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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
Sun Jan 01 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
The dynamics of a delayed ecological model with predator refuge and cannibalism
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This study has contributed to understanding a delayed prey-predator system involving cannibalism. The system is assumed to use the Holling type II functional response to describe the consuming process and incorporates the predator’s refuge against the cannibalism process. The characteristics of the solution are discussed. All potential equilibrium points have been identified. All equilibrium points’ local stability analyses for all time delay values are investigated. The system exhibits a Hopf bifurcation at the coexistence equilibrium, which is further demonstrated. The center manifold and normal form theorems for functional differential equations are then used to establish the direction of Hopf bifurcation and the stability of the per

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Publication Date
Mon Jan 15 2018
Journal Name
International Journal Of Science And Research (ijsr)
Production a Digital Map with the Aid of Total Station and (GIS)
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Geographic information system (GIS) is utilized in a variety of tasks such as, resource management, urban planning, emergency planning in case of accident, and rapid response etc. The aim of this study is to produce a digital map with the aid of GIS and a survey data. A survey data is conducted with Total Station technique on sanitary planning positions. The campus of Baghdad University is chosen to test the execution and accuracy of the results for sewer manholes locations. During the field survey, Total Station (Nikon Nivo) is used to identify the 3-D coordinates for each location. Finally, Geographical Information System (GIS) are utilized to present the digital map of the network sewer pipe line to the end users. Although Geographic Inf

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Publication Date
Sat Jun 30 2012
Journal Name
Al-kindy College Medical Journal
Angiolymphoid Hyperplasia with Eosinophilia : a Case Report and Review of the Literature
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A case of angiolymphoid hyperplasia with eosinophilia (ALH) is reported in a 42-year-old woman who developed multiple nodules behind the ear. Angiolymphoid hyperplasia with eosinophilia usually occurs on the head and neck of young adults and is more common in women than in men. Characteristic histologic features of ALH present in this case included proliferation of thick-walled blood vessels lined by prominent endothelial cells, infiltration of the interstitium by chronic inflammatory cells (mainly eosinophils), and presence of lymphoid follicles with germinal centers. The patient referred for surgeon for complete excision. in this context , cases previously described in the literature, and the differential diagnosis of ALH are discussed

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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
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
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
Fri Sep 01 2023
Journal Name
Cureus
The Evaluation of Dihydropyrimidine Dehydrogenase Enzyme Level in the Serum of Colorectal Cancer Iraqi Males on Fluoropyrimidine-Based Chemotherapy (Capecitabine)
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Publication Date
Sun Oct 01 2017
Journal Name
Ieee Transactions On Neural Systems And Rehabilitation Engineering
A Framework of Temporal-Spatial Descriptors-Based Feature Extraction for Improved Myoelectric Pattern Recognition
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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Relationship between the Strategies of E-marketing mix and Marketing Effectiveness of the Palestinian Small Business Industrial Organizations in the City of Hebron
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In the city of Hebron, small business industrial organizations face a major challenge related to its ability to reach, attract and sustain a sufficient number of customers in order to ensure its continuity and sustainability. The research problem is summarized in an attempt to reveal how the e-marketing could improve and support the marketing effectiveness of small business industrial organizations in the city of Hebron/Palestine. The importance of this research stems from the fact that it addresses a new knowledge branch of the field of marketing, which is electronic marketing for small business organizations, and the fact that the research highlights appropriate marketing solutions for these organizations in light of the Intern

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Publication Date
Fri May 15 2015
Journal Name
Euphrates Journal Of Agricultural Science
Performance Evaluation of field and genetic for genotype selection from Tomato Lycopersicon esculeuntum Mill.
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The study was conducted at the fields of the Department of Horticulture and Landscape Gardening,College of Agriculture, University of Baghdad during the growing seasons of 2013- 2014 .forPerformance of Evaluation Vegetative growth and yield traits and estimate some important geneticparameter on seven selected breed of tomato which (S1-S7 ) Pure line. the results found significantdifferences between breeds in all study trails except clusters flowering number .S1 significantly plantlength which reached 227.3 .Also S1,S2 and S4 were significantly increased the number fruit for plant,Fruit weight Increased in S3 ,S6 and plant yield. Increased in S1, S4 ,S5. Genetic variation valueswere low in Floral clusters , TSS and fruit firmest and medium i

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