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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
Tue Mar 31 2020
Journal Name
Association Of Arab Universities Journal Of Engineering Sciences
Experimental and Theoretical Analysis of a Mono PV Cell with Five Parameters, Simulation Model Compatible with Iraqi Climate
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The present work included study of the effects of weather conditions such as solar radiation and  ambient temperature on solar panels (monocrystalline 30 Watts) via proposed mathematical model, MATLAB_Simulation was used by scripts file to create a special code to solve the mathematical model , The latter is single –diode model (Five parameter) ,Where the effect of ambient temperature and solar radiation on the output of the solar panel was studied, the Newton Raphson method was used to find the  output current of the solar panel and plot P-V ,I-V curves, the performance of the PV was determined at Standard Test Condition (STC) (1000W/m2)and a comparison between theoretical and experimental results were done .The best efficiency

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Publication Date
Mon May 27 2019
Journal Name
Al-khwarizmi Engineering Journal
Investigation the Influence of SPIF Parameters on Residual Stresses for Angular Surfaces Based on Iso-Planar Tool Path
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Incremental Sheet Metal Forming (ISMF) is a modern sheet metal forming technology which offers the possibility of manufacturing 3D complex parts of thin sheet metals using the CNC milling machine. The surface quality is a very important aspect in any manufacturing process. Therefore, this study focuses on the resultant residual stresses by forming parameters, namely; (tool shape, step over, feed rate, and slope angle) using Taguchi method for the products formed by single point incremental forming process (SPIF). For evaluating the surface quality, practical experiments to produce pyramid like shape have been implemented on aluminum sheets (AA1050) for thickness (0.9) mm. Three types of tool shape used in this work, the spherical tool ga

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Publication Date
Sat Jun 30 2012
Journal Name
The Iraqi Journal Of Veterinary Medicine
Conformation of the clinical diagnoses of some malnutrition diseases in local and Shammi goats in Baghdad province: Al-Shawi A.F.S .; Al-Sammarraie ,S.A.G.and Al-Judi Abdul,M.H.
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The relationship between the clinical singes and some of the hematological and biochemical values in 126 cases of local breed and Shammi breed goats (from both sexes) diagnosed as cases of malnutrition from 230 goats examined .The clinical examination include (beside the general inspection and case history) body temperature, respiratory and pulse rates, mucus membranes skin and coat. Examination of the blood samples included RBCs count, Hb concentration, PCV % and values of cupper, magnesium, phosphorus, and potassium. The results showed that the mean body temperature of these goats was lower than in normal goats, while the respiratory and pulse rates were higher .Examination of blood revealed decrease in the means of RBCs counts ,Hb con

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Publication Date
Sun Jul 02 2017
Journal Name
Iraqi Journal Of Science
A Study Medicinal and Nutritional Effects of Thyme on Hematological Changes in Male Albino Rats
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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
On Blow-up Solutions of A Parabolic System Coupled in Both Equations and Boundary Conditions
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This paper is concerned with the blow-up solutions of a system of two reaction-diffusion equations coupled in both equations and boundary conditions. In order to understand how the reaction terms and the boundary terms affect the blow-up properties, the lower and upper blow-up rate estimates are derived. Moreover, the blow-up set under some restricted assumptions is studied.

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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Study on Viral Infection and Related Parameters in A Sample of Diabetes Mellitus Type 2
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Publication Date
Thu May 18 2023
Journal Name
Journal Of Engineering
A Modified Strength Pareto Evolutionary Algorithm 2 based Environmental /Economic Power Dispatch
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A Strength Pareto Evolutionary Algorithm 2 (SPEA 2) approach for solving the multi-objective Environmental / Economic Power Dispatch (EEPD) problem is presented in this paper. In the past fuel cost consumption minimization was the aim (a single objective function) of economic power dispatch problem. Since the clean air act amendments have been applied to reduce SO2 and NOX emissions from power plants, the utilities change their strategies in order to reduce pollution and atmospheric emission as well, adding emission minimization as other objective function made economic power dispatch (EPD) a multi-objective problem having conflicting objectives. SPEA2 is the improved version of SPEA with better fitness assignment, density estimation, an

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Publication Date
Sun Aug 01 2021
Journal Name
International Journal Of Mechanical Engineering And Robotics Research
Adaptive Approximation-Based Feedback Linearization Control for a Nonlinear Smart Thin Plate
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This paper proposes feedback linearization control (FBLC) based on function approximation technique (FAT) to regulate the vibrational motion of a smart thin plate considering the effect of axial stretching. The FBLC includes designing a nonlinear control law for the stabilization of the target dynamic system while the closedloop dynamics are linear with ensured stability. The objective of the FAT is to estimate the cubic nonlinear restoring force vector using the linear parameterization of weighting and orthogonal basis function matrices. Orthogonal Chebyshev polynomials are used as strong approximators for adaptive schemes. The proposed control architecture is applied to a thin plate with a large deflection that stimulates the axial loadin

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Publication Date
Sun Jul 01 2012
Journal Name
Applied Soft Computing
A new evolutionary based routing protocol for clustered heterogeneous wireless sensor networks
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Publication Date
Mon Apr 26 2021
Journal Name
Journal Of Electrical Engineering &amp; Technology
ANFIS Based Reinforcement Learning Strategy for Control A Nonlinear Coupled Tanks System
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