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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
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
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
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
A Review Study on Forgery and Tamper Detection Techniques in Digital Images
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Digital tampering identification, which detects picture modification, is a significant area of image analysis studies. This area has grown with time with exceptional precision employing machine learning and deep learning-based strategies during the last five years. Synthesis and reinforcement-based learning techniques must now evolve to keep with the research. However, before doing any experimentation, a scientist must first comprehend the current state of the art in that domain. Diverse paths, associated outcomes, and analysis lay the groundwork for successful experimentation and superior results. Before starting with experiments, universal image forensics approaches must be thoroughly researched. As a result, this review of variou

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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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Publication Date
Wed Oct 25 2023
Journal Name
Urban Planning And Construction
A Review on Urban Planning and Its Role in Managing Flood Risks
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This review delves deep into the intricate relationship between urban planning and flood risk management, tracing its historical trajectory and the evolution of methodologies over time. Traditionally, urban centers prioritized defensive measures, like dikes and levees, with an emphasis on immediate solutions over long-term resilience. These practices, though effective in the short term, often overlooked broader environmental implications and the necessity for holistic planning. However, as urban areas burgeoned and climate change introduced new challenges, there has been a marked shift in approach. Modern urban planning now emphasizes integrated blue-green infrastructure, aiming to harmonize human habitation with water cycles. Resil

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Publication Date
Thu Jul 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Processing Eruca sativa leaves in the nanoscale and study its effectiveness for removing Cibacron red dye from their aqueous solutions
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    The discharge of dyes into the water is a significant source of pollution, which is especially concerning given that textile mills are the primary contributor. Nanomaterial-based solutions to this issue have required extensive research and investigation due to their complex nature. In this research, novel nanoparticle were successfully synthesized using the leaves of the Eruca sativa plant. The nano was analyzed using scanning and transmission electron microscopy (SEM and TEM) measurements, and their crystal structure was determined using the X-ray diffraction technique (XRD). The incorporation of NPs resulted in an increase in the uptake of the Cibacron red dye. At a contact time of 30 minutes, observed a faster adsorption o

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Publication Date
Tue Nov 09 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Enhancing the effectiveness of the company in light of the practice of leadership empowerment: Applied research in the National Insurance Company
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The aim of the research is to demonstrate the importance of leadership empowerment in its dimensions (knowledge, participation in decision-making, incentives, trust between the leader and subordinate, delegation of authority and communication) and its impact on enhancing the effectiveness of the company in its dimensions Represented by (achievement of objectives, quality of insurance service, adaptation to work environment and job satisfaction), by adopting the questionnaire as a main tool in collecting data from officials in the National Insurance Company, numbering (56) surveyed in job sites (section manager, division official and unit official) Their answers were analyzed using the SPSS statistical program in calculating the a

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Publication Date
Wed Apr 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The role of the effectiveness of self-managed teams in improving the quality of services / an applied study in Ramadi municipality
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This research aims to identify the effective role of self-managed teams in the quality of service performance in the directorate of Ramadi municipality. The problematic nature of our research involves this main question of the effective role of self-managed teams in the Municipality of Ramadi in improving the services of performance quality to the beneficiaries from the Directorate service. The importance of this study lies in the role played by the work teams in the organizations that excel in their field, the attendant of the changes in the leadership, administrative roles of the institutions, and teams leaders, will be achieved by the self-managed teams in improving the quality of the service provided by the institution to whi

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Publication Date
Sun Sep 27 2020
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of PDEODE Strategy in Acquiring Historical Concepts in the Subject of History for Students of the Fourth Literary Grade
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The research aims to know (the effect of the pdeode strategy) in acquiring historical concepts among the fourth-grade literary female students in the history module. To achieve the goal of this research, the following null hypothesis was formulated. There is no statistically significant difference at the level of (0.05) between the average scores of the experimental group students, who study history according to the PDEODE strategy, and the average scores of the control group students who study the same module in the traditional way of the historical concepts acquisition test.The researcher chose the experimental method for the current research and adopted the experimental design of partial control with a post-test, which depends on the

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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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