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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 03 2021
Journal Name
Journal Of Global Trends In Pharmaceutical Sciences
A REVIEW: CEFPODOXIME PROXETIL (DOXEF. PROXETIL) DISCOVERY, PREPARATION, APPLICATIONS AND COMPARISON WITH CEFPODOXIME- CLAVULANIC ACID IN ACTIVITY
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Publication Date
Mon Jun 01 2009
Journal Name
Al-khwarizmi Engineering Journal
Effect of Adding Alcohols and Gas Velocity on Gas Hold up and Mass Transfer Coefficient in Bubble Columns with Draught Tube
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     The bubble columns are widely used as a two or three phase reactor in industrial chemical process such as absorption, biochemical reactions, coal liquefaction, etc. To design such a column, two main parameters should be taken in consideration, the gas hold-up (), and the liquid phase mass transfer coefficient KLa. The study includes the effect of gas velocity and the addition of alcohols on gas hold-up and mass transfer coefficient in bubble column with draught tube when the length of the column is 1.5m and the ratio of the draught tube diameter to the column diameter equals 0.5 and the air dispersion into the base of the draught tube using a multi hole tuyere is equivalent to a diameter of 0.15 mm and

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Polymorphism study of MTHFR 677C?T and its correlation with oxidative stress and their influence on female infertility in Erbil – Iraq
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This research includes a study of Methylenetetrahydrofolate reductase gene’s allele 677C?T and its correlation with oxidative stress and their impact on female infertility. Fifty infertile women with the range age (23-42) years and twenty five fertile women with the range age (22-39) years as control group living in Erbil city were selected. The serum level of Malondialdehyde (MDA), superoxide dismutase (SOD), prolactin hormone (PRL), Luteinizing hormone (LH), Thyroid stimulating hormone (TSH), Triiodothyronine hormone (T3), and Thyroxine hormone (T4) were measured, also a body mass index (BMI) was calculated. A restriction enzyme (Hinf1) was used to improve the mutation in DNA bands of infertile women. The results showed significant inc

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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
Fri Dec 01 2023
Journal Name
Baghdad Science Journal
In vivo evaluation the efficiency of nitazoxanide with cationic Gemini surfactant on Cryptosporidiosis
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Infection with cryptosporidiosis endangers the lives of many people with immunodeficiency, especially HIV patients. Nitazoxanide is one of the main therapeutic drugs used to treat cryptosporidiosis. However, it is poorly soluble in water, which restricts its usefulness and efficacy in immunocompromised patients. Surfactants have an amphiphilic character which indicates their ability to improve the water solubility of the hydrophobic drugs. Our research concerns the synthesis of new cationic Gemini surfactants that have the ability to improve the solubility of the drug Nanazoxide. So, we synthesized cationic Gemini surfactants. N1,N1,N3,N3-tetramethyl-N1,N3-bis(2-octadecanamidoethyl)propane-1,3-diaminium bromide (CGSPS18) and 2,2‘-(etha

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Publication Date
Wed May 01 2024
Journal Name
Structures
Efficiency of self-prestressing Fe-based shape memory alloys on shear strengthening of high-strength RC beams: experimental and numerical investigation
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Publication Date
Sun Feb 28 2021
Journal Name
Journal Of Economics And Administrative Sciences
The effect of innovation and modernization as an approach to strategic change in the efficiency of organizational performance Field research in the Oil Projects Company (SCOP(
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The purpose of this research is to improve the organizational performance of the Oil Projects Company by adopting an approach to strategic change، and finding appropriate solutions to the problems facing the company. The researcher adopted in designing his research by conducting a survey of previous literature that dealt with approaches to strategic change، as the results of the survey showed that most researchers agree on the approach of renewal and modernization، Which formed a starting point for the researcher to identify the extent of the company's management interest in renewal and modernization to improve its level of performance، and the quality of the procedures followed on the ground that is related to

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Publication Date
Sat Aug 08 2026
Journal Name
Scientific Reports
Enhancement of selecting the cluster head based on the voting mechanism and Elliptic Curve Cryptography for Wireless Sensor Networks (ECHVM)
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Abstract<p> The Wireless Sensor Networks (WSNs), which are deployed in harsh environments, are extremely susceptible to localized battery exhaustion as well as intelligent inside routing threats, especially sinkhole and data falsification attacks. In this paper, we present ECHVM (Enhanced Cluster Head selection by Voting and an ECC-based Blockchain Mechanism), a novel, secure, and energy-efficient routing framework to achieve an optimal trade-off between network security and hardware resource efficiency. We present the ECHVM protocol that combines Elliptic Curve Cryptography (ECC) with a lightweight, local distributed ledger to mitigate risks of centralized authority by tr</p> ... Show More
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Publication Date
Sun Mar 03 2013
Journal Name
Baghdad Science Journal
The ability of Pisum sativum plant to use tricalcium super phosphate (TSP) in the presence and absence of mycorrhizal fungi under field conditions
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Efficiency of Pisum sativum plants in using tricalcium super phosphate (TSP) in presence and absence of mycorrhizal fungi was evaluated in the field experiment in College of Science / Al-Mustansiriyah University. The experiment comprised of (6) treatments prepared from the interaction of two levels of inoculation [non-inoculation with fungus F0 and inoculation with Glomus mosseae fungus (F1)]. And three levels of phosphorus: 0,20,40 Kg P/ha. The experimental size was (1x2)m. Irrigation and hand-weeding were done when needed. The following plant measurements were recorded: (Shoots dry weight, concentration of N and P% in addition to percentage of root infection with mycorrhizal fungi at flowering 50% of plants. The re

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Publication Date
Fri May 01 2020
Journal Name
Iraqi Geological Journal
DETERMINATION OF PORE TYPES AND POROSITY TRENDS USING OF VELOCITY-DEVIATION LOG FOR THE CARBONATE MISHRIF RESERVOIR IN HALFAYA OIL FIELD, SOUTHEAST IRAQ
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