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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
Journal Of Molecular Liquids
Theoretical modeling study on preparation of nanosized drugs using supercritical-based processing: Determination of solubility of Chlorothiazide in supercritical carbon dioxide
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Publication Date
Sun Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Metformin Treatment on some Blood Biomarkers in Women with Endometriosis.
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 Endometriosis is a common women health disorder that occurs when Endometrial-like tissue grows outside the uterus. This may lead to irregular bleeding , pelvic pain, infertility and other complications.   Metformin,  because of its activity to improve  insulin sensitivity, it is  used for  the treatment of diabetes; it  also  has a modulatory  effect  on  ovarian  steroid  production and has  anti-inflammatory  properties,  all may  suggest  its possible effect in treatment  of endometriosis. This  study  was  planned  to  determine  the  effect  of  metformin  on serum levels  of&nbs

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Publication Date
Sun Jan 02 2022
Journal Name
Journal Of The College Of Languages (jcl)
A Pragmatic Analysis of Illocutionary Act in a Selected Presidential Speech on COVID-19
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     This paper aims at studying the illocutionary speech acts: direct and indirect to show the most dominant ones in a presidential speech delivered by the USA president. The speech is about the most critical health issue in the world, COVID-19 outbreak.  A descriptive qualitative study was conducted by observing the first speech delivered by president Trump concerning coronavirus outbreak and surveying the illocutionary acts: directive, declarative, commissive, expressive, and representative. Searle's (1985) classification of illocutionary speech acts is adopted in the analysis.

     What are the main types of the illocutionary speech acts performed by Trump in his speech?; Why does

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Publication Date
Tue Jun 30 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Antibacterial Effect of Aqueous and Alcoholic Propolis Extracts on Aggregatibacter Actinomycetemcomitans in Patients with Chronic Periodontitis (An In-vitro Study)
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Background: Propolis has received great interest because of its wide range antimicrobial activity. Propolis also called (bee glue) due to its collection by (Apismellifera) honeybees from various plants resinous substance. The aim of this study was to determine the antibacterial effect of propolis extracts (aqueous and alcoholic) on anaerobic periodontal pathogen namely Aggregatibacteractinomycetemcomitans. Materials and Methods: Strains of Aggregatibacter actinomycetemcomitans wasisolated from pockets of systemically healthy patients aged between 35-55 years old suffering from chronic periodontitis with pocket depths of 5-6 mm, the bacteria cultured on special blood Agar plates solid media. Propolis was extracted by using water and alcohol.

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Engineering
Mixed Convection in a Square Cavity Filled with Porous Medium with Bottom Wall Periodic Boundary Condition
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Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic pressure head , , , , and ), sinusoidal amplitude range of

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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Mixed Convection in a Square Cavity Filled with Porous Medium with Bottom Wall Periodic Boundary Condition
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Transient mixed convection heat transfer in a confined porous medium heated at periodic sinusoidal heat flux is investigated numerically in the present paper. The Poisson-type pressure equation, resulted from the substituting of the momentum Darcy equation in the continuity equation, was discretized by using finite volume technique. The energy equation was solved by a fully implicit control volume-based finite difference formulation for the diffusion terms with the use of the quadratic upstream interpolation for convective kinetics scheme to discretize the convective terms and the temperature values at the control volume faces. The numerical study covers a range of the hydrostatic  pressure sinusoidal  amplitude  range and

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Application Effect of the Conflict Management Strategies On Increasing Workers Productivity at the Electricity Company (IGEC) (Field Study Irbid Governorate)
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Research aimed to explore the Application Effect of the Conflict Management Strategies by the managements to solve conflict between and inside the conflicted parties within (IGEC) to increase the productivity of the workers. To collect data, 110 questioners had been distributed among managers and heads of departments of all managerial levels, 102 answered questioners regained, 5 of them were disqualify for statistical analytic, only 97 were taking in consideration   for statistical analysis presenting 93% of the retained number.

SPSS Program supported with a group of statistical tools, had been used for analysis purposes such as Kronbach Alpha test to assure the validity & stability of the t

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Publication Date
Tue Jun 30 2026
Journal Name
Journal Of Al-turath University College
The role of the Prophet ( peace be upon him and progeny) in the field of the Administration Regulation and applying Shura Principle Council in Islamic State Administration
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Publication Date
Tue Jul 01 2008
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
A NEW RECORD OF GOSH HAWK (BAZ) ACCIPITER GENTILIS (AVES-FALCONIFORMES) WITH SHORT NOTES ON DISTRIBUTION OF LAUGHING DOVE SLREPTOPELIA SENEGALENSIS (AVES. COLUMBIFORMES) IN IRAQ
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The present paper is very important for study of biodiversity of Iraq , to know how the
changes going and how the laughing dove S. senegalensis was a rare species in Iraq and now
is common and also the (baz) gosh hawk A. gentilis is common and the most famous 6rd of
pray in Iraq, till now missing from ornithologist and bird watcher to record it

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Publication Date
Sat Jul 01 2023
Journal Name
Heliyon
Effect of plasma surface treatment of three different CAD/CAM materials on the micro shear bond strength with resin cement (A comparative in vitro study)
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Objectives: This study aimed to evaluate and compare the effect of plasma treatment versus conventional treatment on the micro shear bond strength (μSBS), surface roughness, and wettability of three different CAD/CAM materials. Materials and methods: Sixty cylindrical specimens (5 mm diameter ×3 mm height) were prepared from three different CAD/CAM materials: Group A: Zirconia, Group B: Lithium disilicate, and Group C: Resin nano-ceramic. Each group was subdivided into two subgroups according to surface treatment used: Subgroup I: Conventional treatment, zirconia was sandblasted with Al2O3, while lithium disilicate and resin nano-ceramic were etched with hydrofluoric acid. Subgroup II: Plasma treatment, the surface of each material was tr

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