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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 Jan 01 2026
Journal Name
Aip Conference Proceedings
Evaluation of energy loss of hydrogen ion beams moving in nacl: Study based on Drude–Lorentz model and stopping and range of ions in matter/transport of ions in matter calculations
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Publication Date
Thu Oct 01 2020
Journal Name
Plant Archives
Tracking the existence of PAH in water resources around and away from Al-Ahdab Oil Field in Wasit Governorate of Iraq
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Some major pollutants of polycyclic aromatic hydrocarbons (PAH) those discharged as water produced (WP) from the AlAhdab oil field (AOF) in the ponds close to it may leak to the water resources around and eventually reaches the marshes which will affect its ecosystem. Thus, this work aims to track the availability of PAH in the water resources and the Main Outfall Drain (MOD) nearby. The determination of PAH was evaluated using “High-Performance Liquid Chromatography (HPLC)”. The mean concentration of sixteen PAH in the produced water within the field was relatively high (0.01 to 10.89 g/ml) with standard deviations of (0.10.9). While, PAH outside the field were gradually diminishes down to (0.01-0.039) x10-2 g/ml which exceeds th

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Publication Date
Tue Nov 01 2022
Journal Name
Computers And Electronics In Agriculture
A novel heat-pulse probe for measuring soil thermal conductivity: Field test under different tillage practices
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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Improving the Accuracy of Handheld GPS Receivers Based on NMEA File Generating and Least Squares Adjustment
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This study aims to improve the quality of satellites signals in addition to increase accuracy level delivered from handheld GPS data by building up a program to read and decode data of handheld GPS. Where, the NMEA protocol file, which stands for the National Marine Electronics Association, was generated from handheld GPS receivers in real time using in-house design program. The NMEA protocol file provides ability to choose points positions with best status level of satellites such as number of visible satellite, satellite geometry, and GPS mode, which are defined as accuracy factors. In addition to fix signal quality, least squares technique was adopted in this study to minimize the residuals of GPS observations and enh

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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Comparison of Maximum Likelihood and some Bayes Estimators for Maxwell Distribution based on Non-informative Priors
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In this paper, Bayes estimators of the parameter of Maxwell distribution have been derived along with maximum likelihood estimator. The non-informative priors; Jeffreys and the extension of Jeffreys prior information has been considered under two different loss functions, the squared error loss function and the modified squared error loss function for comparison purpose. A simulation study has been developed in order to gain an insight into the performance on small, moderate and large samples. The performance of these estimators has been explored numerically under different conditions. The efficiency for the estimators was compared according to the mean square error MSE. The results of comparison by MSE show that the efficiency of B

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Publication Date
Wed Apr 01 2026
Journal Name
Journal Of Molecular Structure
Synthesis and studying the mesomorphic behavior of some new compounds based on 1H -benzimidazole-2-thiol
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Publication Date
Sun Jun 02 2013
Journal Name
Baghdad Science Journal
Comparison of Maximum Likelihood and some Bayes Estimators for Maxwell Distribution based on Non-informative Priors
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In this paper, Bayes estimators of the parameter of Maxwell distribution have been derived along with maximum likelihood estimator. The non-informative priors; Jeffreys and the extension of Jeffreys prior information has been considered under two different loss functions, the squared error loss function and the modified squared error loss function for comparison purpose. A simulation study has been developed in order to gain an insight into the performance on small, moderate and large samples. The performance of these estimators has been explored numerically under different conditions. The efficiency for the estimators was compared according to the mean square error MSE. The results of comparison by MSE show that the efficiency of Bayes est

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Publication Date
Sun Oct 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Synthesis and Investigation The Biological Activity of Some New Alkenes Based on Thiazoldin-4-one Compounds
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This work has been done to prepare a series of new alkene compounds derived from 4-thiozolidinones by substituting different aldehydes, P-acetamido-phenol, and 2-mercapto-benzoimidazole, which were used as starting materials to form ester [I]a,b and then make hydrazides [II]a,b, which were used to prepare 1, 3, and 4-oxadiazoles [III]a,b, which were then used for prepared Schiff bases [IV]a-f, The next step was the synthesis of 4-thiazoldinone derivatives [V]a-f  from Schiff bases. The final step was the synthesis of alkenes [VII]a-f, the prepared derivatives were identified with spectral methods (FT-IR, 1H-NMR, mass, and CHNS). The antibacterial activity of the prepared derivatives was evaluated against four types of bacteria, pos

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Publication Date
Thu Jun 29 2023
Journal Name
Iraqi Journal Of Computer, Communication, Control And System Engineering
Recognition of Upper Limb Movements Based on Hybrid EEG and EMG Signals for Human-Robot Interaction
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Upper limb amputation is a condition that severely limits the amputee’s movement. Patients who have lost the use of one or more of their upper extremities have difficulty performing activities of daily living. To help improve the control of upper limb prosthesis with pattern recognition, non-invasive approaches (EEG and EMG signals) is proposed in this paper and are integrated with machine learning techniques to recognize the upper-limb motions of subjects. EMG and EEG signals are combined, and five features are utilized to classify seven hand movements such as (wrist flexion (WF), outward part of the wrist (WE), hand open (HO), hand close (HC), pronation (PRO), supination (SUP), and rest (RST)). Experiments demonstrate that usin

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Publication Date
Tue Sep 21 2021
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Earth Resources And Environmental Remote Sensing/gis Applications Xii
Investigating the old city of Babylon: tracing buried structural history based on photogrammetry and integrated approaches
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