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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 Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Measure the effectiveness of the Balanced Scorecard strategic performance management in public institutions of Jordan )An Empirical Study on the Social Security Corporation – Irbid(
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The goal of this research to identify a set of criteria that can be measured on the basis of which the effectiveness of the application of the Balanced Scorecard in the Jordanian Public Institutions in order to identify the basic requirements to ensure the application of balanced performance measures. The study population consisted of the staff of the Public Institution for Social Security - Irbid of directors of departments and heads of departments and administrative staff, was the use of a random sample of (50) an employee and the employee. The questionnaire was used as a tool to collect data, and as a result of subjecting these standards for the field test and the use of statistical analysis tools to the results of the study c

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
A Competitive Study Using UV and Ozone with H2O2 in Treatment of Oily Wastewater
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          In this study, ultraviolet (UV), ozone techniques with hydrogen peroxide oxidant were used to treat the wastewater which is produced from South Baghdad Power Station using lab-scale system. From UV-H2O2 experiments, it was shown that the optimum exposure time was 80 min. At this time, the highest removal percentages of oil, COD, and TOC were 84.69 %, 56.33 % and 50 % respectively. Effect of pH on the contaminants removing was studied in the range of (2-12). The best oil, COD, and TOC removal percentages (69.38 %, 70 % and 52 %) using H2O2/UV were at pH=12. H2O2/ozone experiments exhibited better performance compared to

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Publication Date
Mon Nov 06 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
Effect of hunting cooperation and fear in a food chain model with intraspecific competition
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Taking into account the significance of food chains in the environment, it demonstrates the interdependence of all living things and has economic implications for people. Hunting cooperation, fear, and intraspecific competition are all included in a food chain model that has been developed and researched. The study tries to comprehend how these elements affect the behavior of species along the food chain. We first examined the suggested model's solution properties before calculating every potential equilibrium point and examining the stability and bifurcation nearby. We have identified the factors that guarantee the global stability of the positive equilibrium point using the geometric approach. Additionally, the circumstances that would gu

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Biochemical Study of Proteins Profile in Iraqi Children and Adolescent with ?-Thalassemia
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The aim of the present research is to study different protein fractions in sera of children and adolescent with  β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with  β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied  groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects.  A Significant  decrease  was  found  in  the  total  protein and  albumin&nb

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Publication Date
Sun Feb 25 2024
Journal Name
Baghdad Science Journal
Efficient Task Scheduling Approach in Edge-Cloud Continuum based on Flower Pollination and Improved Shuffled Frog Leaping Algorithm
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The rise of edge-cloud continuum computing is a result of the growing significance of edge computing, which has become a complementary or substitute option for traditional cloud services. The convergence of networking and computers presents a notable challenge due to their distinct historical development. Task scheduling is a major challenge in the context of edge-cloud continuum computing. The selection of the execution location of tasks, is crucial in meeting the quality-of-service (QoS) requirements of applications. An efficient scheduling strategy for distributing workloads among virtual machines in the edge-cloud continuum data center is mandatory to ensure the fulfilment of QoS requirements for both customer and service provider. E

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Publication Date
Sun Jun 30 2013
Journal Name
Al-khwarizmi Engineering Journal
Estimated Outlet Temperatures in Shell-and-Tube Heat Exchanger Using Artificial Neural Network Approach Based on Practical Data
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The objective of this study is to apply Artificial Neural Network for heat transfer analysis of shell-and-tube heat exchangers widely used in power plants and refineries. Practical data was obtained by using industrial heat exchanger operating in power generation department of Dura refinery. The commonly used Back Propagation (BP) algorithm was used to train and test networks by divided the data to three samples (training, validation and testing data) to give more approach data with actual case. Inputs of the neural network include inlet water temperature, inlet air temperature and mass flow rate of air. Two outputs (exit water temperature to cooling tower and exit air temperature to second stage of air compressor) were taken in ANN.

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Publication Date
Sun Sep 01 2024
Journal Name
International Immunopharmacology
Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study
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Evaluating treatment effect on interferon-alpha in female patients with systemic lupus erythematosus: a case-control study

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Publication Date
Sat Jun 30 2018
Journal Name
Iraqi Journal Of Medical Sciences
CLINICAL UTILITY OF URINARY ANTIGEN TEST AND MOLECULAR METHOD FOR DETECTION OF LEGIONELLA PNEUMOPHILA
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Background: Legionella pneumophila (L. pneumophila) is gram-negative bacterium, which causes Legionnaires’ disease as well as Pontiac fever. Objective: To determine the frequency of Legionella pneumophila in pneumonic patients, to determine the clinical utility of diagnosing Legionella pneumonia by urinary antigen testing (LPUAT) in terms of sensitivity and specificity, to compares the results obtained from patients by urinary antigen test with q Real Time PCR (RT PCR) using serum samples and to determine the frequency of serogroup 1 and other serogroups of L. pneumophila. Methods: A total of 100 pneumonic patients (community acquired pneumonia) were enrolled in this study during a period between October 2016 to April 2017; 92 sam

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Publication Date
Sun Dec 02 2012
Journal Name
دراسات عربية في التربية وعلم النفس
The effectiveness of environmental enrichment activities in the achievement of chemistry and environmental awareness for fifth-grade science students
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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of University Leaders' Behavior and the Faculty Members' Motivation towards the Work in the Iraqi Colleges of Nursing
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Objective(s): The present study aims at identifying the Iraqi Colleges of Nursing Deans' leadership
behaviors effectiveness and faculty members' motivation towards work in these colleges.
Methodology: Descriptive design has been used for the sample survey manner, which is the
appropriate approach to the study of social phenomena in the field where provides data on the reality of
these phenomena and relations between the causes and consequences and an analysis of it and perhaps
the factors affecting it and how it appears. The study relies on a questionnaire to collect data from the
participants which is composed of (86) items distributed on three axes: First, the demographic
characteristics which are composed of (8) i

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