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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
Fri Sep 15 2023
Journal Name
Technology And Health Care
Clinical management and infection control protocols during the COVID-19 pandemic: An online survey
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BACKGROUND: SARS-CoV-2 (COVID-19) is considered a highly infectious and life threatening disease. OBJECTIVE: The present paper aims to evaluate various aspects of preventive measures and clinical management of the scheduled visits for orthodontic patients to the dental clinics during the outbreak of COVID-19, and to assess how orthodontists dealt with this challenge. METHODS: Orthodontists in private and public clinics were invited to fill a questionnaire that addressed infection control protocols and concerns about clinical management of patients in the clinics during the pandemic. Frequncies and percentages of the responses were obtained and compared using Chi-square tests. RESULTS: About 77% of those working in private clinics, a

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Preparation and diagnosis of new types of Schiff bases one-and two- claw and complexes to study the effectiveness of chemical
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In this research we prepared shiff bases unilateral claw( benzyl imine aniline ) and Bilateral claw ( benzayal-2-imine phenol ) in high purity reach to 98% , which it's prepared from aromatic amine with aldehydes, it's solid,thermosetting, not dissolved in water in general. Diagnosed prepared article by using infra red spectroscopy (IR) which shows azomethen grop at 1640cm-1 At this diagnosis we suggest tetra headral mechanism in this Circumstances For a reaction.

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Publication Date
Sun Mar 30 2014
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Design of Horizontal Well Program for Ajeel Field
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Horizontal wells are of great interest to the petroleum industry today because they provide an attractive means for improving both production rate and recovery efficiency. The great improvements in drilling technology make it possible to drill horizontal wells with complex trajectories and extended for significant depths.
The aim of this paper is to present the design aspects of horizontal well. Well design aspects include selection of bit and casing sizes, detection of setting depths and drilling fluid density, casing, hydraulics, well profile, and construction of drillstring simulator. An Iraqi oil field (Ajeel field) is selected for designing horizontal well to increase the productivity. Short radius horizontal well is suggested fo

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Publication Date
Wed Jul 01 2020
Journal Name
Journal Of Engineering
Permeability Determination of Tertiary Reservoir/Ajeel Oil Field
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This paper discusses the method for determining the permeability values of Tertiary Reservoir in Ajeel field (Jeribe, dhiban, Euphrates) units and this study is very important to determine the permeability values that it is needed to detect the economic value of oil in Tertiary Formation. This study based on core data from nine wells and log data from twelve wells. The wells are AJ-1, AJ-4, AJ-6, AJ-7, AJ-10, AJ-12, AJ-13, AJ-14, AJ-15, AJ-22, AJ-25, and AJ-54, but we have chosen three wells (AJ4, AJ6, and AJ10) to study in this paper. Three methods are used for this work and this study indicates that one of the best way of obtaining permeability is the Neural network method because the values of permeability obtained be

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Publication Date
Sat Mar 01 2025
Journal Name
Microbial Biosystems
Distribution of cytotoxic necrotizing factor type 1 in clinical isolates of Escherichia coli isolated from urinary tract infections in Iraq
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Uropathogenic Escherichia coli is the main cause of urinary tract infections, the ability of this bacteria to cause urinary tract infections is related to a variety of virulence factors that enhance colonization and evade the immune response, one of these virulence factors is cytotoxic necrotizing factor 1 toxin which converts the glutamine residue to glutamic acid to activated GTPase Rho family. The study was meant to find out the prevalence rate of the cnf1 gene in Uropathogenic Escherichia coli isolated from Iraqi patients. Conventional laboratory methods were used for primary bacterial identification and molecular methods were used to confirm bacterial identity and gene detection. Escherichia coli was identified in 89/165 (53.93%) of th

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Publication Date
Sat Jun 01 2019
Journal Name
Collegian
Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq
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Publication Date
Wed Dec 31 2025
Journal Name
Modern Sport
The Contribution of Design Thinking to Reducing Excessive Sensitivity to Criticism Among Athletes in Selected Track and Field Events
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Publication Date
Mon Jun 29 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of tongue space area in a sample of Iraqi adults with class I dental and skeletal pattern
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Background: Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. This study aimed to determine the tongue and surrounding space area in a sample of Iraqi adults with class I dental and skeletal pattern. Materials and methods: The study included thirty healthy subjects (15 males and 15 females) with an age ranged between 23-34 years and class I dental and skeletal pattern with no history of any sleep related disorders. The assessed cephalometric measurement included length and height of the tongue and position of hyoid bone from cervical line. Descriptive statistics were obtained for the data. Genders difference was evaluated by independent sample t-test. Results: There wer

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Publication Date
Fri Mar 10 2023
Journal Name
Aspac J. Mol. Biol. Biotechnol
Influence of IL-28B serum level and gene polymorphism in a sample of Iraqi patients with ankylosing spondylitis
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Ankylosing spondylitis (AS) represents one kind of advanced arthritis formed via inflammatory stimuli long-term in the spin‘s joints. Interleukin (IL)-29 (interferon- lambda1(IFN- λ1)), interleukin (IL)-28A (interferon- lambda 2 (IFN- λ2)) and interleukin (IL)-28B (interferon- lambda 3(IFN-λ3)) are three interferon lambda (IFN- λs) molecules that have recently been identified as new members of the IFN family. IL-28B expression in ankylosing spondylitis (AS) is not well understood. 150 male healthy controls ((HC) and 160 males with AS as patients group participated in this study. Serum level and gene polymorphism were assessed using an enzyme-linked immunosorbent assay and Sanger sequencing for IL-28B, respectively. The results showed

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessment of Quality of Life in a Sample of Iraqi Patients with Psoriasis.
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Psoriasis is a dermatological, chronic, immune-mediated condition. Psoriasis symptoms are not associated with physical burden only, but it may also have psychosocial effects on patients, diminished cognitive control, poor body image and impairments in everyday life. The value of quality of life is important since improving it is the principal goal for non-curative disease. The aim of the current study was to evaluate quality of life in a sample of Iraqi patients with psoriasis. This study is a cross-sectional study that involved 300 already diagnosed psoriasis patients who attended to the center of Dermatology and Venereology, Medical City/Baghdad. The mean age of patients was (35.156 ±10.549 years). The Arabic version of Dermatology Li

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