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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
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
The Effect of Artificial Accelerated Aging on The Color of Ceramic Veneers Cemented With Different Resin Cements (A Comparative In Vitro Study)
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ABSTRACT Background: Color changes that are detectable to human eye can affect the esthetic appearance of ceramic veneers. The purpose of this study was to evaluate and compare the effect of artificial accelerated aging on the color of ceramic veneers cemented with different resin cements. Materials and Methods: Sixty discs were prepared with 0.5 mm thickness, 30 discs made from IPS e.max press (Ivoclar Vivadent) and 30 discs were made from VITA Enamic (VITA Zahnfabrik). The discs were cemented with three resin cements: Variolink Veneer MV 0 shade (Ivoclar Vivadent), Rely X veneer Translucent shade (3M ESPE) and NX3 Nexus Clear shade (Kerr Corporation) with 0.1 mm thickness. The spectrophotometer Easyshade Advance was used to measure the co

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Publication Date
Tue Dec 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of ageing media on shear bond strength of metal orthodontic brackets bonded with different adhesive systems (A comparative in-vitro study)
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Background: The aim of this study was to evaluate the shear bond strength (SBS) and adhesive remnant index (ARI) of different orthodontic adhesive systems after exposure to aging media (water storage and acid challenge). Materials and methods: Eighty human upper premolar teeth were extracted for orthodontic purposes and randomly divided into two groups (40 teeth each): the first group in which the bonded teeth were stored in distilled water for 30 days at 37°C, and the second group in which the bonded teeth were subjected to acid challenge. Each group was further subdivided into four subgroups (10 teeth each) according to the type of adhesive system that would be bonded to metal brackets: either non-fluoride releasing adhesive (NFRA),

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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 Jul 09 2023
Journal Name
Journal Of Engineering
Adsorption of Levofloxacine Antibacterial from Contaminated Water by Non – Conventional Low Cost Natural Waste Materials
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An experimental study was conducted with low cost natural waste adsorbent materials, barley husks and eggshells, for the removal of Levofloxacine (LEVX) antibacterial from synthetic waste water. Batch sorption tests were conducted to study their isothermal adsorption capacity and compared with conventional activated carbon which were, activated carbon > barley husks > eggshells with removal efficiencies 74, 71 and 42 % with adsorbents doses of 5, 5 and 50 g/L of activated carbon, barley husks, and eggshells respectively. The equilibrium sorption isotherms had been analyzed by Langmuir, Freundlich, and Sips models, and their parameters were evaluated. The experimental data were correlated well with the Langmuir model which gives the

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Publication Date
Sat Dec 01 2018
Journal Name
Indian Journal Of Ecology
Classification of al-hammar marshes satellite images in Iraq using artificial neural network based on coding representation
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Publication Date
Wed Sep 01 2021
Journal Name
Baghdad Science Journal
The Vertical variations of Atmospheric Methane (CH4) concentrations over selected cities in Iraq based on AIRS data
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The Atmospheric Infrared Sounder (AIRS) on EOS/Aqua satellite provides diverse measurements of Methane (CH4) distribution at different pressure levels in the Earth's atmosphere. The focus of this research is to analyze the vertical variations of (CH4) volume mixing ratio (VMR) time-series data at four Standard pressure levels SPL (925, 850, 600, and 300 hPa) in the troposphere above six cities in Iraq from January 2003 to September 2016. The analysis results of monthly average CH4VMR time-series data show a significant increase between 2003 and 2016, especially from 2009 to 2016; the minimum values of CH4 were in 2003 while the maximum values were in 2016. The vertical distribution of CH4<

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Publication Date
Mon Jul 01 2019
Journal Name
Biocatalysis And Agricultural Biotechnology
Determination of Diazinon in fruit samples using electrochemical sensor based on carbon nanotubes modified carbon paste electrode
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Publication Date
Sun Jan 24 2016
Journal Name
Al-academy
The effectiveness of balance in building formal relationships for media evidence: ساهرة عبد الواحد حسن
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The media guide is a small-sized printed medium, whose importance is highlighted through the specific information it carriesThe task of the guide lies in the clarity of these indications and making a positive impact on the recipient with understanding so it is a means for the purpose of reaching the effect and effectiveness of the message symbols from the movements of lines in which elements that are supposed to be equal in the performance of their functions and the purpose of their existence gather to achieve the mental response of perception, understanding and enjoyment. It must be in an objective unity based on the balance in this distribution. To form a formal organizational unit and an integrated system, the result of which is to gi

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Publication Date
Sun Jul 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of Barman model in acquiring the historical concepts among fourth-grade literary students
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The researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data.    &

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of Barman model in acquiring the historical concepts among fourth-grade literary students
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The researcher attempts to examine Barman model in acquiring the historical concepts among fourth-grade students at literary classrooms. To this end, the researcher held the null hypothesis, there is no significant difference between the experimental groups who was taught based on Barman model and the control group that taught based on the traditional method in acquiring the historical concepts on the post-test. To testify the effectiveness of Barman model, the researcher administered a questionnaire included (60) items on bunch of female-students who were selected from al-khamaeal preparatory school in al-hurriyah district in Baghdad. The author utilized different statistical tools to analyze the collected data.    &

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