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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 Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Impact of omega 3 alone or in combination with irinotecan on bone marrow and spleen of rats: in vivo study
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Abstract

Objectives: The present study designed to explore the genotoxicity through measurement of Mitotic index in bone marrow and the spleen cells, as possible mechanism of bone marrow and spleen toxicity that induced by irinotecan; and to describe the protective actions of omega 3 against irinotecan induced genotoxicity in bone marrow and the spleen of rats.

Methods: Twenty four (24) rats (Sprague-Dawley) were randomly divided into four groups: Group Ӏ, rats  received single oral daily dose of distilled water (2 ml/kg) for 25 days (negative control group); Group ӀӀ (irinotecan-treated), receiv

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Publication Date
Wed Jul 24 2024
Journal Name
An International Journal Of Optimization And Control: Theories &amp; Applications (ijocta)
The effect of a psychological scare on the dynamics of the tumor-immune interaction with optimal control strategy
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Contracting cancer typically induces a state of terror among the individuals who are affected. Exploring how chemotherapy and anxiety work together to affect the speed at which cancer cells multiply and the immune system’s response model is necessary to come up with ways to stop the spread of cancer. This paper proposes a mathematical model to investigate the impact of psychological scare and chemotherapy on the interaction of cancer and immunity. The proposed model is accurately described. The focus of the model’s dynamic analysis is to identify the potential equilibrium locations. According to the analysis, it is possible to establish three equilibrium positions. The stability analysis reveals that all equilibrium points consi

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Publication Date
Thu Nov 21 2019
Journal Name
Al-kindy College Medical Journal
Magnetic Resonance Venography Findings In A Group Of Patients With Multiple Sclerosis
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Background: Multiple sclerosis is a chronic heterogeneous demyelinating axonal and inflammatory disease involving the Central Nervous System [CNS] white matter with a possibility of gray matter involvement in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms. Cerebral venous insufficiency theory was raised as a possible etiology for the disease at 2008 by Zamboni an Italian cardiothoracic surgeon. This theory was defeated by Multiple Sclerosis[ MS] researchers and scientists who thought that the disease is an autoimmune rather than vascular.

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Publication Date
Wed Jul 05 2017
Journal Name
International Journal Of Science And Research (ijsr)
Hyperglycosylated hCG in a Group of Iraqi Patients with Gestational Trophoblastic Disease
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Background : Hyperglycosylated hCG a newly discovered variant of hCG which can be used as a predictor of invasion of trophoblastic cells in patient with gestational trophoblastic disease. Objectives : To measure hyperglycosylated human chorionic gonadotrophin and to assess how far it can be used as predictor of invasion in invasive mole and choriocarcinoma. Study design control study. Setting: : Case Gynecological department in Baghdad Teaching Hospital from January 2016 to January 2017. Patient and Methods : 60 women were enrolled in this study 30 of them were with gestational trophoblastic disease (no.= 30 ) the remainder were normal pregnancy (no. =30) , hCG –H level was measured in both groups. Results : Mean serum hCG-H le

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Publication Date
Fri Jun 11 2021
Journal Name
Egyptian Journal Of Chemistry
Visfatin as a biomarker of obesity in iraqi adolescences with metabolic syndrome
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The present study aims to study the correlation between visfatin levels and metabolic syndrome in Iraqi obese adolescence (with and without metabolic syndrome) and its relation with other studied biochemical parameters. Sixty obese adolescences were depended in this study (with and without metabolic syndrome), compared with (30) non-obese children as control group. This study was done in the period from April 2020 until the end of December 2020, in the National Diabetes Centre/Mustansiriya University, Baghdad/Iraq. There were no significant differences in age, height, waist circumferences (WC), and diastolic blood pressure (DBP) in the patients' groups. In contrast, a significant increase differs (p<0.05) was recorded in the values of

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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The application target cost technique by using reverse engineering: An application study in the general company for vegetable oils industry
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The Purpose of this study is mainly to improve the competitive position of products economic units using technique target cost and method reverse engineering and through the application of technique and style on one of the public sector companies (general company for vegetable oils) which are important in the detection of prices accepted in the market for items similar products and processing the problem of high cost which attract managerial and technical leadership to the weakness that need to be improved through the introduction of new innovative solutions which make appropriate change to satisfy the needs of consumers in a cheaper way to affect the decisions of private customer to buy , especially of purchase private economic units to

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Publication Date
Wed Jan 11 2023
Journal Name
Healthcare
Short-Term (4 Day) Effects of Oral Rinsing with Miswak and Green Tea on Gingival Crevicular Fluid Flow and IL-1β Levels: A Pilot Study
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Despite the antiplaque effect of mouth-rinsing with a combination composed of miswak (Salvadora persica L.) and green tea (Camellia sinensis var. assamica) extracts, no data are available regarding its effect on gingival tissue at the molecular level. This pilot study aimed to assess the effect of oral rinsing with this combination on gingival crevicular fluid (GCF) flow and IL-1β levels. Ten subjects rinsed with either the combination, 0.12% chlorhexidine gluconate (CHX) or distilled water without toothbrushing for 4 days after receiving baseline polishing. GCF IL-1β concentration, influx, resting volume and plaque quantity were measured at baseline and after 4 days for each intervention. No significant differences in GCF flow or

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Publication Date
Fri Jan 05 2018
Journal Name
International Journal Of Science And Research (ijsr)
Image Steganography Based on Discrete Wavelet Transform and Chaotic Map, IJSR, Call for Papers, Online Journal
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'Steganography is the science of hiding information in the cover media', a force in the context of information sec, IJSR, Call for Papers, Online Journal

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Publication Date
Fri Dec 01 2023
Journal Name
Iraqi Journal Of Physics
Polluted Water Sensor Based on Carbon Quantum Dots/Alq3 Using Drop Casting and Spin Coating Techniques
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Water quality sensors have recently received a lot of attention due to their impact on human health. Due to their distinct features, environmental sensors are based on carbon quantum dots (CQDs). In this study, CQDs were prepared using the electro-chemical method, where the structural and optical properties were studied. These quantum dots were used in the environmental sensor application after mixing them with three different materials: CQDs, Alq3 polymer and CQDs and Alq3 solutions using two different methods: drop casting and spin coating, and depositing them on silicon. The sensitivity of the water pollutants was studied for each case of the prepared samples after measuring the change in resistance of the samples at a temperature of

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Publication Date
Thu Jun 01 2023
Journal Name
Measurement: Sensors
Improved airborne computer system strategy for swarm drones flying based on skybrush suite and inspired technique
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