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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 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Alendronate Treatment on Salivary Levels of Osteoprotegrin and TNF-α in Postmenopausal Woman with Osteoporosis and Periodontal Diseases
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Background: All diseases concerning bone destruction such as osteoporosis and periodontal diseases share common pattern in which the osteoclast cells are absolutely responsible for bone resorption that occurred when osteoclast activity exceeds osteoblast activity. Osteoprotegrin (OPG) considered as novel soluble decoy receptor known as “bone protector” since it prevents extreme bone resorption through inhibition of differentiation and activity of osteoclast by competing for binding site. It binds to receptor activator of nuclear factor kappa-B ligand (RANKL) and prevent its interaction with receptor activator of nuclear factor kappa-B (RANK), thus inhibits osteoclast formation. TNF-α is a pro-inflammatory cytokines having

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
Biochemical and Kinetic Studies on Alkaline Phosphatase and other Biochemical Features in Sera of Patients with type 2 Diabetes
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Background :Alkaline phosphatase (ALP) was a widely used marker for skeletal and hepatobiliary disorders, but its activity was also increased in atherosclerosis and peripheral vascular disease. Several study has showed that ALP activity was increased in the sera of diabetic patients. The current study was conducted to evaluate ALP activity in type 2 diabetic patients and optimum conditions for enzyme activity in their sera.Methods: This study was carried out at in AL-Yarmok hospital(diabetic center) between February /2009 and April /2009. Fifty two patients with type 2 diabetes have been enrolled. Besides BMI, WHR, serum fasting blood glucose, ALP, HbA1C,uric acid and lipid profile levels have been performed .The relationship bet

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Publication Date
Mon Apr 04 2016
Journal Name
European Journal Of Oral Sciences
Experimental polyethylene-hydroxyapatite carrier-based endodontic system: an in vitro study on dynamic thermomechanical properties, sealing ability, and measurements of micro-computed tomography voids
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The dynamic thermomechanical properties, sealing ability, and voids formation of an experimental obturation hydroxyapatite-reinforced polyethylene (HA/PE) composite/carrier system were investigated and compared with those of a commercial system [GuttaCore (GC)]. The HA/PE system was specifically designed using a melt-extrusion process. The viscoelastic properties of HA/PE were determined using a dynamic thermomechanical analyser. Human single-rooted teeth were endodontically instrumented and obturated using HA/PE or GC systems, and then sealing ability was assessed using a fluid filtration system. In addition, micro-computed tomography (μCT) was used to quantify apparent voids within the root-canal space. The data were statistically analys

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Publication Date
Sat Mar 26 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Role of Big Data applications in forecasting corporate bankruptcy: Field analysis in the Saudi Business Environment
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This study aimed to investigate the role of Big Data in forecasting corporate bankruptcy and that is through a field analysis in the Saudi business environment, to test that relationship. The study found: that Big Data is a recently used variable in the business context and has multiple accounting effects and benefits. Among the benefits is forecasting and disclosing corporate financial failures and bankruptcies, which is based on three main elements for reporting and disclosing that, these elements are the firms’ internal control system, the external auditing, and financial analysts' forecasts. The study recommends: Since the greatest risk of Big Data is the slow adaptation of accountants and auditors to these technologies, wh

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Factors associated with Exacerbation of Myasthenia Gravis in a Group of Iraqi Patients
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Background: Myasthenia gravis is an autoimmune disease of the neuromuscular junction that results in fluctuating muscle weakness as well as significant fatigue. Disease exacerbation is a critical condition, and the predisposing factors for it need to be identified to improve preventive measures.

Objectives:  Our study aims to determine the predisposing factors for myasthenia gravis exacerbations in a group of Iraqi patients.

Subjects and Methods: A total number of 30 myasthenia gravis patients were admitted to the hospital with an exacerbation of their symptoms, determined as the development of functional disability, dysphagia, or respiratory fai

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Publication Date
Thu Sep 26 2019
Journal Name
Al-kindy College Medical Journal
Administration of I.V. lidocaine before induction of general anesthesia prolong suxamethonium action in caesarian section surgeries. clinical assessment--------
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Background: Known as suxamethonium or succinylcholine, is a medication used to cause short-term paralysis as part of general anesthesia. The duration of operation is one of the important factors accounting to the success of the operation. Simple safe available drug can change the plan of anesthesia.

Objective:  The purpose of this study was to assess adding Lidocaine three minutes intravenously before induction of general anesthesia on the duration of optimum prolongation the action of  Suxamethonium  . With other group with regular meth

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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
Tue Jun 09 2020
Journal Name
Article In Journal Of Engineering Science And Technology
English Numbers Recognition Based on Sign Language Using Line-Slope Features and PSO-DBN Optimization Method
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Publication Date
Sat Apr 01 2023
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
Flexible handover solution for vehicular ad-hoc networks based on software defined networking and fog computing
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<p>Vehicular ad-hoc networks (VANET) suffer from dynamic network environment and topological instability that caused by high mobility feature and varying vehicles density. Emerging 5G mobile technologies offer new opportunities to design improved VANET architecture for future intelligent transportation system. However, current software defined networking (SDN) based handover schemes face poor handover performance in VANET environment with notable issues in connection establishment and ongoing communication sessions. These poor connectivity and inflexibility challenges appear at high vehicles speed and high data rate services. Therefore, this paper proposes a flexible handover solution for VANET networks by integrating SDN and

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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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