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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
Tue May 07 2019
Journal Name
Acm Journal On Emerging Technologies In Computing Systems
Neuromemrisitive Architecture of HTM with On-Device Learning and Neurogenesis
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Hierarchical temporal memory (HTM) is a biomimetic sequence memory algorithm that holds promise for invariant representations of spatial and spatio-temporal inputs. This article presents a comprehensive neuromemristive crossbar architecture for the spatial pooler (SP) and the sparse distributed representation classifier, which are fundamental to the algorithm. There are several unique features in the proposed architecture that tightly link with the HTM algorithm. A memristor that is suitable for emulating the HTM synapses is identified and a new Z-window function is proposed. The architecture exploits the concept of synthetic synapses to enable potential synapses in the HTM. The crossbar for the SP avoids dark spots caused by unutil

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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
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
A Comparative Study on the Double Prior for Reliability Kumaraswamy Distribution with Numerical Solution
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This work, deals with Kumaraswamy distribution. Kumaraswamy (1976, 1978) showed well known probability distribution functions such as the normal, beta and log-normal but in (1980) Kumaraswamy developed a more general probability density function for double bounded random processes, which is known as Kumaraswamy’s distribution. Classical maximum likelihood and Bayes methods estimator are used to estimate the unknown shape parameter (b). Reliability function are obtained using symmetric loss functions by using three types of informative priors two single priors and one double prior. In addition, a comparison is made for the performance of these estimators with respect to the numerical solution which are found using expansion method. The

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Publication Date
Mon Jan 01 2018
Journal Name
African Journal Of Hospitality, Tourism And Leisure
An analytical study of the strategic flexibility variation as a function of the dynamic capabilities based on supply chain management (Case study: The General Petroleum Products Distribution Company in Baghdad)
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Publication Date
Sat Dec 28 2024
Journal Name
Journal Of Physical Education
The effectiveness of using interactive harmonic exercises in improving the level of some physical and motor abilities and intelligence for students aged (9-10) years
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We discussed the proper preparation, directing, and implementation of physical education lessons, and clarification of the duties that fall upon the physical education teacher in addition to his physical and skill duties, which is the duty of the physical education lesson. The problem of the research lies in the fact that interactive harmonic exercises are not implemented accurately by physical education teachers because they require great experience, exceptional efforts, and accuracy in performance. The research aims to identify the level of some physical and motor abilities and intelligence among students aged (9-10) years, and to know the effect of some harmonic exercises. Interactivity at the level of some physical and motor abi

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Publication Date
Fri Oct 09 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
Mon Mar 13 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Osseointegration of Dental Implants Prepared by Piezosurgery (Clinical Study)
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ABSTRACT Background: Piezosurgery device is a system developed recently to overcome the limitation of the traditional surgical technique in implant site preparation, which use the principle of ultrasonic microvibrations to create precise & selective cut in bone in harmony with the surrounding tissues. The aim of this study was to evaluate the outcomes of implants inserted by ultrasonic implant site preparation protocol (UISP) using piezosurgery device, regarding the survival rate, stability and other related factors, at 16 weeks postoperative follow up period. Materials and Methods: A total of (24) patients, (6) males and (18) females, aged between (19-51) years old, contributed in this study receiving a total of (42) implants, all of these

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Publication Date
Sat Dec 24 2022
Journal Name
Research Journal Of Pharmacy And Technology
Biological Study of protease produced by clinical isolates of Staphylococcus aureus
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The bacterial isolates were obtained from Al-Kindi Hospital were diagnosed by the Vitek-2 system and re confirm by 16srRNA gene as S. aurous, the results were shown 20 isolates (66.7%) out of 30 isolates were positive to protease production. All bacterial isolates (100%) were sensitive to Gentamicin and Levofloxacin. but resistant (100%) to aztreonam. The best temperature for enzyme production from bacteria was 37 °C, and the best pH for enzyme production was 7. Partial purification of the bacterial enzyme (protease) was carried out using short steps included ammonium sulfate 65% saturation, ion exchange using DEAE- cellulose column and then applied on gel filtration chromatography using Sephadex G-200 column. The enzymatic activit

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Publication Date
Wed Aug 27 2025
Journal Name
Baghdad Science Journal
A Clustering Technique Based on the Hard K-Means (H.KM.) Method to Determine the Governorate That Have More Influence for Spreading COVID-19 in the Kingdom of Saudi Arabia
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