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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 01 2022
Journal Name
Microbiology And Biotechnology Letters
Production and Identification of Secondary Metabolite Gliotoxin-Like Substance Using Clinical Isolates of <i>Candida</i> spp.
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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
Multiple Intelligence Test Item Selection-Based on Howard Gardner's MI Model Using a Generalized Partial Estimation Model: Ministry of Education \ Karkh First Directorate of Education
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The aim of the research is to examine the multiple intelligence test item selection based on Howard Gardner's MI model using the Generalized Partial Estimation Form, generalized intelligence. The researcher adopted the scale of multiple intelligences by Kardner, it consists of (102) items with eight sub-scales. The sample consisted of (550) students from Baghdad universities, Technology University, al-Mustansiriyah university, and Iraqi University for the academic year (2019/2020). It was verified assumptions theory response to a single (one-dimensional, local autonomy, the curve of individual characteristics, speed factor and application), and analysis of the data according to specimen partial appreciation of the generalized, and limits

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Publication Date
Tue Mar 01 2022
Journal Name
Results In Engineering
Predictive model for stress at ultimate in internally unbonded steel tendons based on genetic expression programming
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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
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
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXPERIMENTAL INVESTIGATION OF LAMINAR NATURAL CONVECTION HEAT TRANSFER IN A RECTANGULAR ENCLOSURE WITH AND WITHOUT INSIDE PARTITIONS
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Experimental study has been conducted for laminar natural convection heat transfer of air flow through a rectangular enclosure fitted with vertical partition. The partition was oriented parallel to the two vertical isothermal walls with different temperatures, while all the other surfaces of the enclosure were insulated. In this study a test rig has been designed and constructed to allow studying the effect of Rayleigh number, aperture height ratio, partition thickness, the position of aperture according to the side walls and according to the height, the position of the partition according to the hot wall, and partition inclination. The experiments were carried out with air as the working fluid for Rayleigh number range (5*107 – 1.3*10

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Publication Date
Mon Jun 29 2026
Journal Name
Journal Of Stomatology
Association of modifiable and non-modifiable risk factors with periodontal disease in Iraqi individuals: a retrospective study
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Introduction Periodontal diseases are ranked among the most common health problems affecting mankind. These conditions are initiated by bacterial biofilm, which is further modulated by several risk factors. Objectives To investigate the association of different risk factors with periodontal...

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Publication Date
Tue Dec 24 2024
Journal Name
Malaysian Journal Of Mathematical Sciences
Exploring the Role of Hunting Cooperation, and Fear in a Prey-Predator Model with Two Age Stages
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The aim of this study is to utilize the behavior of a mathematical model consisting of three-species with Lotka Volterra functional response with incorporating of fear and hunting cooperation factors with both juvenile and adult predators. The existence of equilibrium points of the system was discussed the conditions with variables. The behavior of model referred by local stability in nearness of any an equilibrium point and the conditions for the method of approximating the solution has been studied locally. We define a suitable Lyapunov function that covers every element of the nonlinear system and illustrate that it works. The effect of the death factor was observed in some periods, leading to non-stability. To confirm the theore

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Publication Date
Fri May 30 2025
Journal Name
Iraqi Journal Of Science
A Novel Approach for Synthesizing the Pan-chromatic Band to (10 m) of Landsat 9 Based on Sentinel-2 Data to Improve Classification Performance
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This study investigates the impact of spatial resolution enhancement on supervised classification accuracy using Landsat 9 satellite imagery, achieved through pan-sharpening techniques leveraging Sentinel-2 data. Various methods were employed to synthesize a panchromatic (PAN) band from Sentinel-2 data, including dimension reduction algorithms and weighted averages based on correlation coefficients and standard deviation. Three pan-sharpening algorithms (Gram-Schmidt, Principal Components Analysis, Nearest Neighbour Diffusion) were employed, and their efficacy was assessed using seven fidelity criteria. Classification tasks were performed utilizing Support Vector Machine and Maximum Likelihood algorithms. Results reveal that specifi

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Publication Date
Mon Nov 06 2023
Journal Name
Eneurologicalsci
Dandy-Walker syndrome associated with a giant occipital meningocele: A case report and a literature review
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HTH Ahmed Dheyaa Al-Obaidi,", Ali Tarik Abdulwahid', Mustafa Najah Al-Obaidi", Abeer Mundher Ali', eNeurologicalSci, 2023

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