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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
Mon Feb 01 2010
Journal Name
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, And Endodontology
Oral Candida flora in a group of Jordanian patients with β-thalassemia major
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Objective Thalassemic patients present with multiple immune abnormalities that may predispose them to oral Candida, however this has not been investigated. The aim of this study was to assess oral candidal colonization in a group of patients with β-thalassemia major both qualitatively and quantitatively. Study design The oral mycologic flora of 50 β-thalassemia major patients and 50 age- and sex-matched control subjects was assessed using the concentrated oral rinse technique. Candida species were identified using the germ tube test and the Vitek yeast identification system. Results Oral Candida was isolated from 37 patients (74%) and 28 healthy subjects (56%; P = .04). The mean candidal count was significantly higher in thalassemic patie

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Publication Date
Tue Jun 30 2020
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
RATIONALIZATION OF CONSUMPTION AND ITS IMPACT ON ECONOMIC DEVELOPMENT (A PRELIMINARY STUDY): RATIONALIZATION OF CONSUMPTION AND ITS IMPACT ON ECONOMIC DEVELOPMENT (A PRELIMINARY STUDY)
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The research deals with the concept of rationalization of consumption, which is legitimately legitimized, by indicating the permissibility of consumption and its limits in Islam, the legitimate aspects of spending and its controls, and the concept of development in the Islamic economy. The researcher followed the descriptive method by presenting the legal texts and jurisprudential opinions and linking them to contemporary economic problems.The research has reached several conclusions, the most important of which is that the goal of Islam in relation to consumption is to inform the Muslim of the amount of economic maturity, and the truth of alms is good in money and religion. It is necessary for achieving maturity that both means

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of the (PEOE) Model in Teaching Science to Develop the Skills of Generating and Evaluating Information and the Scientific Sense among Intermediate First Grade Students
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The research aimed mainly to discover the effectiveness of the (PEOE) model in teaching science to develop the skills of generating and evaluating information and the emotional side of the scientific sense of the intermediate first grade students. An experimental approach with a quasi-experimental design called pre-test and post-test control design was used. The research sample consisted of (60) students, who were selected in a random cluster method, (30) students in the experimental group studied the unit "The Nature of Material" using the (PEOE) model, and (30) students in the control group studied according to the prevailing method of teaching. The research materials and tools were represented in: a teacher's guide for teaching the un

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Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Orthodontic Science
Presurgical management trends and nasoalveolar molding usage for infants with cleft lip and palate in the capital of a developing country
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BACKGROUNDS Nasoalveolar molding (NAM) application is among presurgical management (PSM) techniques used for infants with cleft lip and palate (CLP). It helps to approximate the palatal cleft and to reshape the nasoalveolar complex prior to primary lip repair. This study aimed to explore types of PSM and the dental speciality provision for infants with CLP in Baghdad. The status of NAM usage and surgeons’ perceptions toward NAM usage were assessed. MATERIALS AND METHODS This is a cross-sectional paper-based questionnaire study that collected responses of surgeons perform primary lip and nose repair regarding PSM. The questionnaire was distributed amongst public and private hospitals in Baghdad. Twenty surgeons were enrolled (only those su

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi Geological Journal
ROCK JOINTS ANALYSIS TO DETERMINE THE MAIN STRESS FIELD IN BUSTANAH STRUCTURE NORTHEAST OF IRAQ
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Joints are among the most widespread geologic structures as they are found in most each exposure of rock. They differ greatly in appearance, dimensions, and arrangement, besides they occur in quite different tectonic environments. This study is important because joints provide evidence on what kind of stress produced them (history of deformation) and also because they change the characteristics of the rocks in which they occur. The Measured data of joints from the studied area which are located in the high folded zone – Northeast of Iraq, were classified according to their relationship with the tectonic axes by projecting them stereographically using Schmidt net in GEOrient ver.9.5.0 software. The joint systems revealed the orientation of

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Publication Date
Mon Mar 01 2021
Journal Name
Journal Of Physics: Conference Series
High pollutant levels of produced water around Al-Ahdab oil field in Wasit governorate (Iraq)
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Abstract<p>Exploration activities of the oil and gas industry generate loads of formation water called produced water (PW) up to thousands of tons each day. Depending on the geographic area, formation depth, oil production techniques, and age of oil supply wells, PW from different oil fields contain different chemical compositions. Currently, PW is also known as industrial waste water containing heavy metals that are toxic to humans and the environment, requiring special processing so that they can be disposed of in the environment. To determine the heavy metals content in PW from the Al-Ahdab oil field (AOF), the Ministry of Science and Technology/Agricultural Research Department determined som</p> ... Show More
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Publication Date
Tue Jan 31 2023
Journal Name
Iraqi Geological Journal
Geological Model for Jeribe/Euphrates Formation, Tertiary Reservoir in Qaiyarah Oil Field, North of Iraq
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Visualization of subsurface geology is mainly considered as the framework of the required structure to provide distribution of petrophysical properties. The geological model helps to understand the behavior of the fluid flow in the porous media that is affected by heterogeneity of the reservoir and helps in calculating the initial oil in place as well as selecting accurate new well location. In this study, a geological model is built for Qaiyarah field, tertiary reservoir, relying on well data from 48 wells, including the location of wells, formation tops and contour map. The structural model is constructed for the tertiary reservoir, which is an asymmetrical anticline consisting of two domes separated by a saddle. It is found that

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Publication Date
Wed Oct 25 2023
Journal Name
College Of Islamic Sciences
The effect of fainting on a person’s behavior in (worship)
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The Messengers and the Imam of the God-fearing, Muhammad is God, his family, and all of his companions. As for what comes after... Fainting is one of the involuntary symptoms and states that occur to a person when carrying out his life’s tasks suddenly due to his loss of sense and movement, so he loses consciousness for a period of time that is short or may be long, and the person is held accountable and responsible for every moment of his life. He is required to perform duties specified by Sharia law, such as prayer, fasting, and Hajj...and fainting prevents him from performing these actions. We must consider the opinions of jurists and know the legal implications resulting from it. It was said that a person has a capacity that enable

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Publication Date
Thu Jul 01 2010
Journal Name
International Journal Of Advancements In Computing Technology
Implementation of digital chaotic signal generator based on reconfigurable LFSRs for multiple access communications
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This paper describes the digital chaotic signal with ship map design. The robust digital implementation eliminates the variation tolerance and electronics noise problems common in analog chaotic circuits. Generation of good non-repeatable and nonpredictable random sequences is of increasing importance in security applications. The use of 1-D chaotic signal to mask useful information and to mask it unrecognizable by the receiver is a field of research in full expansion. The piece-wise 1-D map such as ship map is used for this paper. The main advantages of chaos are the increased security of the transmission and ease of generation of a great number of distinct sequences. As consequence, the number of users in the systems can be increased. Rec

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Scopus
Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Solution of the electromechanical machining problem using the collocation method based on Bernstein polynomials
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