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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 Dec 16 2021
Journal Name
Kufa Medical Journal
Clinical and Refractive Outcomes of Toric Phakic Implantable Collamer Lens Implantation for correction of myopic astigmatism
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Background: Currently there are four general approaches to correct refractive errors: refractive corneal surgery, crystalline lens surgery and implantation of an intraocular lens in anterior or posterior chamber. Aim: To evaluate the predictability, safety and stability of toric phakic implantable collamer lens implantation to correct moderate to high myopic astigmatism. Methods: Sixty eyes of 40 patients underwent implantation of a toric implantable collamer lens (V4c design) in the Eye Specialty Private Hospital, Baghdad, Iraq were studied. The mean spherical refraction was -11.32±3.17 diopter (D) with a range of -6.00 to -18.00 D and a mean cylinder of -2.61±1.16 with range of -1.00 to -5.50 D. The outcome measures that evaluat

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Publication Date
Fri Oct 09 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The relationship among bite force with facial dimensions and dental arches widths in a sample of Iraqi adults with Class I skeletal and dental relations
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Background: This study aimed to determine whether there is a relationship among the bite force with facial dimensions and dental arches in a sample of Iraqi adults with Class I skeletal and dental relations. Materials and methods: Forty dental students (20 males and 20 females) were selected under certain criteria. For those individuals, dental impressions, frontal facial photographs and maximum bite force at molar and incisor regions were taken. The dental arches widths and facial dimensions were measured using the AutoCAD program 2007, while the bite force was determined using special device. Descriptive statistics for the measured variables were performed and gender difference was determined using independent sample t-test, while the rel

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Publication Date
Fri Jun 02 2023
Journal Name
East European Journal Of Physics
Electroexcitation Form Factors and Deformation of 20,22Ne Isotopes Based on the Shell Model and Hartree-Fock plus BCS Calculations
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Nuclear structure of 20,22Ne isotopes has been studied via the shell model with Skyrme-Hartree-Fock calculations. In particular, the transitions to the low-lying positive and negative parity excited states have been investigated within three shell model spaces; sd for positive parity states, spsdpf large-basis (no-core), and zbme model spaces for negative parity states. Excitation energies, reduced transition probabilities, and elastic and inelastic form factors were estimated and compared to the available experimental data. Skyrme interaction was used to generate a one-body potential in the Hartree-Fock calculations for each selected excited states, which is then used to calculate the single-particle matrix elements. Skyrme interac

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Publication Date
Thu Mar 31 2022
Journal Name
Journal Of The College Of Education For Women
The Impact of a Counseling Program with a Cognitive Reconstruction Method on the Development of the Psychological Hardness among Middle School Students
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The current research aims to determine the impact of the cognitive reconstruction program on the development of psychological hardness among middle school students through the experimental verification of three hypotheses. The research sample consisted of (16) out of (450) students selected from Ibn Rushud preparatory school- Al-Rusafa 2. These participants have been randomly distributed into two equal groups. The researcher has used the method of cognitive reconstruction with the experimental group, whereas with the controlling group, he used nothing. The researcher has further used the scale of psychological hardness of Kobassa with the participants; the scale has been built in a way that suits the sample of the study, which consisted

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Publication Date
Thu Jun 08 2023
Journal Name
Iraqi Journal Of Laser
PDF Effectiveness of 980nm diode Laser in reduction the diameters of exposed dentinal tubules for hypersensitive tooth
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Abstracts:

Background: The oral cavity is a complex environment, both structurally and functionally, the hard and soft tissues are in close a proximity. Oral tissues subjected to wear throughout the life, that threatened the vitality of the pulp or increase the sensitivity of dentinal tubules. One of the common dental problems is loss of enamel or cementum, which stimulate the nerve ending in or near the pulp and manifested as pain sensation. Aim of the study: This study had done to evaluate the effects of 980nm diode Laser in diameters reduction of exposed dentinal tubules analyze the results and morphological changes of irradiated dentine surface by FE-SEM (field emission scann

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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Enhancing Smart Cities with IoT and Cloud Computing: A Study on Integrating Wireless Ad Hoc Networks for Efficient Communication
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Smart cities have recently undergone a fundamental evolution that has greatly increased their potentials. In reality, recent advances in the Internet of Things (IoT) have created new opportunities by solving a number of critical issues that are allowing innovations for smart cities as well as the creation and computerization of cutting-edge services and applications for the many city partners. In order to further the development of smart cities toward compelling sharing and connection, this study will explore the information innovation in smart cities in light of the Internet of Things (IoT) and cloud computing (CC). IoT data is first collected in the context of smart cities. The data that is gathered is uniform. The Internet of Things,

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Publication Date
Mon Nov 14 2022
Journal Name
Physica Scripta
A wavelet-based collocation technique to find the discontinuous heat source in inverse heat conduction problems
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Abstract<p>This paper is devoted to an inverse problem of determining discontinuous space-wise dependent heat source in a linear parabolic equation from the measurements at the final moment. In the existing literature, a considerably accurate solution to the inverse problems with an unknown space-wise dependent heat source is impossible without introducing any type of regularization method but here we have to determine the unknown discontinuous space-wise dependent heat source accurately using the Haar wavelet collocation method (HWCM) without applying the regularization technique. This HWCM is based on finite-difference and Haar wavelets approximation to the inverse problem. In contrast to othe</p> ... Show More
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Publication Date
Sat Apr 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Reproductive Dysfunction in Women with PCOS: A Review Article
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Polycystic ovary syndrome (PCOS) is a significant cause of infertility due to ovulation dysfunction in women of childbearing age. Although the pathogenesis of PCOS is still not clear, many studies have shown that many factors within the ovary promote infection. With this syndrome, the disruption of the natural monthly ovulation process causes an imbalance in the body's hormones, and the high level of insulin in the body and the blood sugar imbalance leads to the occurrence of hyperandrogenism, which is the main factor for the occurrence of pathogens, in addition to genetic factors, if any. This study aims to identify this disease and its most important causes, symptoms, and modern treatments to prevent and get rid of it. Polycystic

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Viable Strategies to Increase Clinical Trial Patient Diversity
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In the United States, the pharmaceutical industry is actively devising strategies to improve the diversity of clinical trial participants. These efforts stem from a plethora of evidence indicating that various ethnic groups respond differently to a given treatment. Thus, increasing the diversity of trial participants would not only provide more robust and representative trial data but also lead to safer and more effective therapies. Further diversifying trial participants appear straightforward, but it is a complex process requiring feedback from multiple stakeholders such as pharmaceutical sponsors, regulators, community leaders, and research sites. Therefore, the objective of this paper is to describe three viable strategies that can p

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Material Selection for Unmanned Aerial Vehicles (UAVs) Wings Using Ashby Indices Integrated with Grey Relation Analysis Approach Based on Weighted Entropy for Ranking
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The designer must find the optimum match between the object's technical and economic needs and the performance and production requirements of the various material options when choosing material for an engineering application. This study proposes an integrated (hybrid) strategy for selecting the optimal material for an engineering design depending on design requirements. The primary objective is to determine the best candidate material for the drone wings based on Ashby's performance indices and then rank the result using a grey relational technique with the entropy weight method. Aluminum alloys, titanium alloys, composites, and wood have been suggested as suitable materials for manufacturing drone wings. The requirement

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