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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
Thu Nov 18 2021
Journal Name
Frontiers In Public Health
Dentists' Practices and Attitudes Toward Using Personal Protection Equipment and Associated Drawbacks and Cost Implications During the COVID-19 Pandemic
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Objectives: During the COVID-19 pandemic, dentists have had to work under stressful conditions due to the nature of their work. Personal protection equipment (PPE) has become mandatory for work in the dentistry field. This study aimed to examine dentists' practices and attitudes regarding the use of PPE and the associated drawbacks and cost implications during the pandemic.

Methods: A questionnaire-based survey was used and was divided into five sections dedicated to collect demographic variables and to examine the dentists' practices, attitudes toward PPE, drawbacks, and cost of using PPE. Mann-Whitney U and Kruskal-Wallis tests were used to compare different sections of

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of TD-ABC approach in decreasing of cost per unit: Applied study in the General company of Hydraulic Industries \ Plastic Factory
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The aim of the research is to use this technique and to determine the effect of this method in reduce cost per unit of the company. The traditional method used in the company the research sample to determine the indirect costs, the definition of the concepts and characteristics of the method of cost-based activity and the cost method based on time-driven activity and justifications applied to companies.   In order to achieve the research objectives, the main hypotheses were formulated. That was represented: (The applied of (TDABC) Time driven activity based costing method in reducing indirect costs, leads reduce cost per unit than the use of the traditional method of allocating indirect costs in the research sample company).&nb

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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Risk-Based Inspection Due to Corrosion Consequences for Oil and Gas Flowline: A Review
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   The petroleum industry, which is one of the pillars of the national economy, has the potential to generate vast wealth and employment possibilities. The transportation of petroleum products is complicated and changeable because of the hazards caused by the corrosion consequences. Hazardous chemical leaks caused by natural disasters may harm the environment, resulting in significant economic losses. It significantly threatens the aim for sustainable development. When a result, determining the likelihood of leakage and the potential for environmental harm, it becomes a top priority for decision-makers as they develop maintenance plans. This study aims to provide an in-depth understanding of the risks associated with oil and gas pipeli

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Publication Date
Fri Dec 25 2009
Journal Name
Wireless Personal Communications
A N-Radon Based OFDM Trasceivers Design and Performance Simulation Over Different Channel Models
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In this paper a new method is proposed to perform the N-Radon orthogonal frequency division multiplexing (OFDM), which are equivalent to 4-quadrature amplitude modulation (QAM), 16-QAM, 64-QAM, 256-QAM, ... etc. in spectral efficiency. This non conventional method is proposed in order to reduce the constellation energy and increase spectral efficiency. The proposed method gives a significant improvement in Bit Error Rate performance, and keeps bandwidth efficiency and spectrum shape as good as conventional Fast Fourier Transform based OFDM. The new structure was tested and compared with conventional OFDM for Additive White Gaussian Noise, flat, and multi-path selective fading channels. Simulation tests were generated for different channels

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Publication Date
Tue Dec 07 2021
Journal Name
2021 14th International Conference On Developments In Esystems Engineering (dese)
Study the use of Nano-limestone and Egg-shell Ash in Eco-friendly SCC: an Experimental and Statistical Evaluation Based on Computer Programming
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Publication Date
Fri Mar 31 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin and Antioxidant Agents on Hirsutism in Women with Polycystic Ovary Syndrome
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Forty six Iraqi women with PCOS were involved in this study . They were treated with metformin alone and with antioxidant agents (vitamin E or C).It was found that all patients who treated with metformin or with combination of metformin with antioxidant agents showed significant decrease in hirsutism score. The treatment of metformin with antioxidant agents is of great benefit in treatment of hirsutism in PCOS due to that there was no worsening effect after treatment. This may indicate that antioxidant agents may participate in alleviation of hirsutism so it can be said that oxidative stress may play an important role in developing of hirsutism in PCOS.   

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effect of Physiotherapy on the Motor Recovery and Improvement in Patients with Facial Palsy
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Objectives: The study aims to investigate the efficiency of physiotherapy methods to improve the
degree of the clinical recovery of the peripheral facial palsy.
Methodology: This study is carried out at the Rehabilitation Center-Baghdad from November 2009 till
March 2010. This study includes (40) patient, their ages are from (13) to (55) years old; (24) male and
(16) female with unilateral facial palsy of undetermined cause. House-Brackmann facial recovery
scores have been used before and after the physiotherapy treatment.
Results: The results show that the physiotherapy sessions obtained the best effect of the electrical
stimulation, exercises and massage in the treatment of facial palsy. Highly respondents in femal

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Publication Date
Thu Jun 24 2021
Journal Name
Ibero-american Journal Of Exercise And Sports Psychology
The effect of an educational curriculum based on metacognitive skills in teaching some offensive skills on the specialized school of basketball in Baghdad governorate
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The educational process depends on the means of conveying information from the teacher to the learner. Whenever appropriate, this means the learning process takes place better, faster, and with less effort, and the problem of research lies. The players lack learning in the meta-knowledge curriculum in basketball offensive skills than offensive skills. The aim of the research is to identify the effect of training exercises for educational numbers based on metacognitive skills in teaching some offensive skills with basketball. As for the research assignment, there are statistically significant differences between the results of the pre and post tests for the experimental group and in favor of the post tests. The experimental approach was used

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Publication Date
Mon Oct 01 2012
Journal Name
Applied Energy
Analysis of thermal and electrical performance of a hybrid (PV/T) air based solar collector for Iraq
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The electrical and thermal performance of a typical single pass hybrid photovoltaic/thermal (PV/T) air collector is modeled, simulated and analyzed for two selected case studies in Iraq. An improved mathematical thermo-electrical model is derived in terms of design, operating and climatic parameters of the hybrid solar collector to evaluate its important characteristics: collector flow and heat removal factors, PV maximum power point and its temperature coefficient, and overall power and efficiency. Unlike previous PV/T thermal models, the present model is obtained with some additions and corrections in radiation and convection heat coefficients for the top loss and for the air duct with more applicable sky temperature correlation. The well

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Publication Date
Mon Oct 01 2012
Journal Name
Applied Energy
Analysis of thermal and electrical performance of a hybrid (PV/T) air based solar collector for Iraq
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