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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
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
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of instructional intervention upon multipara women’s practices to control stress incontinence
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Objective(s): to determine the effectiveness of instruction intervention upon multipara women's practices to
control stress incontinence.
Methodology: A quasi-experimental study was carried out from (2nd) April, 2010 to 15th June, 2010. Nonprobability
(purposive sample) of (60) multiparous women was selected from Baghdad Teaching Hospital and AlElwia
Maternity Teaching Hospital in Baghdad city, the sample was divided into two groups (30) women were
considered as a study group, and another (30) were considered as the control group. An instructional intervention
was applied on the study group, while the intervention was not applied on control group. A questionnaire was
resolve as a tool of data collection to suit the p

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Publication Date
Fri May 11 2018
Journal Name
Nanotechnology
Doped bottom-contact organic field-effect transistors
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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
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
Thu Oct 15 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
Sun Nov 19 2017
Journal Name
Iraqi Journal Of Laser
Effects of Diode Laser 940 nm with and without 5 % Sodium Fluoride White Varnish with Tri-calcium Phosphate on Dentin Permeability (In vitro study)
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It is found that hypersensitive teeth have a larger number and wider patent tubules than those of non-sensitive teeth. Objective: The aim of this study is to compare between the effects of diode laser at different power densities, with and without sodium fluoride on the sealing of exposed dentinal tubules and dentin permeability. Materials and methods: 118 teeth were used. Samples were divided into three major groups. The first consisted of 100 teeth used for permeability test. The second consisted of 16 teeth for measuring external surface temperature elevation while irradiation. The third, in turn, consisted of one pair of teeth observed under SEM for dentine surface morphology analysis. Results: For dentin permeability measurement, th

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Engineering
Wormholes Models for the Optimum Matrix Acidizing in Mi4 Unit-Ahdeb Oil Field
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Innovative laboratory research and fluid breakthroughs have improved carbonate matrix stimulation technology in the recent decade. Since oil and gas wells are stimulated often to increase output and maximum recovery, this has resulted in matrix acidizing is a less costly alternative to hydraulic fracturing; therefore, it is widely employed because of its low cost and the fact that it may restore damaged wells to their previous productivity and give extra production capacity. Limestone acidizing in the Mishrif reservoir has never been investigated; hence research revealed fresh insights into this process. Many reports have stated that the Ahdeb oil field's Mishrif reservoir has been unable to be stimulated due to high injection pressures, wh

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Modifying an Equation to Predict the Asphaltene Deposition in the Buzurgan Oil Field
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Buzurgan oil field suffers from the phenomenon of asphaltene precipitation. The serious negatives of this phenomenon are the decrease in production caused by clogging of the pores and decrease in permeability and wettability of the reservoir rocks, in addition to the blockages that occur in the pipeline transporting crude oil. The presence of laboratories in the Iraqi oil companies helped to conduct the necessary experiments, such as gas chromatography (GC) test to identify the components of crude oil and the percentages of each component, These laboratory results consider the main elements in deriving a new equation called modified colloidal instability index (MCII) equation based on a well-known global equation called colloidal in

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Modifying an Equation to Predict the Asphaltene Deposition in the Buzurgan Oil Field
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Buzurgan oil field suffers from the phenomenon of asphaltene precipitation. The serious negatives of this phenomenon are the decrease in production caused by clogging of the pores and decrease in permeability and wettability of the reservoir rocks, in addition to the blockages that occur in the pipeline transporting crude oil. The presence of laboratories in the Iraqi oil companies helped to conduct the necessary experiments, such as gas chromatography (GC) test to identify the components of crude oil and the percentages of each component, These laboratory results consider the main elements in deriving a new equation called modified colloidal instability index (MCII) equation based on a well-known global equation called colloidal instabi

... Show More
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