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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
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
Thu Jan 30 2020
Journal Name
Neuroquantology
Studying Effect of Temperature on Electron Transport Parameter and Coefficients in CF3I Mixture with N2O
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Publication Date
Fri May 01 2020
Journal Name
Journal Of Engineering
Numerical investigation on heat transfer enhancement and turbulent flow characteristics in a high aspect ratio rectangular duct roughened by intersecting ribs with inclined ribs
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In this study, the effect of intersecting ribs with inclined ribs on the heat transfer and flow characteristics of a high aspect ratio duct has been numerically investigated. The Relative roughness pitch (P/e) is 10 and the Reynolds number range from 35,700 to 72,800. ANSYS (Fluent-Workbench 18.0) software has been utilized to solve the Reynolds averaged Navier-Stokes (RANS) equations with the Standard k-ε turbulence model. Three ribbed models have been used in this study. Model 1 which is a just inclined ribs, Model 2 which has a single longitudinal rib at the center with inclined ribs and Model 3 which has two longitudinal ribs at the sides. The results showed that the heat transfer rate has been enhanced when the int

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Publication Date
Thu Oct 12 2017
Journal Name
Iraqi Journal Of Agricultural Sciences
THE BIOLOGICAL EFFECTIVENESS OF GIBBERELLIC ACID SEEDS SOAKING AND FOLIAR TO ABSCISIC ACID IN THE GROWTH , ANISE OIL YIELD AND ITS CHEMICAL CONTENT
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A field experiment was carried out during two winter season 2013, 2014 at the field of the Department of Field Crops, College of Agriculture, University of Baghdad, to study the effect of seeds soaking with Gibberellic acid and foliar with Abscisic Acid on the growth, yield, and content of Anise oil seeds using factorial experiment within RCBD design with three replicates. The seeds was treated within GA3 were soaked with two concentrations of  30, and 60 mg. litter-1 in addition to without soaking and the code has been B0 , B1 , B2 overlapped these transactions with two concentrations of Abscisic Acid  3, and 6 mg. litter-1 in addition to without foliar A0 , A1 , A2The seeds to be treated  with GA3 are soaked for 24 hours prior

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Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Dimensions of binding and non-binding social responsibility and its relationship to organizational performance / Field Study in telecommunications companies in the Republic of yemen
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The study aims at measuring the dimensions of binding and non-binding social responsibility and its relation to the organizational performance in telecommunication companies in the Republic of Yemen using analytical descriptive approach and questionnaire as a main tool for data collection and comprehensive inventory method.

It has been found  that there is a positive effect and significant moral relation between social responsibility with its binding and non-binding dimensions  and the organizational performance of telecommunication companies in the Republic of Yemen at a level of significance below (0.05). It has also been found that the correlation between the non-binding social responsibilit

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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
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
Fri Sep 30 2022
Journal Name
Journal Of Computational Design And Engineering
CFD analysis of phase-change material-based heat storage with dimple-shaped fins: evaluation of fin configuration and distribution pattern
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Abstract<p>Phase-change materials (PCMs) have a remarkable potential for use as efficient energy storage means. However, their poor response rates during energy storage and retrieval modes require the use of heat transfer enhancers to combat these limitations. This research marks the first attempt to explore the potential of dimple-shaped fins for the enhancement of PCM thermal response in a shell-and-tube casing. Fin arrays with different dimensions and diverse distribution patterns were designed and studied to assess the effect of modifying the fin geometric parameters and distribution patterns in various spatial zones of the physical domain. The results indicate that increasing the number of </p> ... Show More
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