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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 Aug 23 2022
Journal Name
Frontiers In Energy Research
Evaluation of T-Shaped Fins With a Novel Layout for Improved Melting in a Triple-Tube Heat Storage System
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The effects of T-shaped fins on the improvement of phase change materials (PCM) melting are numerically investigated in vertical triple-tube storage containment. The PCM is held in the middle pipe of a triple-pipe heat exchanger while the heat transfer fluid flows through the internal and external pipes. The dimension effects of the T-shaped fins on the melting process of the PCM are investigated to determine the optimum case. Results indicate that while using T-shaped fins improves the melting performance of the PCM, the improvement potential is mainly governed by the fin’s body rather than the head. Hence, the proposed T-shaped fin did not noticeably improve melting at the bottom of the PCM domain; additionally, a flat fin is ad

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Laser
Plasmonic Nanoparticles Decorated Salty Paper Based on SERS Platform for Diagnostic low-Level Contamination: Lab on Paper
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In this research, a low cost, portable, disposable, environment friendly and an easy to use lab-on-paper platform sensor was made. The sensor was constructed using a mixture of Rhodamine-6G and gold nanoparticles also Sodium chloride salt. Drop–casting method was utilized as a technique to make a platform which is a commercial office paper. A substrate was characterized using Field Emission Scanning Electron Microscope, Fourier transform infrared spectroscopy, UV-visible spectrophotometer and Raman Spectrometer. Rh-6G Raman signal was enhanced based on Surface Enhanced Raman Spectroscopy technique utilized gold nanoparticles. High Enhancement factor of Plasmonic commercial office paper reaches up to 0.9 x105 because of local surface pl

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Publication Date
Tue Jul 01 2014
Journal Name
Ieee Transactions On Circuits And Systems I: Regular Papers
Crosstalk-Aware Multiple Error Detection Scheme Based on Two-Dimensional Parities for Energy Efficient Network on Chip
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Achieving reliable operation under the influence of deep-submicrometer noise sources including crosstalk noise at low voltage operation is a major challenge for network on chip links. In this paper, we propose a coding scheme that simultaneously addresses crosstalk effects on signal delay and detects up to seven random errors through wire duplication and simple parity checks calculated over the rows and columns of the two-dimensional data. This high error detection capability enables the reduction of operating voltage on the wire leading to energy saving. The results show that the proposed scheme reduces the energy consumption up to 53% as compared to other schemes at iso-reliability performance despite the increase in the overhead number o

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Publication Date
Sun Jan 04 2026
Journal Name
Iraqi Journal Of Biotechnology
The Frequency of Some Colibactin Genes Amongst the Clinical Strains of E. coli Isolated From Urinary Tract Infections in Iraq
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Escherichia coli has been recognized worldwide as the most common causative agent for severe infections of the urinary tract. Colibactin is a genotoxin produced through a gene cluster called polyketide synthase (pks) island by members of Enterobacteriaceae. Limited information is available about the frequency of colibactin in E. coli isolates in Iraq. Hence, this study aimed to examine the frequency of some colibactin genes (CIbA and CIbQ) in clinical isolates of E. coli obtained from urinary tract infections (UTIs) in Iraq. Between October 2023 and January 2024, 120 urine samples were collected from females diagnosed with UTIs in Iraqi hospitals. 70 E. coli isolates were isolated after identification by biochemical methods and confirmed by

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
A Note on the Hierarchical Model and Power Prior Distribution in Bayesian Quantile Regression
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  In this paper, we investigate the connection between the hierarchical models and the power prior distribution in quantile regression (QReg). Under specific quantile, we develop an expression for the power parameter ( ) to calibrate the power prior distribution for quantile regression to a corresponding hierarchical model. In addition, we estimate the relation between the  and the quantile level via hierarchical model. Our proposed methodology is illustrated with real data example.

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Publication Date
Wed Sep 20 2023
Journal Name
Journal Of Applied And Natural Science
Detection of some virulence genes (esp, agg, gelE, CylA) in Enterococcus faecalis isolated from different clinical cases at Baghdad
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The virulent genes are the key players in the ability of the bacterium to cause disease. The products of such genes that facilitate the successful colonization and survival of the bacterium in or cause damage to the host are pathogenicity determinants. This study aimed to investigate the prevalence of virulence factors (esp, agg, gelE, CylA) in E. faecalis isolated from diverse human clinical collected in Iraqi patient , as well as to assess their ability to form biofilm and to determine their haemolytic and gelatinase activities. Thirty-two isolates of bacteria Enterococcus faecalis were obtained, including 15 isolates (46.87%) of the urine, 6 isolates (18.75%) for each of the stool and uterine secretions, and 5 isolates (15.62%) of the wo

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Publication Date
Thu Dec 28 2023
Journal Name
Farmacia
LASMIDITAN NANOEMULSION BASED IN SITU GEL INTRANASAL DOSAGE FORM: FORMULATION, CHARACTERIZATION AND IN VIVO STUDY
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Publication Date
Fri Jul 03 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Radiographic follow up for clinical cases of mandibular implant retained overdenture MIR-OD
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Background: The use of osseointegrated fixtures in dentistry has been demonstrated both histologically and clinically to be beneficial in providing long term oral rehabilitation in completely edentulous individual. Most patients suffer from denture instability; particularly with mandibular prosthesis, the use of dental implant will be benefit significantly from even a slight increase in retention. The concept of implanting two to four fixtures in a bony ridge to retain a complete denture prosthesis appealing therefore, as retention, stability and acceptable economic compromise to the expanse incurred with the multiple fixture supported fixed prosthesis. Materials and methods in this study the sample were eight patients selected from a hosp

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Publication Date
Fri Nov 01 2019
Journal Name
Indian Journal Of Public Health Research & Development
Prevalence of β-lactam Resistant Klebsiella Pneumoniae Isolates among Clinical Specimensin Baghdad Hospitals
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One hundred forty three of Klebsiellapneumoniae isolates had been collected from some hospitals in Baghdad city. The isolates were taken from different clinical specimens.Antimicrobial susceptibility test was carried out towards fifteen antimicrobial agents by using Vitek2 system with Antimicrobial susceptibility test cards. The results of antibiogram showed that the local isolates were possess highly resistance towards most antimicrobial agents under study. The high resistance wastoAmpicillin while the low resistance was to Imipenem.Two methods were used for detection of Extended Spectrum Beta Lactamases (ESBLs) production; first methods by using of Vitek2 system,thesecondmethods by using of polymerase chain reaction (PCR) technique to dis

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Publication Date
Fri Jul 03 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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