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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
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Using the Google Classroom Educational Platform in Teaching Mathematics Curricula from the Teachers' Point of View
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The study aims to find out the effectiveness of using the Google classroom educational platform in teaching mathematics curricula from the viewpoint of teachers in the Governorate of Al Dhahirah, Sultanate of Oman. The researcher adopted the descriptive-analytical approach. To collect the needed data, a questionnaire of two dimensions was used. It includes (13) items to measure the effectiveness of using the Google classroom in teaching mathematics curricula from the teacher's point of view and includes (10) items to measure the difficulties of using the Google classroom in teaching mathematics curricula from the teachers' point of view. These tools were applied to (32) male and (31) female as the study sample. They represent mathematics

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Publication Date
Tue Feb 27 2024
Journal Name
Mathematical Modelling Of Engineering Problems
Dynamics of a Fractional-Order Prey-Predator Model with Fear Effect and Harvesting
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Publication Date
Thu Jun 27 2024
Journal Name
Malaysian Journal Of Mathematical Sciences
Dynamics of a Social Model for Marriage and Divorce Relationship with Fear Effect
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The objective of this article is to delve into the intricate dynamics of marriage relationships, exploring the impact of emotions such as fear, love, financial considerations and likability. In our investigation, we adopt a perspective that acknowledges the nonlinear nature of interactions among individuals. Diverging from certain prior studies, we propose that the fear element within the context of marriage is not a singular, isolated factor but rather a manifestation resulting from the amalgamation of numerous social issues. This, in turn, contributes to the emergence of strained and unsuccessful relationships. Unlike conventional approaches, we extensively examine the conditions essential for the existence of all socially signifi

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Publication Date
Mon Jul 01 2024
Journal Name
Journal Of Engineering
Design and Implementation of a Microstrip Six-Port Reflectometer (SPR) with Enhanced Bandwidth
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A compact microstrip six-port reflectometer (SPR) with extended bandwidth is proposed in this paper. The design is based on using 16-dB multi-section coupled line directional couplers and a multi-section 3-dB Wilkinson power divider operating from 1 to 6 GHz. The proposed SPR employs only two calibration standards: a matched load and an open load. As compared to other dielectric substrates, fabricating the proposed SPR involves using a low-cost (FR4) substrate. A novel algorithm is also proposed to estimate the complex reflection coefficient over the frequency ranges at which the standard performance of the circuit components is not fully satisfied. The new algorithm is based on the circles’ intersection points, which have been de

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Publication Date
Mon Feb 23 2026
Journal Name
Baghdad Science Journal
Preparation, Characterization, and Antimicrobial Evaluation of a Cefepime Derivative with Divalent Transition Metals
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Publication Date
Thu Jun 20 2019
Journal Name
Baghdad Science Journal
Taxonomy of Memory Usage in Swarm Intelligence-Based Metaheuristics
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Metaheuristics under the swarm intelligence (SI) class have proven to be efficient and have become popular methods for solving different optimization problems. Based on the usage of memory, metaheuristics can be classified into algorithms with memory and without memory (memory-less). The absence of memory in some metaheuristics will lead to the loss of the information gained in previous iterations. The metaheuristics tend to divert from promising areas of solutions search spaces which will lead to non-optimal solutions. This paper aims to review memory usage and its effect on the performance of the main SI-based metaheuristics. Investigation has been performed on SI metaheuristics, memory usage and memory-less metaheuristics, memory char

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Publication Date
Tue Feb 28 2023
Journal Name
Applied System Innovation
Earthquake Hazard Mitigation for Uncertain Building Systems Based on Adaptive Synergetic Control
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This study presents an adaptive control scheme based on synergetic control theory for suppressing the vibration of building structures due to earthquake. The control key for the proposed controller is based on a magneto-rheological (MR) damper, which supports the building. According to Lyapunov-based stability analysis, an adaptive synergetic control (ASC) strategy was established under variation of the stiffness and viscosity coefficients in the vibrated building. The control and adaptive laws of the ASC were developed to ensure the stability of the controlled structure. The proposed controller addresses the suppression problem of a single-degree-of-freedom (SDOF) building model, and an earthquake control scenario was conducted and simulat

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Publication Date
Fri Jul 03 2026
Journal Name
Journal Of Advanced Research Design
Sustainable Leaf Plant Disease Based on Salp Swarm Algorithm for Feature Selection
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Sustainable plant protection and the economy of plant crops worldwide depend heavily on the health of agriculture. In the modern world, one of the main factors influencing economic growth is the quality of agricultural produce. The need for future crop protection and production is growing as disease-affected plants have caused considerable agricultural losses in several crop categories. The crop yield must be increased while preserving food quality and security and having the most negligible negative environmental impact. To overcome these obstacles, early discovery of satisfactory plants is critical. The use of Advances in Intelligent Systems and information computer science effectively helps find more efficient and low-cost solutions. Thi

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Publication Date
Sat Dec 01 2018
Journal Name
2018 Third Scientific Conference Of Electrical Engineering (scee)
An Intelligent Cognitive System Design for Mobile Robot based on Optimization Algorithm
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Publication Date
Wed Sep 07 2022
Journal Name
2022 Iraqi International Conference On Communication And Information Technologies (iiccit)
Construct an Efficient DDoS Attack Detection System Based on RF-C4.5-GridSearchCV
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