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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
Thu Jul 01 2021
Journal Name
Diyala Journal For Pure Science
Survey of Air Quality and Health Risk Assessment Around East Baghdad Oil Field, Iraq
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Air pollution evaluation of the operational processes in the East Baghdad oil field was carried out. The analysis was carried out by ICP-MS technique. Total Suspended Particles (TSP) air load was higher than Iraqi Standards and world international allowable limits of World Health Organization. The mean concentrations of gases carbon monoxide, carbon dioxide, sulfur dioxide, in the air were within national and world standards, while the mean concentration of nitrogen dioxide was higher than standard limits. The air of the study area is considered a good quality for CO, CO2 and NO2 with no health effect, while it is hazardous for TSP that have serious risk for people with respiratory disease. The mean concentrations of Cd, Cr, Cu and

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Publication Date
Wed Jan 31 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad (jfacmed Baghdad)
The Role of Activin A levels, Body Mass Index and Beta-Human Chorionic Gonadotropin in Ectopic Pregnancies and Missed Abortions – A Study on a Group of Iraqi Women
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Publication Date
Mon Apr 29 2024
Journal Name
Journal Of The College Of Basic Education
Detection Of Biofilm Formation By Beta- Lactam Resistance Klebsiella Pneumoniae Isolated From Clinical Specimens And Aquatic Samples
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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
Antibiotic Resistance of Staphylococcus Sp. Isolated from Air, Surface, Food and Clinical samples Collected from Baghdad Hospital
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Staphylococcus Sp.is the most common type of bacteria found in contamination place, we design this
study to compare the contamination accident between two hospitals in Baghdad.One of them isthe Burns
Specialist Hospital in the Medical CityinRusafa and another one is Al-Karama Hospital in Karkh. The
samples were collected fromOperativeWard No1 (OW1), Operative Ward No2 (OW2), Consulting Pharmacy
(CP), Emergency Room (ER), Reception Room (RR), Women's Ward (WW) and Men's Ward (MW).The
samples were taken from inside each clinical unit, surfaces, food, and air. The results showed that the
number of samples containing Staphylococcus sp. bacteria is 81, including 45 belonging to Al-Karama Burns
Ward Ho

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Publication Date
Mon Dec 13 2021
Journal Name
International Journal Of Reproductive Biomedicine (ijrm)
Differences in perinatal outcomes in teenage mothers with their first and third pregnancies and predictors of adverse neonatal events: A cross-sectional study
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Background: Repeated teenage pregnancy is a major burden on the healthcare system worldwide. Objective: We aimed to compare teenagers with their first and third pregnancies and to evaluate the likelihood of neonatal complications. Materials and Methods: This cross-sectional study was performed on female teenagers (aged ≤ 19 yr) with singleton pregnancies. The subjects (n = 298) were screened over 12 months. Ninety-six women were excluded, based on the exclusion criteria. The remaining subjects (n = 202) were divided into two groups: teenagers with first pregnancy (n = 96) and teenagers with third pregnancy (n = 47). The subjects were observed throughout pregnancy and delivery. The final sample size of the first and thi

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Publication Date
Mon Jul 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of thinking Skills in Developing Life Skills among First Year Students at Al- Bisha University
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     The aim of this research is to identify the effectiveness of thinking skills in developing the life skills of the students of the first Academic year, particularly the differences in life skills according to the variable of study specialization (human-scientific). To achieve the research objectives, the life skills scale was constructed on the classification of (WHO). The psychometric properties of the scale were examined. The validity of the scale, which is the final form of (60) items, was valid for measuring the life skills. The scale was then applied to the research sample of (112) students of the first year of the University of Bisha.  The SPSS program processed statistical analysis.  Resul

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Publication Date
Tue Nov 06 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Nursing Management Education Program upon the Nurse Managers' Knowledge about Planning in Baghdad City Hospitals
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Objective: To determine the effectiveness of the Nursing Management Education Program upon the Nurse
Managers' Knowledge about planning in Nursing Management at Baghdad City Hospitals.
Methodology: A Quasi-experimental study in which a purposive "non-probability" sample of (50) Nurse
Managers was selected from Baghdad City Hospitals. These Managers were divided into two equal groups of
(25) Nurse Managers for each (study and control ones). A questionnaire was developed as a tool for data
collection. A pilot study was carried out to test the reliability of the questionnaire for the period from April 2nd to
June 20th 2007. The pre-post test approach was applied to the study and control groups as mean for the quasiexperime

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
Developing the high performance practices to attain Organizational effectiveness
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Abstract

        This current research aims to make theoretical frame for the thoughts and principle knowledge for high performance work system ،also trying to know the role that high performance work system practices which is (Effective staffing، comprehensive training، providing work career، and employee participation) play to enhance the  organization effectiveness ، although knowing the principles of high performance work system which is: (Shared Information، Knowledge Development Performance and Reward linkage Egalitarianism)and its effect on the organizations. As well as defining the special concept of High performance wo

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Publication Date
Sat Oct 20 2018
Journal Name
Iraqi Journal Of Agricultural Sciences
EFFECT OF FOLIAR APPLICATION WITH CALCIUM, MAGNESIUM AND FERTILIZING WITH HUMIC ACID ON GROWTH , YIELD, AND STORAGE ABILITY OF POTATO TUBERS.
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Two experiments were carried out, the first at the College of Agriculture - University of Baghdad during spring season 2017 Everest cv. class (Elite) was used to study the effect of foliar application of calcium and magnesium and addition of humic acid to the soil on potato growth and yield, The layout of the experiment was factorial within RCBD design using three replicates. Calcium and Magnesium sprayed with concentrations (0, 500, 1000 mg.L-1), while the  humic acid was added to the soil with (0, 0.75 gm.m2),  The second experiment included  storage of tubers produced from the spring season, with to study the effect of field treatments  on improving the storability of the tubers. The results showed that the treatment of calci

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the Educational Program to Develop Recall Habits of Late School Students in the Intermediate Stage
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The research aimed to explore the recall habits and developing the right recall habits at middle school students. A sample of (40) students were chosen intentionally from middle school students in two schools (almntzr- zany aleabdyn) with an average of (20) students from each school. They were evenly distributed in two experimental and control groups. To achieve the aims of the research, a scale was designed to measure the recall habits, and a preparation of an educational program to develop recall habits.

To process data statistically, the researcher used several statistical methods such as Pearson correlation coefficient, chi-square, T-test for one sample, T-test for two independent samples, Wilcoxon test, Mann-Whitney test, ET

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