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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
Tue Oct 30 2018
Journal Name
Al-kindy College Medical Journal
The Effectiveness of Calcaneal Drilling for Treatment of Resistance Cases of Plantar Heel Pain
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Background: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders. Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome. Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and AlWassity Hospitals. Result: Drilling of the calcaneum is a simple procedure achieving 70.6% cure in resistant as

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Publication Date
Sun Jun 09 2019
Journal Name
Al-kindy College Medical Journal
The Effectiveness of Calcaneal Drilling for Treatment of Resistance Cases of Plantar Heel Pain
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Background: Plantar heel pain is a clinical syndrome characterized by pain and tenderness beneath the heel which is typically worse in the morning and improves after the first few steps in the day. It is a common and frequently disabling clinical complaint that may be caused by a broad spectrum of osseous or soft tissue disorders.

Objective: To evaluate the effectiveness of an operation of multiple drilling of calcaneum for resistant plantar heel pain syndrome.

Methods: During the period from November 2012 to August 2016, 17 patients (17heels) were enrolled in a cohort clinical study at the orthopedic unit in AL-Sheikh Zayed and Al-Wassity Hospitals.

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Publication Date
Wed Sep 01 2021
Journal Name
Euphrates Journal Of Agriculture Science
A survey study on artificial fraud and thickeners in local and imported cream and yogurt that available in Baghdad city
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The current study aimed to detect artificial fraud in chemical additives (formalin, hydrogen peroxide) and to detect thickeners (starch) in imported and local dairy products and to determine their suitability for human consumption due to the high demand for their consumption by members of society, 20 samples of products were collected The local and imported milk in the Iraqi markets of the city of Baghdad consisted of 10 samples of yoghurt and 10 samples of cream. The tests were carried out, which were the detection of chemicals and additive thickeners such as formalin, hydrogen peroxide and starch, respectively, as well as the examination of the microbial load, which included the detection of colon bacteria, yeasts and molds, and the resul

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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
Wed Jun 27 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Cluster Analysis Approach to Identify Rock Type in Tertiary Reservoir of Khabaz Oil Field Case Study
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Rock type identification is very important task in Reservoir characterization in order to constrict robust reservoir models. There are several approaches have been introduced to define the rock type in reservoirs and each approach should relate the geological and petrophysical properties, such that each rock type is proportional to a unique hydraulic flow unit. A hydraulic flow unit is a reservoir zone that is laterally and vertically has similar flow and bedding characteristics. According to effect of rock type in reservoir performance, many empirical and statistical approaches introduced.  In this paper Cluster Analysis technique is used to identify the rock groups in tertiary reservoir for Khabaz oil field by analyses variation o

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Well Performance Following Matrix Acidizing Treatment: Case Study of the Mi4 Unit in Ahdeb Oil Field
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The productivity of oil wells may be improved by determining the value of enhancing well productivity and the likely reasons or sources of formation damage after the well has been recognized as underperforming. Oil well productivity may be improved, but the economics of this gradual improvement may be compromised. It is important to analyze the influence of the skin effect on the recovery of the reserve.    The acid treatment evaluated for the well AD-12, primarily for the zone Mi4;  using a license of Stimpro Stimulation Software to validate the experimental work to the field scale, this software is considered the most comprehensive instrument for planning and monitoring matrix acid treatments and utilizing actual data to provide a far

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Publication Date
Fri Dec 30 2022
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Well Performance Following Matrix Acidizing Treatment: Case Study of the Mi4 Unit in Ahdeb Oil Field
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The productivity of oil wells may be improved by determining the value of enhancing well productivity and the likely reasons or sources of formation damage after the well has been recognized as underperforming. Oil well productivity may be improved, but the economics of this gradual improvement may be compromised. It is important to analyze the influence of the skin effect on the recovery of the reserve.

   The acid treatment evaluated for the well AD-12, primarily for the zone Mi4;  using a license of Stimpro Stimulation Software to validate the experimental work to the field scale, this software is considered the most comprehensive instrument for planning and monitoring matrix acid treatments and utilizing actual data to prov

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Crossref (3)
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Publication Date
Tue Jun 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The impact of the empowerment strategy in the employees performance by mediating organizational trust (Field res
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The research aims to measure the impact of the empowerment strategy on the performance of employees by mediating organizational trust in the organization. The problem of research was the weak ability of most business organizations to employ the strategy of empowerment in maximizing the performance of employees, and the importance of research in practice lies in the results of a guide to managers in how to use the strategy of empowerment in maximizing the performance of employees by mediating organizational trust dimensions of ability, benevolence, integrity. In order to achieve the objectives of the research and to answer the questions of the problem, the researcher has adopted the descriptive analytical approach as the questionnaire was

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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 May 03 2020
Journal Name
Journal Of Advanced Laboratory Research In Biology
Hepatitis B Virus (HBV): A Review on its Prevalence and Infection in different areas of Iraq
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