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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
Fri Apr 16 2021
Journal Name
Pharmaceutical Medicine
The Epidemic of Substandard and Falsified Medications in Iraq: Evaluating the Effectiveness of National Pharmacovigilance Alerts to Community Pharmacies
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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
Sun Jan 24 2016
Journal Name
Al-academy
The effectiveness of pantomime in development of movement skills for Kindergarten: محمد إسماعيل الطائي
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In order to a chive the aim of the research the researcher chose the (Nebras kindergarten) to be the search sample .the member of the sampleFrom(males and fameless)and the researcher chose the class of(butterfly) as experimental group to do the pantomime consist of(15)males and fameless, and put(singles, senses ,double senses and communal senses)in the binging of the experiment the researcher applied the measurement of(AL Kaswany and other)as(pre_ test)which prepare to measure, the movement skills for kindergarten, the measurement have the validity and reliability to knowledge the difference between the two experiment. The experiment continue from(20/1/201to 20/2/2014)in the end of experiment the researcher applied the measurement of(AL

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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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This paper discuses the mindset contribution of the organization Science in organizational effectiveness (OE), and the most valuable thoughts they introduced in this subject, starting from the pre- classical era, through classical era to present time. This paper has identified the main contribution in OE. The concept of OE didn’t arise until what had been introduced by Chester Barnard, although Max Weber mentioned this concept in his bureaucratic theory, but he didn’t explain it as Barnard does. After that no clear focus was pointed to this subject until Peter Drucker did so, which considered as the main participant in OE after Barnard. After that many researchers be interested in OE and they start studying this subject like

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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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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi Journal Of Veterinary Sciences
Incidence of cutaneous and subcutaneous tumors of dogs from Baghdad city: Clinical, cytological and histopathological features
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The present study was conducted to estimate the incidence, clinical findings, cytological and histopathological characteristics of spontaneously occurring skin neoplasms in dogs. A total of 40 grossly suspected cases of cutaneous and subcutaneous tumors were gathered during the period from July 2016 to August 2018 from male and female dogs in Baghdad city. Dogs with skin neoplasia revealed various clinical signs, and their ages were older than 5 years to 15 years. German shepherd 30% followed by Terrier dogs 25% were more influenced than other breeds. Concerning tumor features, the majority of neoplasms had solitary lesion 70%, regular shapes 65% with black color 55%. The tumors frequently occurred on fore-limbs and abdomen, and 80% of them

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Publication Date
Wed Jun 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Beta angle in a sample of Iraqi adults with Class I skeletal and dental relations and its correlation with other craniofacial measurements
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Background: This study aimed to determine the value of Beta angle for a sample of Iraqi adults with class I skeletal and dental relations and to verify the existence of sexual dimorphism and to find out the relation between this angle and other craniofacial measurements. Materials and Methods: Sixty dental students (23 males and 37 females) with an age ranged between 20-31 years old and having class I skeletal and dental relations were chosen for this study. Each student was subjected to clinical examination and digital true lateral cephalometric radiograph. The radiographs were analyzed using AutoCAD 2007 computer program to measure the angular and linear variables. Descriptive statistics were obtained for the measurements for both genders

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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Developmental Role of Social Work in Reducing Social Extremism:A Field Study in Baghdad University-College of Mass Communication as a Model: محمد حميد علوان
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This study deals with the role that social work profession plays in all its fields to reduce social extremismat home, or school or within society. The study aims to: examine the historical roots of social work in the Iraqi society, investigate the objectives of the developmental role of social work, review the theories of social extremism, its characteristics, and causes, and to analyze the developmental role of social work to limit social extremism. To meet the objectives of the study, a descriptive analytical approach has been adopted. It involves using the social sampling survey method, i.e., a questionnaire tool in the University of Baghdad community-College of Media. The sample was randomly selected to include (100) students from th

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Publication Date
Tue Aug 01 2023
Journal Name
Baghdad Science Journal
A Developed Colorimetric Assay Using Unmodified Gold Nanoparticles for the Identification of Acinetobacter baumannii Isolates from Different Clinical Samples
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  Acinetobacter baumannii (A. baumannii ) is considered a critical healthcare problem for patients in intensive care units due to its high ability to be multidrug-resistant to most commercially available antibiotics. The aim of this study is to develop a colorimetric assay to quantitatively detect the target DNA of A. baumannii based on unmodified gold nanoparticles (AuNPs) from different clinical samples (burns, surgical wounds, sputum, blood and urine). A total of thirty-six A. baumannii clinical isolates were collected from five Iraqi hospitals in Erbil and Mosul provinces within the period from September 2020 to January 2021. Bacterial isolation and biochemical identification of isolates

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Publication Date
Sun Jan 01 2023
Journal Name
Chemical Engineering And Processing - Process Intensification
Optimization of a combined electrocoagulation-electro-oxidation process for the treatment of Al-Basra Majnoon Oil field wastewater: Adopting a new strategy
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