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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 Mar 12 2024
Journal Name
Semiconductor Physics, Quantum Electronics And Optoelectronics
Numerical study of single-layer and interlayer grating polarizers based on metasurface structures for quantum key distribution systems
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Polarization is an important property of light, which refers to the direction of electric field oscillations. Polarization modulation plays an essential role for polarization encoding quantum key distribution (QKD). Polarization is used to encode photons in the QKD systems. In this work, visible-range polarizers with optimal dimensions based on resonance grating waveguides have been numerically designed and investigated using the COMSOL Multiphysics Software. Two structures have been designed, namely a singlelayer metasurface grating (SLMG) polarizer and an interlayer metasurface grating (ILMG) polarizer. Both structures have demonstrated high extinction ratios, ~1.8·103 and 8.68·104 , and the bandwidths equal to 45 and 55 nm for th

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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 the Clinical Pharmacists' Role by Physicians at Baghdad Hospitals
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In Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals.  To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view. The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire  The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in Baghdad h

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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 the Clinical Pharmacists' Role by Physicians at Baghdad Hospitals
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In Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals.

 To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view.

The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire 

The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in

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Publication Date
Fri Oct 02 2026
Journal Name
Advances In Environmental Biology
A study effect of thyme on biochemical and histological changes in liver of male rats
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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of The College Of Languages (jcl)
(comparative analysis of phraseological units in the lexical-semantic field "on the material of Arabic and Russian languages"): (сопоставительный анализ фразеологических единиц лексико-семантического поля " на материале арабского и русского языков")
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Establishing the systemic character of vocabulary, its relationship with other language systems, their interdependence creates the possibility of a comprehensive scientific study and description of the lexical system of each language, as well as contrastive comparative studies of several languages, including their phraseological composition.

It is known that not all words-components of phraseological units are equivalent in their role in the formation of the semantic content of phraseological units. In this regard, it is necessary to introduce the concept of a lexical dominant. To this we include words, which are kind of centers around which the entire semantic complex of phraseological units, the entire set of its words-componen

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Publication Date
Thu Nov 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Creative Thinking Skills in Administrative Leadership style " Field research in the Medical City " *
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 This research aims at to identify the extent to which creative thinking skills Impact the change &development of Administrative Leadership styles In Administrative Leadership of the Medical City Department. Identify the nature of the relationship between them, determine the prevailing leadership style, &measure the level of creative thinking skills they have. In order to achieve the objectives of the research, the descriptive analytical method was adopted.

The research tool consisted of a questionnaire consisting of (61) paragraphs, in addition to the interview & observation. The research sample consisted of (170) administrative leaders in the upper &middle organizational levels. The

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The role of strategic leadership in achieving organizational excellence: field research in Al-Faris General Company
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The current research aims to determine the role of strategic leadership in achieving organizational excellence. In this context the sample of the research consist of 123 managers .The research problem can be summarized as {what is the role of strategic leadership in achieving organizational excellence}which resulted in a number of sub-questions and its goal was to explain the theoretical philosophy and intellectual expositions of this variables because of they are vital variables imposed by the current situation. To achieve research objectives we had use the questionnaire as a tool to collect data and information after verifying the validity and dependency of the measures. A number of statistical techniques and tools had been use

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of knowledge management in achieving strategic excellence Field research in some Iraqi private banks
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The purpose of the research is to study the impact of knowledge management (personalization and coding strategy) in achieving strategic excellence in the environment of Iraqi private banks, and the descriptive and analytical research approach has been adopted, so the researcher adopted positive philosophy according to the deductive approach for the purpose of deriving the first research hypothesis from the theoretical side and the research reached a group of The most important results are that the personalization strategy has made great progress in its ability to influence strategic superiority as a responsive variable, as the civil bank departments were successful in employing the changes that occurred in the personalization str

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Publication Date
Wed Jun 11 2008
Journal Name
Journal Of Al-nahrain University
ANALYSIS OF A MOLECULAR DYNAMICS SIMULATION OF THE ACETYLCHOLINESTERASE ENZYME AND ITS COMPLEX WITH (AXILLARIDINE-A) INHIBITOR
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Molecular dynamics (MD) simulations were carried out in order to investigate the binding mode of axillaridine-A at the active site of human acetylcholinesterase (AChE) enzyme. 2.0 nanosecond of MD simulations was made for the protein and the complex to dynamically explore the active site and the behavior of the ligand at the peripheral AChE binding site. These calculations for the enzyme alone showed that the active site of AChE is located at the bottom of a deep and narrow cavity whose surface is lined with rings of aromatic residues and Tyr72 is almost perpendicular to the Trp286 ring and forms a stable - interaction. The size of the active site of the complex decreases with time due to increase the interaction. Axillaridine-A forms

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Publication Date
Wed Mar 01 2023
Journal Name
Baghdad Science Journal
A Study on Nψβ and Nβψ - Closed sets in Neutrosophic Topological spaces
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The aim of this paper is to introduce the concept of N  and Nβ -closed sets in terms of neutrosophic topological spaces. Some of its properties are also discussed.

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