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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
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Factors Associated with Anemia in A sample of Pregnant Women Attending Primary Health Centers
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Objective (s): To determine proportion of anemia among sample of Pregnant women. To identify factors
associated with the anemia (Maternal age, maternal education, gestational age, parity, gravidity, birth
interval, smoking, taking iron supplements and dietary habits).
Methodology: A cross-sectional study conducted at Al- washash & Bab-almoadham primary health care
centers. The sample was selected by (non-probability convenient sampling) and sample size was (550).
The study started from 1st March 2011 to 30th of March 2012. The data was collected by direct interview
using special questionnaire to obtained socio-demographic information.
Results: the result shows that mean age of the subjects was 26.5± 7.5 years, 8

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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
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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Crossref
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)
Crossref
Publication Date
Sun Nov 27 2022
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Extent of auditors' commitment to the quality control system according to the Iraqi Audit guide / 7 : A field study of a sample of auditors of the second district audit office In the The Federal Financial Supervision Board
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The research aims to achieve a set of objectives, the most important of which is determining the extent to which the auditors of the research sample in the Federal Bureau of Financial Supervision adhere to the requirements of the quality control system according to the Iraqi Audit Manual No. The federal financial / research sample with the quality control system according to the Iraqi audit guide No. 7), and the researcher seeks to test the main research hypothesis and sub-hypotheses, and to achieve this, a questionnaire was designed by (Google Form) and distributed electronically to the elements of the research sample, Through the statistical package program (SPSS), the results of the questionnaire were analysed. In light of the applied

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
Evaluation of the Organic-Pollution Based on the Determination of some Polycyclic Aromatic Hydrocarbons(PAHs) in Tigris River Water in 2012 at Baghdad City , Iraq
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This study aims to predict the organic pollution produced from the presence of some polycyclic aromatic hydrocarbons (PAHs) and determination it's concentrations (µg/L , ppb) in Tigris river water by a collection twenty-seven water samples from a selected three stations with nine sampling sites and three depths of water (5 cm , 2 m and 4 m) each site for 4.6 km distance of a geographic studied area which is located between the ( Al-Senak and AL-Sarrafiah bridges ) at Baghdad city – Iraq on May, 2012. The geographic location was determined with a Global Positioning System (GPS) and Geographic Information System (GIS) software program. The concentrations of fourteen components (PAHs) were performed using the reverse phase

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Crossref (1)
Crossref
Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Employment cost management tools in the fast-track method Of the constructionindustries for the purpose of rationalizing costs: An applied research in the Shatt al-Diwaniya transference project General Authority for projects of irrigation and reclamation
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The important factor in the success of construction projects is its ability to objective estimate of the cost of the project and adapt to the changes of the external environment, which is affected by a lot of elements and the requirements of the competitive environment. The faces of those projects are several problems in order to achieve particular goals. To overcome these difficulties has been the development of research in the last two decades and turn the focus on the role of the cost of project management, by providing information and assist management in planning and control of the budget among the main elements of the project, namely, (time-cost-quality),The research aims at the possibility of developing and implementing mechanisms

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Crossref
Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Impact of Cognitive Behavior Program Based on Meichenbaum Theory in Reducing the Negative Emotional Sensitivity among the Intermediate Stage Students
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The aim of this research is to construct a cognitive behavior program based on the theory of Meichenbaum in reducing the emotional sensitivity among Intermediate school students. To achieve the aims of the research, two hypotheses were formulated and the experimental design with equal groups was chosen. The population of research and its sample are determined. The test of negative emotional sensitivity, which is constructed by the researcher, was adopted. The test contains (20) items proved validity and reliability as a reliable test by presenting it to a group of arbitrators and experts in education and psychology. An educational program is constructed based on the theory of Meichenbaum. The test was applied to a sample of (60) second i

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Publication Date
Fri Sep 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Geological Model of Khasib Reservoir- Central Area/East Baghdad Field
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The Geological modeling has been constructed by using Petrel E&P software to incorporate data, for improved Three-dimensional models of porosity model, water saturation, permeability estimated from core data, well log interpretation, and fault analysis modeling.

Three-dimensional geological models attributed with physical properties constructed from primary geological data. The reservoir contains a huge hydrocarbon accumulation, a unique geological model characterization with faults, high heterogeneity, and a very complex field in nature.

The results of this study show that the Three-dimensional geological model of Khasib reservoir, to build the reservoir model starting with evaluation of reservoir to interpretation o

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