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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 Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Strategic Flexibility in Achieving Organization Effectiveness: Analytical Research in the Directorates of the Ministry of Education
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This research aims to know the role of strategic flexibility in achieving organizational effectiveness by studying the dimensions of strategic flexibility (capacity flexibility, resource flexibility, information flexibility, and coordination flexibility) on the dimensions of organization effectiveness (environmental adaptation, productivity and achieving goals) through an analytical study conducted in six directorates in the office of the Iraqi Ministry of Education.

The research problem was represented in the form of questions, the most prominent of which was "What is the role of strategic flexibility in achieving organization effectiveness?" The descriptive analytical approach was relied on in applying

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Publication Date
Thu Dec 17 2020
Journal Name
International Journal Of Molecular Sciences
AhR Activation Leads to Alterations in the Gut Microbiome with Consequent Effect on Induction of Myeloid Derived Suppressor Cells in a CXCR2-Dependent Manner
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Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) is a potent ligand for AhR and a known carcinogen. While AhR activation by TCDD leads to significant immunosuppression, how this translates into carcinogenic signal is unclear. Recently, we demonstrated that activation of AhR by TCDD in naïve C57BL6 mice leads to massive induction of myeloid derived-suppressor cells (MDSCs). In the current study, we investigated the role of the gut microbiota in TCDD-mediated MDSC induction. TCDD caused significant alterations in the gut microbiome, such as increases in Prevotella and Lactobacillus, while decreasing Sutterella and Bacteroides. Fecal transplants from TCDD-treated

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Material Selection for Unmanned Aerial Vehicles (UAVs) Wings Using Ashby Indices Integrated with Grey Relation Analysis Approach Based on Weighted Entropy for Ranking
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The designer must find the optimum match between the object's technical and economic needs and the performance and production requirements of the various material options when choosing material for an engineering application. This study proposes an integrated (hybrid) strategy for selecting the optimal material for an engineering design depending on design requirements. The primary objective is to determine the best candidate material for the drone wings based on Ashby's performance indices and then rank the result using a grey relational technique with the entropy weight method. Aluminum alloys, titanium alloys, composites, and wood have been suggested as suitable materials for manufacturing drone wings. The requirement

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Publication Date
Tue Dec 30 2014
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Coagulation/ Flocculation, Microfiltration and Nanofiltration for Water Treatment of Main Outfall Drain for Injection in Nasiriyah Oil Field
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The present work aims to study the efficiency of coagulation/ flocculation as 1st stage, natural gravity water filter or microfiltration (MF) as 2nd stage and nanofiltration (NF) technology as final stage for treatment of water of main outfall drain (MOD) for injection in Nasiriyah oil field. Effects of operating parameters such as coagulant dosage, speed and time of slow mixing step and settling time in the 1st stage were studied. Also feed turbidity and total suspended solids (TSS) in the 2

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Publication Date
Wed Feb 22 2023
Journal Name
Iraqi Journal Of Science
Facies Analyses and Diagenetic features development of Albian - Aptian Succession in the Wset Qurna oil field, Southern Iraq
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The Carbonate-clastic succession in this study is represented by the Shuaiba and Nahr Umr Formations deposited during the Albian - Aptian Sequence. The present study includes petrography, microfacies analyses, and studying reservoir characterizations for 5 boreholes within West Qurna oil field in the study area. According to the type of study succession (clastic – Carbonate) there are two types of facies analyses:-Carbonate facies analysis, which showed five major microfacies were recognized in the succession of the Shuaiba Formation, bioclastic mudstones to wackstone, Orbitolina wackestone to packstone, Miliolids wackestone, Peloidal wackestone to packstone and mudstone to wackestone identified as an open shelf toward the deep basin.

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Publication Date
Thu Jun 01 2023
Journal Name
Optik
Combination of near-field and scattering effects in plasmonic perovskite solar cell including cobalt doped nickel oxide HTL
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Publication Date
Fri Sep 30 2022
Journal Name
Iraqi Geological Journal
Estimation of Initial Oil in Place for Buzurgan Oil Field by Using Volumetric Method and Reservoir Simulation Method
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The estimation of the initial oil in place is a crucial topic in the period of exploration, appraisal, and development of the reservoir. In the current work, two conventional methods were used to determine the Initial Oil in Place. These two methods are a volumetric method and a reservoir simulation method. Moreover, each method requires a type of data whereet al the volumetric method depends on geological, core, well log and petrophysical properties data while the reservoir simulation method also needs capillary pressure versus water saturation, fluid production and static pressure data for all active wells at the Mishrif reservoir. The petrophysical properties for the studied reservoir is calculated using neural network technique

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Publication Date
Wed Dec 30 2020
Journal Name
Al-kindy College Medical Journal
Measurement of plasma fibrinogen and D-dimer in a sample of Iraqi patients with solid malignant tumors
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Background: Multifactor affect the pathogenesis of thrombosis in solid malignancy; however, a significant role is attributed to the cancer cells ability to interact with and activate the host hemostatic system. [1] 

Hemostasis is highly correlated to tumor growth, angiogenesis and metastasis, modulation of these pathways reflects interesting and promising treatment options in the future. [1]

Most patients with cancer frequently suffer from chronic compensated DIC and have abnormal laboratory coagulation tests without clinical manifestations of thrombosis, which is a subclinical hypercoagulable state that can be detected by varying degrees of activation of blood clotting. The results of laboratory tests in th

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Publication Date
Sat Jun 27 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The relationship among bite force with facial dimensions and dental arches widths in a sample of Iraqi adults with Class I skeletal and dental relations
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Background: This study aimed to determine whether there is a relationship among the bite force with facial dimensions and dental arches in a sample of Iraqi adults with Class I skeletal and dental relations. Materials and methods: Forty dental students (20 males and 20 females) were selected under certain criteria. For those individuals, dental impressions, frontal facial photographs and maximum bite force at molar and incisor regions were taken. The dental arches widths and facial dimensions were measured using the AutoCAD program 2007, while the bite force was determined using special device. Descriptive statistics for the measured variables were performed and gender difference was determined using independent sample t-test, while the rel

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Viable Strategies to Increase Clinical Trial Patient Diversity
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In the United States, the pharmaceutical industry is actively devising strategies to improve the diversity of clinical trial participants. These efforts stem from a plethora of evidence indicating that various ethnic groups respond differently to a given treatment. Thus, increasing the diversity of trial participants would not only provide more robust and representative trial data but also lead to safer and more effective therapies. Further diversifying trial participants appear straightforward, but it is a complex process requiring feedback from multiple stakeholders such as pharmaceutical sponsors, regulators, community leaders, and research sites. Therefore, the objective of this paper is to describe three viable strategies that can p

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