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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 Jul 01 2013
Journal Name
International Journal Of Computer Applications
Mixed Convection in a Square Cavity Filled with Porous Medium with Heated Bottom Wall
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Two-dimensional unsteady mixed convection in a porous cavity with heated bottom wall is numerically studied in the present paper. The forced flow conditions are imposed by providing a hydrostatic pressure head at the inlet port that is located at the bottom of one of the vertical side walls and an open vent at the top of the other vertical side wall. The Darcy model is adopted to model the fluid flow in the porous medium and the combination effects of hydrostatic pressure head and the heat flux quantity parameters are carefully investigated. These governing parameters are varied over wide ranges and their effect on the heat transfer characteristics is studied in detail. It is found that the time required to reach a desired temperature at th

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Publication Date
Fri Jan 01 2021
Journal Name
Ieee Access
Multichannel Optimization With Hybrid Spectral- Entropy Markers for Gender Identification Enhancement of Emotional-Based EEGs
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Publication Date
Sat Dec 20 2025
Journal Name
Bmc Musculoskeletal Disorders
Effects of acute static stretching and dynamic warm-up protocols on shoulder function in young adult male athletes with shoulder impingement syndrome: a randomized controlled crossover trial
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Publication Date
Mon Apr 13 2026
Journal Name
Innovative Infrastructure Solutions
Beyond empiricism: a unified physics-based framework for resonance avoidance and carbon-efficient mass optimization of machine foundations
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Dynamic machine foundations can be considered as a necessary component of the industrial infrastructure. Design of the dynamic equipment foundations has, however, traditionally been grounded on a rule of thumb that is inaccurate and rigid to use at the discretion of the engineers. The conventional rule of thumb, which includes minimum weight ratios and resonance avoidance criteria, has been used singularly with two poles, which can be either conservatively designed systems that are too heavy, or systems that are going to experience too much vibration and fatigue. This paper presents a novel, analytical framework for the reinterpretation of traditional design practices, using a physics-based approach, and results in a single, unified overall

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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Intelligent Systems And Applications In Engineering
Artificial Intelligence Based Statistical Process Control for Monitoring and Quality Control of Water Resources: A Complete Digital Solution
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Publication Date
Sat Jun 27 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The benefit of Ramfjord teeth to represent the full-mouth clinical attachment level in epidemiological study
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Background: Since the periodontal disease Index of Ramfjord (Ramfjord index) can potentially shorten the examination time by almost half, many studies evaluated Ramfjord teeth in predicting full-mouth periodontal status of an adult population. The aim of this study was to evaluate the benefit of Ramfjord teeth in predicting the full-mouth clinical attachment level of an adult population in patients attending the college of dentistry- Baghdad University. Materials and methods: The study participants were 100 patients with age range from 30-60 years old which represent group zero. The patients were divided into three main groups according to the age of the patients. Group I and group II each of them composed of 30 patients while group III co

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Publication Date
Sat Dec 24 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Therapeutic Effects of Vitamin E in Non-alcoholic Fatty Liver Disease: An Open-Labeled Clinical Trial
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Abstract: non-alcoholic fatty liver disease (NAFLD) is one of the widespread chronic liver diseases; it is ranging from simple fat buildup in the liver (steatosis) to non-alcoholic steatohepatitis (NASH) presence of inflammation and hepatocyte injury.                                                                                                                                        &nb

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Science
3D Geological Modelling for Asmari Reservoir In Abu Ghirab Oil Field
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    Building a geological model is an essential and primary step for studying the reservoir’s hydrocarbon content and future performance. A three-dimensional geological model of the Asmari reservoir in Abu- Ghirab oil field including structure, stratigraphy, and reservoir petrophysical properties, has been constructed in the present work. As to underlying Formations, striking slip faults developed at the flank and interlayer normal. Abu Ghirab oilfields are located on the eastern anticlinal band, which has steadily plunged southward. 3D seismic interpretation results are utilized to build the fault model for 43 faults of the Asmari Formation in Abu Ghirab Oilfield. A geographic facies model with six different rock facies types

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Publication Date
Sun Jan 05 2014
Journal Name
Journal Of Educational And Psychological Researches
Unemployment & its Problems Between Theory & Applying Field Study in Baghdad City
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The unemployment is considered from the most danger problems that our society face them in current time & in the near future , because it makes prodigality for element of human being , particularly age of youth who have ability to work & producing , that resulted in negative effects forecast to dire consequences social and economical dangers . In the same time as will be stated in our explanation in the following in our research , because the unemployment has ability to help to prepare good environment to grow crime , actions of violence that mostly are main cause to decrease living level of majority of citizens & in increasing numbers who became under poverty , the unemployment is economical problem as it is psycholo

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Publication Date
Thu Jun 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Drilling Optimization by Using Advanced Drilling Techniques in Buzurgan Oil Field
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Efficient and cost-effective drilling of directional wells necessitates the implementation of best drilling practices and advanced techniques to optimize drilling operations. Failure to adequately consider drilling risks can result in inefficient drilling operations and non-productive time (NPT). Although advanced drilling techniques may be expensive, they offer promising technical solutions for mitigating drilling risks. This paper aims to demonstrate the effectiveness of advanced drilling techniques in mitigating risks and improving drilling operations when compared to conventional drilling techniques. Specifically, the advanced drilling techniques employed in Buzurgan Oil Field, including vertical drilling with mud motor, managed pres

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