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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 Dec 01 2018
Journal Name
Indian Journal Of Natural Sciences
Geology and Structure Analysis of Shaqlawa – Merawa Area, Northern Iraq Using Remote Sensing, GIS and Field Observations
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This study appears GIS techniqueand remote sensing data are matching with the field observation to identify the structural features such as fault segments in the urban area such as the Merawa and Shaqlawa Cities. The use of different types of data such as fault systems, drainage patterns (previously mapped), lineament, and lithological contacts with spatial resolution of 30m was combined through a process of integration and index overlay modeling technique for producing the susceptibility map of fault segments in the study area. GIS spatial overlay technique was used to determine the spatial relationships of all the criteria (factors) and subcriteria (classes) within layers (maps) to classify and map the potential ar

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Publication Date
Sun Mar 15 2020
Journal Name
Journal Of The College Of Education For Women
The Role of Supervisory and Training Practices in The Field Education Programmes in Achieving the Course Objectivesfrom the Perspective of the Student Teachers in the Faculty of Science and Arts in Sharourah
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The present study aimed at identifying the role of supervisory and training practices in the field   education program in achieving course objectives from the perspective of the student teachers in the Faculty of Science and Arts in sharourah, and its relationship to some variables (gender, specialization,estimation). To achieve this, the researcher used the descriptive-analytical method, and the study tool was designed, which consists of (24) items distributed on two axes: the objectives of field education and supervisory and training practices.Then, the study tool was applied to the research sample represented in the entire study community, which consists of (65) male and female students in the Faculty of Sciences and Arts in

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Publication Date
Tue Jan 01 2019
Journal Name
البحوث التربوية والنفسية
An educational design based on the models of the constructivist theory of chemistry and its impact on the life skills of second-year middle school female students
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Publication Date
Fri Dec 19 2025
Journal Name
Nursing Science Quarterly
Investigating the Ethical Challenges and Quality of Care for Patients on Psychiatric Units With Aggressive Behaviors in Iraq
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Patient aggression is a global health care problem. This study examined the impact of patient aggression on the quality of care that patients receive as perceived by their family members and the ethical challenges involved from the nurse’s perspective. A descriptive–analytical method was used. The participants of this study were nurses working on psychiatric units and family members of patients in Iraq. Two questionnaires were used: one on nursing care quality and one on ethical challenges in clinical situations. The results showed that the quality of care for these patients was reduced, with a M ±

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Publication Date
Thu Apr 30 2026
Journal Name
Asean Journal Of Scientific And Technological Reports
The Influence of Helicobacter pylori Infection on Hepatic Enzymes, Inflammatory Markers, and Hematological Parameters in Patients with Gastritis
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Helicobacter pylori (HP) colonizes the gastric mucosa and causes gastric and extra-gastric disorders. Several liver diseases, such as Non-alcoholic fatty liver disease, seem to be caused by the gastrointestinal tract, which is primarily determined by the presence of bacteria like Helicobacter pylori. The study aims to evaluate the relationship between Helicobacter pylori infection and liver diseases by measuring liver enzymes, inflammatory markers, and hematological parameters among patients with gastritis and without Helicobacter pylori infection. A total of 1,325 patients who had gastritis diagnosed by gastroscopy were included in our study. They were divided into the HP– group (340 women, 323 men) and the HP+ group (330 women,

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of Ergotamine and its Combination with Vitamin E or Melatonin on Total Antioxidant Status in Migraine Patients
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Free radicals and oxidative damage caused by them have being suggested to be involved in the pathogenesis of migraine. These may result from distorted equilibrium of pro-oxidant/anti-oxidant system that continuously generates and detoxifies oxidants during normal aerobic metabolism. Escape of such system from equilibrium leads to damage of cellular elements with the depletion of cellular stores of anti-oxidants material such as glutathione and vitamin E. Therefore, free radical scavengers (vitamin E or melatonin) seems to be of potential benefit as prophylactic anti-migraine therapy by neutralizing free radicals overproduction and possibly preventing formation of highly toxic intermediates (such as nitric oxide). In addition of being pow

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Publication Date
Sun Dec 31 2006
Journal Name
Modern Sport
The standerd Levels of Some Physical abilities based on playing centers of basketball for youngsters
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Research,s Summary The purpose of the research was to specify the standerd Levels for results of basketball for Iraqi young sters, Becuse there werenot the standerd Levels which related to the testings abilities of the players based on plying centers specially the physical abilities, This made weakness in arrangement and putting the suitable training studies for different age stadges which suitable with game ,s requirements, besides evaluation the performance of the plyers in common and the levels of the coachs train in special according to the scientific style. The researchers depended on (8) special testings of chossen physical abilities, These testings applied on the teams, young players for sharing clubs among excellent series of basket

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Publication Date
Sun Jul 11 2021
Journal Name
Sustainable Civil Infrastructures
Field Soil Electrical Resistivity Measurements of Some Soil of Iraq
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Publication Date
Wed Jul 01 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Caries Infiltrant Combined with and without Conventional Adhesives on Sealing of Sound Enamel (In Vitro Study)
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Background: The formation of white spot lesions around fixed orthodontic attachments is a common complication during and after fixed orthodontic treatment, which hinders the result of a successfully completed orthodontic treatment. The aim of the study was to assess the effectiveness of the Caries Infiltrant (ICON®) on prevention of caries on the smooth enamel surface when applied alone or combined with conventional adhesives. Materials and methods: Seventy eight human premolar enamel discs were randomly assigned to six groups (n=13). The discs were etched and treated with resins of different monomer content forming the following groups: (1)Untreated etched samples served as the negative control, (2) ICON® (DMG), (3) Adper™ S

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Publication Date
Sun Mar 31 2019
Journal Name
Journal Of Pure And Applied Microbiology
Determination of Level of 25-Hydroxy Vitamin D3 in Patients with Multiple Sclerosis and Its Effect on Disease Activity
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