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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 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
Wed Sep 18 2024
Journal Name
World Academy Of Sciences Journal
Impact of gene expression of NFE2L2 on serum superoxide dismutase and hemeoxygenase‑1 levels in patients with type 2 diabetes and retinopathy
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Publication Date
Sat Apr 25 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
A Questionnaire-Based Survey Assessment of Iraqi Dentists Using Repair Versus Replacement of Defective Composite Restoration
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Tooth restoration one of the most common procedures in dental practice. The replacement of the entire restoration leads to loss of tooth structure and increase risk of pulp injury; replacement is also time consuming and costly. According to the minimally invasive approach when minimal defects, repair is the better choice than the total replacement of the restoration. This study aims to evaluate repair rating versus replacement treatment procedure for defective composite fillings among Iraqi dentists. Material and methodology: A questionnaire survey were designed and distributed to 184 post-graduate dentists in Iraq. The inquiry pertained general information; including their clinical experience in years, their preference in terms of direct c

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating Training Programs According to model Kirkpatrick / field research in the Health Maysan Directorate .
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This present paper aim at knowing  the process of evaluating the training program that could be applied  in Maysan Health office  for it significance and importance in field of management and vocational staff  preparations  of high  scientific experience in different fields of  Health.  The society of research includes staffs  working in Maysan Health Office  , of specialists ,  dentists, pharmacists, laboratories, nursing  and administrators. Their number is 100 employees, the researcher has designed questionnaire by depending on "Kirkpatrick"  for assessing  the training . The researcher has used   thorough survey and has entailed 90 questionnaire,

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Publication Date
Thu Apr 09 2020
Journal Name
International Journal Of Agricultural And Statistical Sciences
Host plant resistance, chili pepper to whitefly, Bemisia tabaci (gennadius) (Hemiptera: Aleyrodidae) in field
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A field study was conducted in Al-Khalis district, Diyala Governorate in 2019 to test the sensitivity of three varieties of pepper to the population density of the whitefly B. tabaci, Anaheim pepper, Aleppo and local variety, and the results showed that the Anaheim variety was the most infested with the whitefly density 4.08 whitefly/ leaf and then the local variety 2.7 whitefly/ leaf. The lowest population density was 1.25 whitefly/ leaf of Aleppo variety. Variety Aleppo also recorded the lowest percentage of whitefly infection B. tabaci of 39.22%, but not have significant differences in the percentage of whitefly infestation, as it reached 53.64% and 54.85% for the Anaheim and local varieties, respectively. The resistance of variety Alepp

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Publication Date
Mon Jul 07 2025
Journal Name
Oxidation Communication
ANAPLASTIC LYMPHOMA KINASE EXPRESSION AND OTHER MARKERS AS A PROGNOSTIC BIOMARKER IN FEMALE PATIENTS WITH BREAST CANCER
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Breast cancer is among the primary causes of death among Iraqi women and is a serious worldwide health concern. ALK or anaplastic lymphoma kinase, is connected to several cancers, including breast cancer.. The goal of this research was to assess the prevalence of anaplastic lymphoma kinase (ALK) with Alkaline phosphatise (ALP) and Lactate dehydrogenase (LDH) together as diagnostic markers. The study comprised 60 patients with metastatic breast cancer and 60 healthy volunteers. The blood levels of the enzymes (ALP), (LDH), and ALK in Iraqi breast cancer patients are compared to those of healthy controls. It was shown that compared to healthy people, patients had breast cancer noticeably greater levels of ALK, ALP, and NDH .These biomarkers m

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed rad

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Publication Date
Sat Jan 01 2011
Journal Name
Journal Of Engineering
MIXED CONVECTION PHENOMINA AFFECTED BY RADIATION IN A HORIZONTAL RECTANGULAR DUCT WITH COCENTRIC AND ECCENTRIC CIRCULAR CORE
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The numerical investigation has been performed to study the radiation affected steady state laminar mixed convection induced by a hot inner varied positions circular core in a horizontal rectangular channel for a fully developed flow. To examine the effects of thermal radiation on thermo fluid dynamics behavior in the eccentric geometry channel, the generalized body fitted co-ordinate system is introduced while the finite difference method is used for solving the radiative transport equation. The governing equations which used are continuity, momentum and energy equations. These equations are normalized and solved using the Vorticity-Stream function. After validating numerical results for the case without radiation, the detailed radiatio

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Publication Date
Tue Jun 28 2022
Journal Name
Research Journal Of Pharmacy And Technology
A Case-control Study to Determine Metalloproteinase-12 and Lysyl Oxidase Levels in Iraqi women with Osteoporosis
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The current study aimed to ascertain the levels of matrix metalloproteinase-12 (MMP-12) and Lysyl oxidase (LOX) in osteoporosis patients and their correlation with alkaline phosphatase (ALP), magnesium (Mg), vitamin D (Vit D), calcium (Ca), phosphorus (P), and T-score %. 110 participants recruited from Baghdad Teaching Hospital, Iraq, were enrolled in this study from November 2019 to March 2020). The participants were divided into two groups: Group 1 comprised 60 osteoporotic women and group 2 consisted of 50 healthy women. (MMP and LOX) were estimated using a quantitative enzyme-linked immunosorbent assay (ELISA. The results showed significant differences in serum LOX, age, ALP, Mg, and T-score %, while no significant differences i

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Publication Date
Sun Sep 22 2019
Journal Name
Baghdad Science Journal
A Molecular and Biochemical Study for Cholesteryl Ester Transfer Protein (CETP) Taq1B in Iraqi Patients with Hyperlipidemia
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Cholesteryl ester transfer protein gene contains some single nucleotide polymorphisms, which have been associated with serum high-density lipoprotein concentration and other lipoproteins. This study is done for determining of cholesteryl ester transfer protein polymorphism and evaluate its effect on serum lipid profile concentrations in some hyperlipidemic patients compared with healthy subjects in Salah Al-din governorate-Iraq. Blood samples were taken from (90) patients suffering from hyperlipidemia, and (70) samples that were apparently healthy controls.  Serum lipid concentrations were measured by enzymatic assays. The polymorphism was genotyped using polymerase chain reaction restriction fragment length polymorphism analysis.&n

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