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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
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instruction-oriented Intervention for Primipara Women upon Episiotomy and Self-perineal Care at Ibn Al-Baladi Hospital
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Objective: To identify the effectiveness of instruction oriented intervention for primipara women upon episiotomy and self
perineal care.
Methodology: A quasi-experimental study was carried out to determine the effectiveness of instruction-oriented
intervention for primipara women upon episiotomy and self-perineal care. A purposive "non-probability" sample of (60)
primipara mothers was selected from Ibn AL-Balady Pediatric and Maternity Hospital, Al-russafa, Baghdad. The sample
has been divided into two groups; (30) primipara women who were considered as a study group, and another (30) primipara
women who were considered as a control one. The study group was exposed to an instruction-oriented intervention. While,
the

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation The Efficiency And Effectiveness of The Iraq stock Exchange -An Empirical Study From July 2004 to March 2008–
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 The aim of this study was to provide an overall assessment to the efficiency of the Iraq stocks exchanges (ISE) through specifying well –known models .First, Fama's efficient market hypothesis as a contrary concept to the random walk hypothesis, was performed and it has been found that ISE follows the random process, so the price of the shares can't be predicated on the basis of past information. Second,we use a multifactor model, which so named multiple regression, to explore the link between ISE  and the main economic indicators. our empirical analysis finds that every weak associations exists between major ISE measures and main economic indicators.

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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Relational leadership and its effect on organizational energy (A comparative study in the Rafidain and Rashid banks)
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This research aims to test the relationship between "relational leadership as an independent variable and organizational energy as a dependent variable. The current research variables are among the recent and important variables for the development of organizations, and for the purpose of explaining the relationship and influence between the variables, a set of goals has been formulated, including providing the interested and scientific and theoretical information explaining the nature of the variables The research, and the extent to which its causes are reflected in the research sample to increase the interest of the research organization’s organization and make it more appropriate to the required performance in light of a cha

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Publication Date
Wed Nov 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Replacing Formalin with Alcohol and its Effect on Preserved Fish Specimens
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Abstract<p>This study aims to formulate an alternative solution for Formalin for preserving fish as study specimens for long periods. The main reason for finding a solution instead of formalin is to get rid of the negative effects of this solution on those who work with it, as well as to better preserve the bodies of fish. Hence, three new solutions were proposed to replace formalin. Thus, Formalin, in turn, may enter the composition of a small part of these solutions to give better results and for long periods of keeping specimens. All solutions prepared in this study participated in being acidic as in formalin. Two solutions succeeded in compensating for the use of formalin in preserving fish </p> ... Show More
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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
The effectiveness of visual intelligence strategy in the collection of students in the Department of Art Education in the perspective material: أسامة حسن عبد علي الصفار
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Select the researcher discussed problem of asking the following : Do you use visual intelligence strategy effective in the collection of students in the Department of Art Education in the foreseeable material ? The research aims to " measure the effectiveness of the strategy in the collection of visual intelligence students in the Department of Art Education in the foreseeable material ". To verify the objective of this research was identify hypotheses zero to measure the level of achievement in the foreseeable material second grade students in the Department of Art Education - Faculty of Fine Arts . The population of the research students in the Department of Art Education / Faculty of Fine Arts at the University of Baghdad who are stud

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Publication Date
Thu Feb 13 2020
Journal Name
International Journal Of Environmental Research
Synthesis of a Novel Composite Sorbent Coated with Siderite Nanoparticles and its Application for Remediation of Water Contaminated with Congo Red Dye
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Abstract

Re-use of the byproduct wastes resulting from different municipal and industrial activities in the reclamation of contaminated water is real application for green projects and sustainability concepts. In this direction, the synthesis of composite sorbent from the mixing of waterworks and sewage sludge coated with new nanoparticles named “siderite” (WSSS) is the novelty of this study. These particles can be precipitated from the iron(II) nitrate using waterworks sludge as alkaline agent and source of carbonate. Characterization tests using X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) mapping revealed that the coating process was c

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Publication Date
Mon Nov 01 2021
Journal Name
Journal Of Engineering
Performance Evaluation of Pole Placement and Linear Quadratic Regulator Strategies Designed for Mass-Spring-Damper System Based on Simulated Annealing and Ant Colony Optimization
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This paper investigates the performance evaluation of two state feedback controllers, Pole Placement (PP) and Linear Quadratic Regulator (LQR). The two controllers are designed for a Mass-Spring-Damper (MSD) system found in numerous applications to stabilize the MSD system performance and minimize the position tracking error of the system output. The state space model of the MSD system is first developed. Then, two meta-heuristic optimizations, Simulated Annealing (SA) optimization and Ant Colony (AC) optimization are utilized to optimize feedback gains matrix K of the PP and the weighting matrices Q and R of the LQR to make the MSD system reach stabilization and reduce the oscillation of the response. The Matlab softwar

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Publication Date
Tue Aug 22 2023
Journal Name
Microbial Science Archives
Unveiling Westiellopsis akinetica: a novel species in the Iraqi habitat, and contrasting its distinctive attributes with Westiellopsis prolifica
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This is the first record of a new species of cyanobacteria Westiellopsis akinetica in the Iraqi environment, Samples were collected on June 2013 and the existence of it was not documented before. We isolated and purified this species ten years ago in Iraq, but we couldn't identify accurately based on all taxonomic handbooks. This is due to the species features being different from the other documented species in the available taxonomic lectures. It resembled many species by morphological characteristics such as Fischerella muscicola, Fischerella thermalis, Westiellopsis biateralis SA16. Westiellopsis interrupta, Westiellopsis persica SA33, Westiellopsis prolifica and Symphyonema bifilamentata. Describing a new species of the Westiellops

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Publication Date
Sat Sep 23 2023
Journal Name
Journal Of Cardiovascular And Thoracic Research
Plasminogen activator urokinase receptor as a diagnostic and prognostic biomarker in type 2 diabetic patients with cardiovascular disease
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Introduction: Cardiovascular diseases are the main cause of death among type 2 diabetic patients. Higher levels of plasminogen activator urokinase receptor have been found to predict morbidity and mortality across acute and chronic diseases in the common populace. This study aims to explore the role of serum plasminogen activator urokinase receptor levels as a cardiometabolic risk factor among type 2 diabetic Iraqi patients. Methods: Seventy type 2 diabetic patients (40 male and 30 female) (mean age: 46.20±7.56 years) participated in this study; 35 patients were with cardiovascular disease and 35 were without cardiovascular disease; their ages range was 40-55 years. In addition, 30 individuals who apparently healthy were selected a

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Basic Education
Beta-2-Microglobulin as a Biomarker in Iraqi Female Patients with Autoimmune Thyroid and Renal Autoimmune Thyroid Diseases
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The present study was performed on 80 female subjects between (30-60) years, who attended the Specialized Center for Endocrinology and Diabetes during the period from April to July; 2011. The subjects were divided into 3 groups : controls , non diabetic autoimmune thyroid patients , and non diabetic autoimmune thyroid patient with renal diseases as complication The results showed a significant increase in serum T 3 T4 levels in hyperthyroidism patients, and significant decrease in serum T3,T4 levels in hypothyroidism patients ,while a significant difference in serum TSH levels in hyperthyroidism and hypothyroidism patients when compared to control group The results show also a significant increase in serum antibodies to thyroid peroxidas

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