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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 Jun 05 2016
Journal Name
Baghdad Science Journal
Effect of varicocelectomy on sperm parameters, oxidative stress and Chromatin maturity in seminal fluid of infertile patients with varicocele
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This study aimed to determine the effect of varicocelectomy on sperm parameters, oxidant- antioxidant status and chromatin maturity percent. The current study has been conducted on 154 infertile patients complaining from varicocele and varicocelomized men in addition to 25 fertile men as control. The results revealed significant decrease (P<0.05) in sperm concentration, progressive motile sperm percent, normal sperm morphology percent, GSH, SOD1, CAT levels and chromatin maturity percent and significant increase (P<0.05) in MDA and ROS concentrations in infertile patients with varicocele when compared to fertile men. The results revealed improvement (P<0.05) of sperm parameters quality, GSH, SOD1, CAT, MDA, ROS concentration and chromatin m

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Publication Date
Thu Jun 30 2011
Journal Name
J Bagh College Dentistry
Comparison of the effect of stannous fluoride and sodium fluoride on surface roughness of Silorane and methacrylate based restorative material using light polarizing microscope
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Background: The high reactivity of hydrogen peroxide used in bleaching agents have raised important questions on their potential adverse effects on physical properties of restorative materials. The purpose of this in vitro study was to evaluate the effect of in-office bleaching agents on the microhardness of a new Silorane-based restorative material in comparison to methacrylate-based restorative material. Materials and method: Forty specimens of Filtek™ P90 (3M ESPE,USA) and Filtek™ Supreme XT (3M ESPE, USA) of (8mm diameter and 3m height) were prepared. All specimens were polished with Sof-Lex disks (3M ESPE, USA). All samples were rinsed and stored in incubator 37˚C for 24 hours in DDW. Ten sample of each material were subjected to

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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 07 2010
Journal Name
Baghdad Science Journal
Simultaneous influences of hematocrit in the erythrocyte medium on erythrocyte aggregation and sedimentation: a kinetic study by a laser scattering technique
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The erythrocyte aggregation is an important physiological phenomenon in the circulation of blood. It is a basic characteristic of normal blood that plays a major role in the cardiovascular system, especially in the microcirculation. This study explained the kinetics of single cells rouleaux formation one- dimensional aggregate and three- dimensional aggregate, during simultaneous, and the effect of hematocrit on the process of aggregation and sedimentation. The present study was done on forty one healthy subjects. Laser light is passed through a well mixed sample of blood and the forward scattered light intensities recorded continuously. The samples were prepared with different hematocrit, (10%, 15%, 20%, and 25%). Increasing

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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
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Asphaltene Precipitation Investigation Using a Screening Techniques for Crude Oil Sample from the Nahr-Umr Formation/Halfaya Oil Field
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Many oil and gas processes, including oil recovery, oil transportation, and petroleum processing, are negatively impacted by the precipitation and deposition of asphaltene. Screening methods for determining the stability of asphaltenes in crude oil have been developed due to the high cost of remediating asphaltene deposition in crude oil production and processing. The colloidal instability index, the Asphaltene-resin ratio, the De Boer plot, and the modified colloidal instability index were used to predict the stability of asphaltene in crude oil in this study. The screening approaches were investigated in detail, as done for the experimental results obtained from them. The factors regulating the asphaltene precipitation are different fr

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Publication Date
Sun May 15 2022
Journal Name
Al-kindy College Medical Journal
Assessment of Nurses’ Knowledge, Attitude, and Practices on Antibiotic Use and Resistance in Baghdad: A single-hospital study
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Background: There are so many evidences that there was antimicrobial resistance, and there were many strains that emerged which were difficult to treat. We are living in a situation that the dissemination of multiple drug resistant bacteria can lead us to the situation, in which no treatment could be offered for bacterial infection in future.

Aim of study: Assessment of nurses’ knowledge, attitude, and practices on antibiotic use and resistance in Fatima Al Zahra hospital in Baghdad.

Subjects and Methods:  A cross-sectional study. The study was carried on from 1st of February to 31st of March 2021.  A questionnaire was constructed by the research team based on literature review and was adapted to asses

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Enhancing Nitrate Ion Removal from Water using Fixed Bed Columns with Composite Chitosan-based Beads
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    Water contamination is a pressing global concern, especially regarding the presence of nitrate ions. This research focuses on addressing this issue by developing an effective adsorbent for removing nitrate ions from aqueous solutions. two adsorbents Chitosan-Zeolite-Zirconium (Cs-Ze-Zr composite beads and Chitosan-Bentonite-Zirconium Cs-Bn-Zr composite beads were prepared. The study involved continuous experimentation using a fixed bed column with varying bed heights (1.5 and 3 cm) and inlet flow rates (1 and 3 ml/min). The results showed that the breakthrough time increased with higher bed heights for both Cs-Ze-Zr and Cs-Bn-Zr composite beads. Conversely, an increase in flow rate led to a decrease in breakthrough time. Notab

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Publication Date
Thu Dec 01 2022
Journal Name
Ieee Transactions On Human-machine Systems
Myoelectric Control With Fixed Convolution-Based Time-Domain Feature Extraction: Exploring the Spatio–Temporal Interaction
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Publication Date
Sat Jan 01 2022
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science (ijeecs)
Increasing validation accuracy of a face mask detection by new deep learning model-based classification
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During COVID-19, wearing a mask was globally mandated in various workplaces, departments, and offices. New deep learning convolutional neural network (CNN) based classifications were proposed to increase the validation accuracy of face mask detection. This work introduces a face mask model that is able to recognize whether a person is wearing mask or not. The proposed model has two stages to detect and recognize the face mask; at the first stage, the Haar cascade detector is used to detect the face, while at the second stage, the proposed CNN model is used as a classification model that is built from scratch. The experiment was applied on masked faces (MAFA) dataset with images of 160x160 pixels size and RGB color. The model achieve

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