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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 Oct 01 2022
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The Egyptian Journal Of Hospital Medicine
Study on Some Parameters and Anti-Rubella Igg in A Sample of Systemic Lupus Erythematosus Patients
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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
A comparative study of stylistic kriging and Co - kriging Multivariate on the barley crop in Iraq
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  This paper deals  the prediction of the process of  random spatial data of two properties, the first is called  Primary variables  and the second is called secondary  variables ,   the method  that were used in the  prediction process for this type  of data is technique Co-kriging  , the method is usually used when the number of primary variables  meant to predict for one of its elements is measured in a particular location a few (because of the cost or difficulty of obtaining them) compare with secondary variable which is the number of elements  are available and  highly correlated with primary variables, as was the&nbs

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Publication Date
Fri Oct 16 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Assessment of Salivary Leptin and Resistin Levels in Type Two Diabetic Patients with Chronic Periodontitis (A Comparative Study)
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Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in eac

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Publication Date
Sun Apr 20 2025
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Irisin Level in Iraqi Patients with Type 2 Diabetes and Pre-Diabetes Status as a Predictive Factor
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      The prevalence of diabetes is increasing rapidly and is now recognized as a significant global health problem. Diabetes occurs when a person does not produce enough insulin due to an imbalance in insulin production. This can lead to the failure of organs and tissues such as the kidneys, heart, blood vessels, eyes, nerves, and kidneys. As a result, early diagnosis and classification of type 2 diabetes mellitus (T2DM) are critical to aiding physician assessments. Subsequently, the current study aims to determine irisin levels in patients with T2DM and pre-DM as early predictors for disease cases. The current study included 138 subjects divided into three groups based on fasting blood glucose (FBG) and glycosylated hemoglobi

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Publication Date
Wed Dec 31 2025
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Determination of Matrix Metalloproteinase 10 and Fetuin-A Levels as Excellent Predictive Factors in Iraqi Patients with Diabetic Nephropathy
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Background: Diabetic nephropathy (DN) is a significant contributor to end-stage renal failure in individuals with type 2 diabetes mellitus (T2DM). Diabetic nephropathy is characterized by tubular atrophy, glomerular dilation, glomerulosclerosis, interstitial fibrosis, and proteinuria, resulting in deterioration of kidney function. DN, primarily caused by hyperglycemia, accounts for millions of deaths globally and is the leading cause of end-stage renal disease. Matrix metalloproteinase 10 is an enzyme essential for the breakdown of extracellular matrix constituents. Fetuin-A forms soluble complexes with calcium and phosphate to prevent soft tissue mineralization Objectives: To determine the levels of Matrix Metalloproteinase 10 and

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Publication Date
Thu May 12 2011
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Iraqi Journal Of Medical Science
A comparative study between the side effects of copper intrauterine device in women with non-scarred and scarred uterus
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Wed Jan 01 2020
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Plant Archives
A novel finding of il-9 genetic polymorphism (rs17317275) and serum level in rheumatoid arthritis patients infected with CMV
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Fri Jul 01 2022
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Publication Date
Fri Jul 12 2013
Journal Name
Journal Of Biosciences
A functional connection of Dictyostelium paracaspase with the contractile vacuole and a possible partner of the vacuolar proton ATPase
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Publication Date
Wed Mar 30 2022
Journal Name
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Comparing Some Methods of Estimating the Parameters and Survival Function of a Log-logistic Distribution with a Practical Application
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The Log-Logistic distribution is one of the important statistical distributions as it can be applied in many fields and biological experiments and other experiments, and its importance comes from the importance of determining the survival function of those experiments. The research will be summarized in making a comparison between the method of maximum likelihood and the method of least squares and the method of weighted least squares to estimate the parameters and survival function of the log-logistic distribution using the comparison criteria MSE, MAPE, IMSE, and this research was applied to real data for breast cancer patients. The results showed that the method of Maximum likelihood best in the case of estimating the paramete

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