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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 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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Publication Date
Wed Jun 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Innovative Marketing on the Organization's Reputation by Mediating the Brand _ Field Research in the Oil Marketing Company (SOMO)
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The research aims to verify that there is an influence between innovative marketing and the organization's reputation by brand mediation.

The research problem is that the Oil Marketing Company (SOMO) needs innovative, unconventional methods in marketing its products and improving its reputation by adopting a solid brand that adds value to the product.

The importance of the research: The importance of the research is highlighted as it deals with essential variables in business organizations that help increase customer loyalty by adopting a distinctive brand.

The research started from four main hypotheses to explore correlations and influence between researc

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Publication Date
Sun Feb 12 2017
Journal Name
World J Exp Biosc
Detection and sequencing of blaVEB-1 gene in clinical isolates of Proteus mirabilis Isolates from Baghdad City`s hospitals
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In Present study, 25 clinical isolates of Proteus spp. of clinical samples, urine, wounds and burns collected from different hospitals in Baghdad city, all isolates were identified as Proteus mirabilis using different bacteriological media, biochemical assays and Vitek-2 system. It was found that 15 (60%) isolates were identifying as P. mirabilis. The susceptibility of P. mirabilis isolates to cefotaxime was 66.6 %, while to ceftazidime was 20%. Extended spectrum β-lactamses producing Proteus was 30.7 %. DNA of 5 isolates of P. mirabilis was extracted and detection for blaVEB-1 gene by using multiplex polymerase chain reaction (PCR). Results showed that the presence of this gene in all tested isolates, as an important indicator for increas

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Publication Date
Tue Jul 01 2025
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Clinical Diagnostic Value of Stromelysin-2 and Highly Sensitive-Cardiac Troponin I in the Severity of Coronary Artery Obstruction
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Background: Coronary artery disease is a leading cause of death worldwide. Troponin is released into blood from patients with reversible myocardial ischemia. Stromelysin-2 is also involved in the development and progression of atherosclerosis by tissue remodeling and degradation of extracellular matrix proteins.Objectives: To investigate the role of serum high-sensitive cardiac troponin I (hs-cTn I) and Stromelysin-2 (Str-2) in the diagnosis and determination of the severity of coronary artery obstruction.Methods: This cross-sectional study was conducted on 125 subjects undergoing coronary angiography for suspicion of coronary artery disease in Baghdad Teaching Hospital/ Medical City complex/ Baghdad/ Iraq by the Department of Bioch

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Publication Date
Wed Apr 01 2020
Journal Name
International Journal Of Pharmaceutical Research
Effectiveness of Self-Instructional Strategy and the Traditional Teaching Approach on Nursing Students&#39; Knowledge toward Cardiopulmonary Resuscitation at the College of Nursing in University of Baghdad: Randomized Comparative Trial
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MM ABDUL-WAHHAB, SA AHMED, International Journal of Pharmaceutical Research, 2020 - Cited by 2

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Publication Date
Tue May 03 2022
Journal Name
Teikyo Medical Journal
Tooth agenesis and palatal dimensions associated with craniofacial deformity- Cone Beam Computed Tomography based study
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Cleft / palate is one of the common congenital deformities in craniofacial region, associated with different types of dental anomalies like (Tooth agenesis, impaction, and supernumerary teeth) with marked changes in palatal dimensions. This study aimed to determine the prevalence of teeth agenesis and dental anomalies in cleft lip/palate patients using CBCT, and to compare the palatal dimension of cleft group with control subjects. Twenty-eight cleft cases collected during the period from 2015 to 2022, CBCT images evaluated, the study sample classified into two groups (14 bilateral and 14 unilateral cleft lip/palate) and the non-cleft control group (14 CBCT images). The presence of dental anomalies was assessed in relation to clef

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Publication Date
Fri Mar 31 2017
Journal Name
Al-khwarizmi Engineering Journal
Design of Nonlinear PID Neural Controller for the Speed Control of a Permanent Magnet DC Motor Model based on Optimization Algorithm
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In this paper, the speed control of the real DC motor is experimentally investigated using nonlinear PID neural network controller. As a simple and fast tuning algorithm, two optimization techniques are used; trial and error method and particle swarm optimization PSO algorithm in order to tune the nonlinear PID neural controller's parameters and to find best speed response of the DC motor. To save time in the real system, a Matlab simulation package is used to carry out these algorithms to tune and find the best values of the nonlinear PID parameters. Then these parameters are used in the designed real time nonlinear PID controller system based on LabVIEW package. Simulation and experimental results are compared with each other and showe

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Publication Date
Tue Jun 30 2026
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Wellbore stability analysis and safe mud weight window selection in the Halfaya oil field
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   Drilling operations in the Halfaya oilfield frequently encounter severe wellbore instability challenges. When navigating shale deposits, wellbore instability remains the primary operational concern. Based on the analysis of the wellbore instability intervals, low-strength shale and marlstone formations are identified as the principal unstable zones that lead to non-productive time and higher drilling costs. By planning a safe operating mud window, these non-productive times and drilling costs can be mitigated. Several wellbore instability concerns have been found in a southern Iraqi oil field. A problem-diagnostic technique was done by evaluating well log data, drilling reports, mud logging reports, and pore pressure readings.

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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
The Energy Spectra and Heat Capacity of GaAs Gaussian Quantum Dot in an External Magnetic Field
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In this paper, a theoretical study of the energy spectra and the heat capacity of one electron quantum dot with Gaussian Confinement in an external magnetic field are presented. Using the exact diagonalization technique, the Hamiltonian of the Gaussian Quantum Dot (GQD) including the electron spin is solved. All the elements in the energy matrix are found in closed form. The eigenenergies of the electron were displayed as a function of magnetic field, Gaussian confinement potential depth and quantum dot size. Explanations to the behavior of the quantum dot heat capacity curve, as a function of external applied magnetic field and temperature, are presented.

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Publication Date
Sun Feb 28 2021
Journal Name
Iraqi Geological Journal
Facies Analysis and Depositional Stages of The Albian-Aptian Succession in Balad Oil Field, Central Iraq
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Carbonate-clastic succession which includes the Shu'aiba, Nahr Umr and Mauddud formations are representing a part of the Barremian-Aptian Sequence (Wasi'a Group). The present study includes three boreholes (Ba-1, 4 and 8) within the Balad Oil Field. The study area is located in central Iraq. This field represents a subsurface anticline with a northwest to southeast direction axis within the Mesopotamian Zone. Eight types of microfacies were recognized in the succession of the Mauddud and Shu’aiba formations. These microfacies represent shallow open marine, restricted and semi-restricted, reef - back reef, deep open marine and basinal depositional environments. While Nahr Umr Formation includes two successions, the first is the upp

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