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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 Oct 31 2021
Journal Name
Iraqi Geological Journal
Estimate Gas Initially in Place of Tight Gas Reservoirs Based on Developed Methodology of Dynamic Material Balance Technique
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With growing global demand for hydrocarbons and decreasing conventional reserves, the gas industry is shifting its focus in the direction of unconventional reservoirs. Tight gas reservoirs have typically been deemed uneconomical due to their low permeability which is understood to be below 0.1mD, requiring advanced drilling techniques and stimulation to enhance hydrocarbons. However, the first step in determining the economic viability of the reservoir is to see how much gas is initially in place. Numerical simulation has been regarded across the industry as the most accurate form of gas estimation, however, is extremely costly and time consuming. The aim of this study is to provide a framework for a simple analytical method to esti

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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
Mon Apr 04 2022
Journal Name
Neuroquantology
The Role of Adropin as a Novel Biomarker in Iraqi Patients with Parkinson's Disease and Osteoporosis
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Publication Date
Sat Apr 02 2022
Journal Name
Neuroquantology
The Role of Neudesin as a Novel Biomarker – in Iraqi Patients with Parkinson's Disease and Osteoporosis
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Neuron-derived neurotrophic factor [NENF], a human plasma neurotrophic factor, also increases neurotrophic activity in conjunction with Parkinson's disease-related proteins in Neudesin. Although Neudesin (neuron-derived neurotrophic secreted protein) is a member of the membrane-associated progesterone receptor (MAPR) protein subclass, it is not evolutionary related to the other members of the same family. The expression of Neudesin is found in both brain and spinal cord from embryonic stages to adulthood, as w Neudesin levels in Parkinson's patients with osteoporosis disease and Parkinson's patients without osteoporosis disease, as well as the relationship between Neudesin levels, Anthropometric and Clinical Features (Age, Gender, BMI) and

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Publication Date
Thu Mar 25 2021
Journal Name
International Journal Of Drug Delivery Technology
A comparative study of retinol-binding protein-4 and progranulin in iraqi women with thyroid disorder
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Thyroid hormones (TH) regulate the metabolic processes required for normal development and growth; also, to organizemetabolism in adults, any defect in thyroid function leads to abnormality in thyroid hormones level. The current study hasbeen designed to find the relationship between retinol-binding protein-4 and progranulin in the serum of Iraqi women withhypothyroidism and hyperthyroidism, also, to study whether these patients are exposed to a risk of developing diabetes mellitus,and PGRN may be a biomarker in detection early stage of diabetes mellitus.Materials and Methods: in this study, serum samples were obtained from 50 Iraqis women patients, [25 patients withhypothyroidism (G2) and 25 patients with hyperthyroidism (G3)] in addition

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Publication Date
Wed Jan 02 2019
Journal Name
Differential Equations And Dynamical Systems
Stability and Bifurcation in a Prey–Predator–Scavenger System with Michaelis–Menten Type of Harvesting Function
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Publication Date
Thu Feb 01 2018
Journal Name
Applied Energy
Solidification enhancement of PCM in a triplex-tube thermal energy storage system with nanoparticles and fins
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Personality Characteristics of the Leader in Business Organizations Entrepreneurship (Field Research)
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This research is aiming to find the effective role of the personality characteristics of the Leader in business organization entrepreneurship by studying the effect of the special dimensions of personality characteristics (neuroticism, extraversion, openness, Agreeableness, and conscientiousness) on business organizations entrepreneurship dimensions representing in the two main dimensions (entrepreneurship direction and strategic entrepreneurship) across field study was conducted in thirteen private colleges in Baghdad.

The problem of the research relies in asking the question, is there an effect for Leader personality characteristics on business organizations entrepreneurship. and statistical methods hav

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Publication Date
Sun Dec 01 2024
Journal Name
Energy Storage
Comprehensive Study of <scp>PAN</scp>‐<scp>NaBF<sub>4</sub></scp> Solid Polymer Electrolytes: Insights Into Optical, Structural, Thermal, Electrical, and Electrochemical Properties for Sodium‐Ion Batteries
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ABSTRACT<p>This research explores the use of solid polymer electrolytes (SPEs) as a conductive medium for sodium ions in sodium‐ion batteries, presenting a possible alternative to traditional lithium‐ion battery technology. The researchers prepare SPEs with varying molecular weight ratios of polyacrylonitrile (PAN) and sodium tetrafluoroborate (NaBF<sub>4</sub>) using a solution casting method with dimethyl formamide as the solvent. Through optical absorbance measurements, we identified the PAN:NaBF<sub>4</sub> (80:20) SPE composition as having the lowest energy band gap value (4.48 eV). This composition also exhibits high thermal stability based on thermogravimetric analysis results. </p> ... Show More
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Publication Date
Thu May 20 2021
Journal Name
Journal Of Research In Medical And Dental Science
Retreatment Efficacy of Continuous Rotation Versus Reciprocation Kinematic Movements in Removing Gutta-Percha with Calcium Silicate-Based Sealer: SEM Study
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Retreatment Efficacy of Continuous Rotation Versus Reciprocation Kinematic Movements in Removing Gutta-Percha with Calcium Silicate-Based Sealer: SEM Study, Raghad Noori Nawaf*, Ra

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