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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
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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Publication Date
Sun Sep 15 2019
Journal Name
Al-academy
The Effectiveness of the Virtual Design Environment in Digital Advertising: بتول راضي كاظم-ابراهيم حمدان سبتي
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   Advertising design is one of the arts of communication of various levels and one of the aspects of the fields of design arts, and that the construction of the design environment in the advertising is one of the important entry points in making the recipient feel this environment and feel as if being one of its elements. It is an entrance worthy of study and research and is a problem worth raising according to the following question: - What is the effectiveness achieved in the virtual design environment for digital advertising? The two  researchers dealt with the research in three frameworks, the methodological framework which identified (the problem of research, its importance, purpose, limits, and the definition of ter

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Publication Date
Tue Jan 01 2019
Journal Name
Reviews In Medical Microbiology
Virulence factors genotyping of Klebsiella pneumoniae clinical isolates from Baghdad
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Seventy of Klebsiella pneumoniae isolates had been collected from some Hospitals in Baghdad city from October to December 2017. The 70 isolates were taken from diverse clinical specimens. All K. pneumoniae isolates were identified based on API 20 E and Vitek2 compact system. Antibiotics sensitivity test was carried out toward 10 antibiotics using discs diffusion method. The level of antibiotics resistance was 81.42% for Ceftriaxone, whereas the low level of antibiotics resistance was 37.14% for Piperacillin. K. pneumoniae isolates were typed genotypically by using two different methods of amplification, multiplex-PCR and enterobacterial repetitive intergenic consensus (ERIC)-PCR typing methods. Results showed that out of 70 isolates, there

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Publication Date
Tue Apr 01 2025
Journal Name
Medical Journal Of Babylon
Response to Treatment in a sample of Iraqi Patients with Prolactinoma
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Abstract<sec> <title>Background:

Hyperprolactinemia is a common endocrine abnormality caused by physiological factors like pregnancy and lactation, drug-induced factors like antipsychotics, pituitary adenomas that secrete prolactin, or stalk compression or section that reduces dopamine inhibition. Dopamine agonists cure most prolactinomas.

Objectives:

To assess response to treatment in micro versus macroprolactinoma.

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Generalizations of Fuzzy k-ideals in a KU-algebra with Semigroup
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Abstract<p>We present the notion of bipolar fuzzy k-ideals with thresholds (<italic>θ, λ</italic>) of a KU-algebra with semigroup and give some basic properties of this ideal. Also, we study some relations about a bipolar fuzzy k-ideal with thresholds (<italic>θ, λ</italic>) and a k-ideal of a KU-semigroup.</p>
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Publication Date
Sun Sep 07 2008
Journal Name
Baghdad Science Journal
A Study of some biochemical parameters in patients with &#61538;- thalassemia
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Serum levels of iron,copper,ceruloplasmin and transferrine were estimated in three groups of patients with ?- thalassemia: 24 patients have splenectomy thalassemia major, 29 patients have non splenectomy thalassemia major and 19 patients have thalassemia intermedia , data were compared to normal and pathological controls (anemia and minor). There were significant increase in trace element levels in all studied groups of pateints as compared to normal and pathological controls. Also there were a significant increase in ceruloplasmin levels,While the result revealed that there were a significant decrease in transferrine levels in all groups of patients studied as compared to normal and pathological controls. The result also indicate that the

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Publication Date
Wed Jan 08 2020
Journal Name
Nursing &amp; Health Sciences
Medication adherence and predictive factors in patients with cardiovascular disease: A cross‐sectional study
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Abstract<p>Adherence to cardiac medications makes a significant contribution to avoidance of morbidity and premature mortality in patients with cardiovascular disease. This quantitative study used cross‐sectional survey design to evaluate medication adherence and contributing factors among patients with cardiovascular disease, comparing patients who were admitted to a cardiac ward (<italic>n</italic> = 89) and those attending outpatient cardiac rehabilitation (<italic>n</italic> = 31) in Australia. Data collection was completed between October 2016 and December 2017. Descriptive and regression analyses were conducted to identify medication adherence and determine factors independently pred</p> ... Show More
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Publication Date
Thu Jul 01 1999
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
Some leaf hopper and a plant hopper with their populations in Abu-Ghraib, Iraq
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Seven leafhoppers (Cicadeilidae). and one plantboppei (Delpbacidae), Homoptera were identified from a one year operated light trap at the College of Agiculture farm in Abu¬Ghraib. The leafhoppers were: Balclutha hortensis Lind.; B. rufaofasciata Merine.; psammctettix alien us Dahlbem.; P. striatus L.; Extianus capicola.; Neoaliturus haematoceps H. R.; and Orozius albicnctus Dist. The planthopper was Sogatella vibix Haupt. one year records of their populations, indicated that B. rufofasciata occured during the fall from October 10 until December 18; E. capicola from October 24 until November 21 and again in the summer from March to October. The others occured only during the summer, from the end of March and early April until Mid-Septemb

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Publication Date
Sun Aug 11 2024
Journal Name
Irish Journal Of Medical Science (1971 -)
Serum fibulin-3 as a diagnostic and prognostic biomarker in patients with knee osteoarthritis
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Background Osteoarthritis is a chronic degenerative disorder with rising prevalence. Early detection of structural damage is difficult. Consequently, there is a pressing demand for reliable biomarkers that enable an earlier diagnosis of osteoarthritis. The aim is to investigate the level of serum fibulin-3 in patients with primary knee osteoarthritis and its correlation with disease severity. Subjects and methods A case–control study was conducted at the Baqubah Teaching Hospital from November 2023 to January 2024. One hundred twenty persons participated in this study (eighty females with the diagnosis of knee osteoarthritis in its early and late stages, and forty age-matched, apparently healthy control. Serum fibulin-3, ESR, CRP, and cal

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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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