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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 24 2020
Journal Name
Modeling Earth Systems And Environment
Assessment of reservoir properties and Buckles model for Rumaila Formation in Ahdeb oil field, Central Iraq
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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Student Teachers Acquisition at Sultan Qaboos University in Skills of Teaching Arabic via A Virtual Micro-Teaching Lab Based on their Point of View
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The study aims to investigate the degree of student teachers at Sultan Qaboos University acquired skills in teaching Arabic via a virtual micro-teaching lab, as well as to reveal the difficulties they faced and their development proposals. To do this, the researchers developed a questionnaire divided into four dimensions: planning, implementation, evaluation, and

ethical values for the teaching profession, in addition to two open-ended questions to identify difficulties and suggestions. It was administered to (30) student teachers. The results revealed that the average degree of student-teacher acquisition of skills was high in its four dimensions. It ranged between (39.2) to (82.2), while the overall average was (56.2).

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Publication Date
Mon Nov 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Field Emergence Affected by Zea Mays L. Cultivars and Seed Soaking in Acids of Ascorbic, Citric and Humic
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A field experiment was carried out during the spring season 2019 and 2020 to obtain a fast, uniform, and high field emergence ratio of maize seeds under a wide range of environmental conditions. Randomize complete block design in the split-plot arrangement was used with three replications. The first factor in the main plots was cultivars (5018, Baghdad3 and Sumer). The second factor in the sub-plots was seeds soaking with ascorbic and citric acids (100 mg L−1) each and humic (1 ml L−1) in addition to control treatment (seeds soaking with distilled water only). Results showed the superiority of soaking with humic acid significantly, as means of characteristics of field emergence in both seasons, respectively, were as follows: Last day of

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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
The role of practices by the Managing of human resources on effectiveness of organizational crisis Management Described and analysis research for ministry of Iraqi interior
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The practice by the  administration of human resources  on effectiveness of organization  crisis as two knowledge fields , it were be until now as center for many studies, but the collect it, study of relation between them ,and The role of practices  by the  administration of human resources  on effectiveness of organization  crisis administration  were considered a new study and first according to the available and showing  studies at this field .

The problem of this research was specified by answer for the question that deal for size of consciousness at the ministry of interior for import of&nbs

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Publication Date
Wed Mar 01 2017
Journal Name
جامعة كرميان
The effect of a training program for chemistry teachers based on the strategy of both sides of the brain together on the thinking patterns of their students
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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis and Biological Effectiveness of Some new Azo Compounds as Derivatives of Nitrogen Bases
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In this study the new azo compounds (3compounds) for nitrogen bases (Adenine and Cytosine) are synthesized through two reaction steps (formation of diazonium salt and coupling reaction). The compounds have been characterized by FTIR, melting point, and ultra-violate (UV) spectra. All synthesized compounds have been estimated in vitro for their antimicrobial activities against two species of bacteria(E.coli, S.aureus)and one kind of fungi ( Aspergillus flavus) .The results show that these compounds have very good antibacterial and antifungal activities especially compounds 1 and 3.To study the effect of these compounds were making some physiological tests on rats are made ,the results of hematological study showed decreasing level of

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Publication Date
Fri Sep 15 2023
Journal Name
Journal Of Baghdad College Of Dentistry
Reliability of the multipeg™ transducer in measuring dental implant stability by using a resonance frequency analysis device (Osstell®): An observational clinical study
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Background: Measuring implant stability is an important issue in predicting treatment success. Dental implant stability is usually measured through resonance frequency analysis (RFA). Osstell® RFA devices can be used with transducers (Smartpeg™) that correspond to the implants used as well as with transducers designed for application with Penguin® RFA devices (Multipeg™). Aims: This study aims to assess the reliability of a MultiPeg™ transducer with an Osstell® device in measuring dental implant stability. Materials and Methods: Sixteen healthy participants who required dental implant treatment were enrolled in this study. Implant stability was measured by using an Osstell® device with two transducers, namely, Smartpeg™ and M

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Publication Date
Tue Sep 06 2016
Journal Name
Al-qadisiyah Journal For Administrative And Economic Sciences
Awareness of the regulatory and administrative leadership and its role in achieving the effectiveness of the internal control system and achieve fair accountability
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The research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso

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Publication Date
Fri Aug 20 2021
Journal Name
Iraqi Journal Of Laser
Design of Tunable Optical Band Pass Filter based on in-Line PM-Mach Zehnder Interferometer
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In this paper, tunable optical band-pass filters based on Polarization Maintaining Fiber –Mach Zehnder Interferometer presented. Tunability of the band-pass filter implemented by applying different mechanical forces N on the micro-cavities splicing regions (MCSRs). The micro-cavity formed by using three variable-lengths of single-mode polarization-maintaining fiber with (8, 16, 24) cm lengths, splice between two segments of (SMF-28) with (26, 13) cm lengths, using the fusion splicing technique.  Ellipsoidal shape micro-cavities experimentally achieved parallel to the propagation axis having dimensions between (12-24) μm of width and   (4-12) μm of length. A micro-cavity with width and length as high as 24 μm and 12 μ

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Publication Date
Fri Jan 24 2025
Journal Name
Cellular Physiology And Biochemistry
Synergistic Activity of Indolicidin and Tigecycline Against Multidrug-Resistant Acinetobacter Baumannii Clinical Isolates
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Background/Aims: Acinetobacter baumannii is a ubiquitous opportunistic microorganism associated with high morbidity and mortality Particularly among burn patients and immunocompromised individuals. This study aimed to assess the time-dependent antimicrobial effectiveness of indolicidin in combination with tigecycline against multidrug-resistant (MDR) A. baumannii isolates from patients with wound infections. Methods: The antimicrobial synergy between indolicidin and tigecycline was evaluated using the checkerboard broth microdilution method And anti-biofilm activity was assessed using the crystal violet assay. Ten isolates resistant to multiple antibiotics were identified and confirmed using the API 20-NE system. Results: Fractional

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