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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
Sun Mar 01 2026
Journal Name
Journal Of Pharmaceutical Sciences
Mechanistic insights into drug loading effect on dissolution performance of Loratadine–Soluplus® amorphous solid dispersions
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Publication Date
Wed Dec 11 2019
Journal Name
Journal Of The College Of Education For Women
Terrorism and Internal Displacement in Iraq: A Field Study in Baghdad
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    Terrorism is a serious problem for many societies today. This research aims to identify the impact of terrorism and displacement crisis on human security, which was a shock to the Iraqi society in terms of its impact on the psychological, social and economic conditions of the individual, family, and society. The variety of methods of carrying out the terrorist operations that resulted from the phenomenon of human displacement witnessed by Iraq since the middle of 2014. This phenomenon has its demographic, political and social dimensions.

    In order to achieve the goal of this study and the importance of the subject, the social survey method was used by selecting a sample of 200 IDPs in a compou

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Publication Date
Wed Jun 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Modes of Knowledge acquisition and their reflections on the tacit knowledge A field study in Tuz General Hospital
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This research aims to knowledge the extent of the application of Tuz General Hospital to the concept of tacit knowledge dimensions (mental models, intuition, experience, skill) and methods of acquiring knowledge dimensions (training, job rotation, work teams) and the measurement and analysis of the link and the kind of impact between the methods of acquiring knowledge and tacit knowledge of the Angels nursing in the researched hospital, and was the questionnaire primary means of collecting information adopted by the researcher that, the research sample of (90) individuals, including the Angels nursing, has been using the statistical program spss for the purpose of conducting statistical treatments, and through the diagnosis and m

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Publication Date
Mon Apr 01 2013
Journal Name
International Journal Of Drug Development And Research
Therapeutic potential effects of pyridoxine and /or ascorbic acid on microalbuminuria in diabetes mellitus patient's: A randomized controlled clinical study
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Objectives: This study aimed to evaluate the therapeutic potential effects of ascorbic acid or and pyridoxine on diabetic renal microalbumiuria. Methods: This was a cross-sectional study on patients with diabetes mellitus at Al-Yarmouk teaching hospital from January to December 2012, Iraq-Baghdad. Twenty one patients with diabetes mellitus (D.M), 8 IDDM and 13 IDDM were selected from, the duration of disease were ranged from 2-12 years for both type (10 females and 11males) and all enrolled patients ages were ranged from 28-65years. The concentration of total protein in urine was calculated by a biuret colorimetric assay and the urine creatinine level was measured by a modified Jaffe test. Statistical analysis: results are expressed as mean

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Scopus
Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Engineering
A Cognition Path Planning with a Nonlinear Controller Design for Wheeled Mobile Robot Based on an Intelligent Algorithm
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This paper presents a cognition path planning with control algorithm design for a nonholonomic wheeled mobile robot based on Particle Swarm Optimization (PSO) algorithm. The aim of this work is to propose the circular roadmap (CRM) method to plan and generate optimal path with free navigation as well as to propose a nonlinear MIMO-PID-MENN controller in order to track the wheeled mobile robot on the reference path. The PSO is used to find an online tune the control parameters of the proposed controller to get the best torques actions for the wheeled mobile robot. The numerical simulation results based on the Matlab package show that the proposed structure has a precise and highly accurate distance of the generated refere

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Publication Date
Mon Nov 23 2020
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Short- and Long-term Effectiveness of Sacral Nerve Stimulation in Patients with Overactive Bladder
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BACKGROUND: Sacral nerve stimulation (SNS) approved for use in North America since 1997 despite the fact that the concept of using SNS to treat patients with voiding dysfunction discussed first almost 50 years ago. AIM: The objectives of the study were to assess the effectiveness of SNS the short and long term for patients with overactive bladder (OAB) dysfunction and its relation to age, gender, and causes. PATIENTS AND METHODS: This is a clinical prospective study that involved 50 cases (32 females and 18 males) with OAB. It was carried out at Ibn Sina Hospital, and the neurosciences hospital in Baghdad/Iraq from April 2015 to April 2018. All the patients were assessed preoperatively and certain inclusion criteria were

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Publication Date
Thu Oct 01 2015
Journal Name
Al–bahith Al–a'alami
Correspondents and Professional Standards in News Coverage (A Field Study)
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         The essence of the new work in the satellite TV channels is to provide news coverage of news that will inform the people of what is going on around them in order to increase their political, social, economic and cultural awareness and this drives them to take positions or certain behaviors on according to what the communicator in these channels wants. News and news reports are generally used as a psychological variable to influence public opinion and does not offer interestingness and information. Therefore, satellite TV channels have assumed special attention towards their correspondents desiring to achieve scoop in news coverage and to have the final word in reading events and install it

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Publication Date
Fri Dec 20 2024
Journal Name
Journal Of Diabetes &amp; Metabolic Disorders
Clinical relevance of midkine as a biomarker predicting atherosclerotic risk factors in individuals with type-2 diabetes mellitus: a cross-sectional study
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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
A Population based Study on Self Medication Practice in Pakistan
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Background: The risk of antibiotics resistance (AR) increases due to excessive of antibiotics either by health care provider or by the patients.

Objective: The assessment of the self-medication Practice of over the counter drugs and other prescription drugs and its associated risk factor.

Subjects and Methods: Study design: A descriptive study was conducted from “20th December 2019 to 08th January 2021”. A pre validated and structured questionnaire in English and Urdu language was created to avoid language barrier including personal detail, reasons and source and knowledge about over the counter drugs and Antibiotics. Sample of the study was randomly selected.

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Publication Date
Wed Nov 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Using Modern Techniques in the Formation of Flexible Interior Spaces: Insights from Iraq
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