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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 Jun 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of dental enamel color after fixed orthodontic therapy using two types of protectors to prevent white spot lesions (A prospective clinical study)
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Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups a

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Publication Date
Mon May 01 2023
Journal Name
3 Biotech
Detection of orthodontically induced inflammatory root resorption-associated biomarkers from the gingival crevicular fluid by proteomics analysis: a randomized-controlled clinical trial
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Publication Date
Wed Dec 15 2021
Journal Name
Journal Of Physics: Conference Series
Pretreated Fishbone as Low Cost-Adsorbent for Cationic Dye Adsorption from Aqueous Solutions: Equilibrium, Optimization, Kinetic and Thermodynamic Study
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The present study investigated the use of pretreated fish bone (PTFB) as a new surface, natural waste and low-cost adsorbent for the adsorption of Methyl green (MG, as model toxic basic dye) from aqueous solutions. The functional groups and surface morphology of the untreated fish bone (FB) and pretreated fish bone were characterized using Fourier transform infrared (FTIR), scanning electron microscopy (SEM) and Energy dispersive X-ray spectroscopy (EDS),respectively. The effect of operating parameters including contact time, pH, adsorbent dose, temperature, and inorganic salt was evaluated. Langmuir, Freundlich and Temkin adsorption isotherm models were studied and the results showed that the adsorption of basic dye followed Freundlich iso

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
Pretreated Fishbone as Low Cost-Adsorbent for Cationic Dye Adsorption from Aqueous Solutions: Equilibrium, Optimization, Kinetic and Thermodynamic Study
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Abstract<p>The present study investigated the use of pretreated fish bone (PTFB) as a new surface, natural waste and low-cost adsorbent for the adsorption of Methyl green (MG, as model toxic basic dye) from aqueous solutions. The functional groups and surface morphology of the untreated fish bone (FB) and pretreated fish bone were characterized using Fourier transform infrared (FTIR), scanning electron microscopy (SEM) and Energy dispersive X-ray spectroscopy (EDS), respectively. The effect of operating parameters including contact time, pH, adsorbent dose, temperature, and inorganic salt was evaluated. Langmuir, Freundlich and Temkin adsorption isotherm models were studied and the results showe</p> ... Show More
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Publication Date
Sat Nov 04 2023
Journal Name
Russian Journal Of General Chemistry
Synthesis and Characterization of Metals Complexes with Uracil and Uracil Derivatives (A Review)
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Previous studies on the synthesis and characterization of metal chelates with uracil by elemental analysis, conductivity, IR, UV-Vis, NMR spectroscopy, and thermal analysis were covered in this review article. Reviewing these studies, we found that uracil can be coordinated through the electron pair on the N1, N3, O2, or O4 atoms. If the uracil was a mono-dentate ligand, it will be coordinated by one of the following atoms: N1, N3 or O2. But if the uracil was bi-dentate ligand, it will be coordinated by atoms N1 and O2, N3 and O2 or N3 and O4. However, when uracil forms complexes in the form of polymers, coordination occurs through the following atoms: N1 and N3 or N1 and O4.

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Publication Date
Sat Apr 01 2023
Journal Name
Russian Journal Of General Chemistry
Synthesis and Characterization of Metals Complexes with Uracil and Uracil Derivatives (A Review)
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Publication Date
Sun Jul 14 2024
Journal Name
مجلة دراسات وبحوث التربية الرياضية
Construction and Validation of a Cognitive Engagement Scale and Its Relationship with Ball Movement Sequence Performance in Rhythmic Gymnastics
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The research aims to: build and record a measure of cognitive participation among second-year female students at the College of Physical Education and Sports Sciences, University of Baghdad. The researchers used the descriptive approach in the survey style for the research sample. The sample was selected from female students and divided into: (10) female students for the survey sample, and (80) female students for the construction and codification sample. The data were statistically analyzed by the researchers using SPSS, the T-test for independent and correlated samples, Pearson's simple correlation coefficient, Cronbach's alpha, Chi-square, and Spearman-Brown. They were recruited for the samples. The study concluded that constr

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Publication Date
Sat Oct 03 2020
Journal Name
International Journal Of Diabetes In Developing Countries
The efficacy of once-daily liraglutide as an add-on to oral antidiabetic agents on weight reduction and glycemic control in obese patients with inadequately controlled type 2 diabetes: a retrospective analysis in relation to liraglutide dose escalation within a 7-month treatment period
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Background This study aimed to evaluate the efficacy of once-daily liraglutide as an add-on to oral antidiabetics (OADs) on glycemic control and body weight in obese patients with inadequately controlled type 2 diabetes (T2D). Methods A total of 27 obese T2D patients who received 7 months (0.6 mg/day for the first month, 1.2 mg/day for 3 months, and 1.8 mg/day for 3 months) of liraglutide treatment as an add-on to OADs were included. Data on body weight (kg), fasting plasma glucose (FPG, mg/dL), postprandial glucose (PPG, mg/dL), and HbA1c (%), were recorded. Results Liraglutide doses of 1.2 mg/day and 1.8 mg/day were associated with significant decreases in body weight (by 8.0% and 11.9%, respectively, p < 0.01 for each) and HbA1c (by 20.0

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Engineering
Water Treatment With Conventional and Alternative Coagulants: A Review
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There is no access to basic sanitation for half the world's population, leading to Socioeconomic issues, such as scarcity of drinking water and the spread of diseases. In this way, it is of vital importance to develop water management technologies relevant to the target population. In addition, in the separation form of water treatment, the compound often used as a coagulant in water treatment is aluminum sulfate, which provides good results for raw water turbidity and color removal. Studies show, however, that its deposition in the human body, even Alzheimer's disease, can cause serious harm to health and disease development. The study aims to improve the coagulation/flocculation stage related to the amount of flakes, i

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Uric Acid as a Natural Scavenger of Peroxynitrite in a Sample of Iraqi Patients with Rheumatoid Arthritis
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Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with decreased antioxidant state .This study aim to investigate the status of oxidant/antioxidant in a sample of  Iraqi patients with RA and the role of peroxynitrite and its natural scavenger uric acid in them .This case-controlled study was conducted at Baghdad teaching hospital /Baghdad from December 2010-May 2011 . Twenty-five patients with mean age 39 years and 25 apparently healthy subject as controls with mean age 29 years were included in the study .Investigations include estimation of serum levels of nitric oxide (NO)  ,peroxynitrite (PN) , malondialdehyde (MDA)  , and uric acid (UA) .Serum PN levels were significantly elevated in RA patients a

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