma knife radiosurgery included in this prospective study between April 2017 and September 2018 with clinical and radiological with MRI follow up was done at three months and six months post-Gamma knife radiosurgery. By the end of the 12th-month post-Gamma knife radiosurgery, the patients were re-evaluated using digital subtraction angiography co-registered with M.R.I. During the 12 months follow up, CT scan or MRI was done at any time if any one of the patients᾽ condition deteriorated or developed signs and s

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