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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
Tue Jan 01 2019
Journal Name
International Journal Of Agricultural And Statistical Sciences
Effect of foliar spraying with gibberellic and humic acid on wheat growth
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Publication Date
Thu Oct 15 2026
Journal Name
Opción: Revista De Ciencias Humanas Y Sociales, Issn 1012-1587, Nº. 89, 2019
The effectiveness of employing the molecular representation strategy in the development of information Generation skills in the chemistry of second grade students in Intermediate School
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Autoría: Jehan Faris Yousif. Localización: Opción: Revista de Ciencias Humanas y Sociales. Nº. 89, 2019. Artículo de Revista en Dialnet.

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Scopus
Publication Date
Sun Dec 30 2018
Journal Name
Modern Sport
Management of wisdom and its relationship to the effectiveness of strategic decisions among members of the boards of faculties of physical education and sports sciences in the universities of Iraq
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The management of wisdom is concerned with the level of expertise, methods of transmission, use and ability to problems and their impact on behavior and human behavior in order to improve it in the form of successful decisions. The importance of management of wisdom in making successful decisions that ensure the survival and development of society through the provision of leaders capable of planning, organization and decision-making to achieve the goals and objectives required in a complex and changing environment. Where the administration faces positions and problems that require operational decisions to organize the activities of the institution in line with the strategic decisions already taken under the proper strategic planning. The ex

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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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Publication Date
Mon Oct 01 2018
Journal Name
International Journal Of Civil Engineering And Technology (ijciet)
Effluent quality assessment of Al-Diwaniyah sewage treatment plant based on wastewater quality index
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Treated effluent wastewater is considered an alternative water resource which can provide an important contribution for using it in different purposes, so, the wastewater quality is very important for knowing its suitability for different uses before discharging it into fresh water ecosystems. The wastewater quality index (WWQI) may be considered as a useful and effective tool to assess wastewater quality by indicating one value representing the overall characteristic of the wastewater. It could be used to indicate the suitability of wastewater for different uses in water quality management and decision making. The present study was conducted to evaluate the Al-Diwaniyah sewage treatment plant (STP) effluent quality based on wastewa

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Publication Date
Wed Jan 01 2014
Journal Name
International Journal Of Computer Applications
Mobile Position Estimation based on Three Angles of Arrival using an Interpolative Neural Network
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In this paper, the memorization capability of a multilayer interpolative neural network is exploited to estimate a mobile position based on three angles of arrival. The neural network is trained with ideal angles-position patterns distributed uniformly throughout the region. This approach is compared with two other analytical methods, the average-position method which relies on finding the average position of the vertices of the uncertainty triangular region and the optimal position method which relies on finding the nearest ideal angles-position pattern to the measured angles. Simulation results based on estimations of the mobile position of particles moving along a nonlinear path show that the interpolative neural network approach outperf

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Publication Date
Sat Mar 29 2014
Journal Name
International Journal Of Academic Research In Progressive Education And Development
The Effects of Problem-Based Learning on Self-Directed Learning Skills among Physics Undergraduates
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The aim of this study is to compare the effects of three methods: problem-based learning (PBL), PBL with lecture method, and conventional teaching on self-directed learning skills among physics undergraduates. The actual sample size comprises of 122 students, who were selected randomly from the Physics Department, College of Education in Iraq. In this study, the pre- and post-test were done and the instruments were administered to the students for data collection. The data was analyzed and statistical results rejected null hypothesis of this study. This study revealed that there are no signifigant differences between PBL and PBL with lecture method, thus the PBL without or with lecture method enhances the self-directed learning skills bette

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Publication Date
Fri Dec 23 2011
Journal Name
International Journal Of The Physical Sciences
Fast prediction of power transfer stability index based on radial basis function neural network
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Publication Date
Sun May 28 2017
Journal Name
Ibn Al-haitham Jour. For Pure & Appl. Sci
Synthesis of Some New Heterocyclic Fused Rings Compounds Based on 5-Aryl-1,3,4-Oxadiazole
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The work includes synthesis and characterization of some new heterocyclic compounds, as flow: The compound (3) (5-(4-chlorophenyl) -2-hydrazinyl-1,3,4-oxadiazole was synthesized by using two methods; the first method includes the direct reaction between hydrazine hydrate 80% and 5-(4-chlorophenyl)-2- (ethylthio) 1,3,4-oxadiazole (1), the second method involves converting 5-(4-chlorophenyl)-1,3,4-oxadiazol-2-amine (2) to diazonium salt then reducing this salt to compound (3) by stannous chloride. Compound (3) was used as starting material for synthesizing several fused heterocyclic compounds. The compound 6-(4- chlorophenyl)[1,2.4] triazolo [3,4,b][1,3,4] oxadiazole-3-(2H) thione (compound 4) was synthesized from the reaction of compo

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