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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
Wed Jun 02 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Identification of microflora associated with dust falling on Karbala province and seasonal distribution
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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Impact of Preparing HMA with Modified Asphalt Cement on Moisture and Temperature Susceptibility
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Many researchers tried to prevent or reduce moisture damage and its sensitivity to temperature to improving the performance of hot mix asphalt because it is decreasing the functional and structural life of fixable pavement due to the moisture damage had exposed to it.

The main objective of this study is to inspect the effect of (fly ash “3%, 6%, 12%”, hydrated lime”5%, 10%, 20%” and silica fumes”1%, 2%, 4%) referring to previous research by the net weight asphalt cement as a modified material on the moisture and temperature sensitivity of hot mix asphalt. This was done using asphalt from AL-Nasiria refinery with penetration grade 40-50, nominal maximum size (12.5) mm (surface course) of aggregate and on

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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
Fri Jan 01 2021
Journal Name
Journal Of Mechanical Engineering Research And Developments
Effect of Circular Turbulators on Heat Transfer in A Square Duct
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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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Publication Date
Mon Jan 02 2017
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of the structural model of learning in the acquisition of geographical concepts among students of the first grade average)
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The current research aims to find out ( the effectiveness of the structural model of learning in the acquisition of geographical concepts at the first grade average students ) , and achieving the goals of research has been formulating the null hypothesis of the following :

    " There is no difference statistically significant when Mistoi (0.5 ) between the mean scores of the collection of students in the experimental group that is studying the general geographical principles " Bonmozj constructivist learning " and the mean scores of the control group , which is considering the same article ," the traditional way " to acquire concepts.

The researcher adopted th

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Women's Self-care Instructions concerning Wound, Perineal & Urinary System Care post cesarean section in Baghdad teaching hospital
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Aim: to determine the effectiveness of women's self-care instructions on their post cesarean section care in Baghdad
teaching hospital.
Methodology: The present study used quasi-experimental study design in maternity words in Baghdad teaching
hospital. The sample was collected and follow up for the period (15) January 2014 until 15 May 2014 Nonprobability
(purposive sample) of (100) women post cesarean section divided in to two groups (50) women post
cesarean section considered as a study group, and another (50) women post cesarean section considered as the
control one, A questionnaire designed as a tool to collect data fit the purpose of the study a questionnaire include
demographic variables, Reproductive variables

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Publication Date
Wed Jan 02 2019
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of an Educational Unit According To the Constructive Strategy in Developing Thinking Skills for Fifth Primary Students
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    The current phase distinguish by the rapid scientific development, which pushes individuals to have the necessities of scientific and practical life through the proper scientific thinking which contribute to the development of invention and creativity away from memorizing and indoctrination and encouraging individuals to looking for information and then attempting to process and develop these information instead of being a passive receiver. The investment of minds becomes the logical investment in all societies by preparing the citizen to become able to face life changes and its necessities. It is very important to take care of individuals and develop their mental abilities and thinking skills. The constructive strateg

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Publication Date
Sun Jun 30 2024
Journal Name
Modern Sport
Evaluating the Effectiveness of Using the Kinesthetic Teaching Style by Basketball Instructors in Practical Lessons from the Students' Perspective
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Advancements and modernizations introduced into the educational and pedagogical systems have significantly impacted teaching processes and how subjects are presented and explained to students. The focus has shifted to how learners interact with the material they need to learn, providing sufficient opportunities for learning and granting them freedom and self-confidence to achieve learning objectives. The research problem stems from the researcher's experience as a lecturer in the College of Physical Education and Sports Science, particularly in teaching basketball. She observed that some instructors were deficient in using the most effective teaching methods. The researcher formulated her research question based on these observations: "What

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