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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 Jan 01 2024
Journal Name
Oncology And Radiotherapy
Comparting study of cytokeratin 18 fragment M65 with CA19-9 and CEA as a biomarker in Iraqi colon cancer patients
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Publication Date
Wed Aug 31 2022
Journal Name
F1000research
Inflammatory markers in patients who presented with acute coronary syndrome and history of COVID-19 infection: a cross-sectional study
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Background: During the COVID-19 outbreak, the number of patients who have developed acute coronary syndromes (ACS) has soared rapidly, cardiovascular disease and mortality are influenced by the elevated inflammatory biomarkers. The aim of this study is to compare inflammatory markers between patients with ACS who hadn’t previously had COVID-19 and those who’d be infected within the preceding three months; as well as, evaluating the effect of statins on inflammatory biomarkers.

Methods: This is a comparative cross-sectional study of 42 patients who presented with ACS and had previously had COVID-19 and 48 patient who had never had CO

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Publication Date
Sat Mar 30 2013
Journal Name
Mathematical Problems In Engineering
CFD analysis of Heat transfer and friction factor characteristics in a circular tube fitted with Quadrant-cut twisted tape inserts
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Publication Date
Fri Sep 15 2023
Journal Name
Bionatura
A comparison of VCAM-1 and ICAM-1 as atherosclerosis risk factors in patients with systemic lupus erythematosus from Iraq
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All major organs may be impacted by the connective disease systemic lupus erythematosus, a separate risk factor for coronary artery disease (CAD). Adhesion molecules like intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM) can detect endothelial damage and dysfunction, which appear to play a crucial role. This study investigated whether people with SLE had elevated subclinical and clinical atherosclerosis risk factors. Traditional CAD risk factors such as smoking, hypertension, and hyperlipidemia cannot entirely explain this elevation. It is thought that immunological dysfunction also increases CAD risk in SLE patients. The study aimed to assess early endothelial changes in SLE Iraqi female patients w

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Publication Date
Sun Jun 10 2018
Journal Name
Annals Of Clinical And Analytical Medicine
Lead among children with autism in Iraq. Is it a potential factor?
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Abstract Aim: Autism is a neurodevelopmental disorder which affects communication and social interaction of children. It is a heterogeneous disease with various clinical presentations. Some genes are involved in its pathogenesis. It has been suggested that environmental exposure to lead can increase the risk of autism. The aim of our study was to compare blood lead levels among autistic and non-autistic children. Material and Method: This retrospective study included 107 children (60 with autism and 47 without autism) referred from the different Iraqi provinces, in the years 2015, 2016 and 2017, to the poisoning consultation center in Baghdad. Data collection including age, gender, residence, referral source, family history and blood lead l

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Publication Date
Sun Jan 01 2023
Journal Name
Česká A Slovenská Farmacie
Hyperferritinemia as a factor associated with poor prognosis in COVID-19 patients
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Worldwide, hundreds of millions of people have been infected with COVID-19 since December 2019; however, about 20% or less developed severe symptoms. The main aim of the current study was to  assess  the  relationship  between  the  severity of Covid-19 and different clinical and laboratory parameters. A total number of 466 Arabs have willingly joined this prospective cohort. Out of the total number, 297 subjects (63.7%) had negative COVID-19 tests, and thus, they were recruited as controls, while 169 subjects (36.3%) who tested positive for COVID-19 were enrolled as cases. Out of the total number of COVID-19 patients, 127 (75.15%) presented with mild symptoms, and 42 (24.85%) had severe symptoms. The age range for the partic

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Publication Date
Sun Nov 02 2025
Journal Name
Nursing Science Quarterly
Managing Anger in Persons With Substance Use Disorders: A Global Nursing Perspective
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The management of anger is problematic for many people and it is a particularly important issue for persons with substance use disorders (SUD). The paper reviews the research studies dating back to 2005 on how to help persons with SUD manage anger. The literature reveals that various pharmaceutical and non-pharmacological approaches have been studied to help persons with SUD manage their anger. In chronic and lower risk situations non-pharmacological are the first line approaches, they include anger management training, cognitive-behavioral based treatments, exercising and relaxing, music therapy and empathy. Atypical antipsychotic and medications for opioid use disorders (MOUD) are also widely used. In acute and high risk of violen

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Publication Date
Fri Nov 01 2019
Journal Name
Civil Engineering Journal
Time-Cost-Quality Trade-off Model for Optimal Pile Type Selection Using Discrete Particle Swarm Optimization Algorithm
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The cost of pile foundations is part of the super structure cost, and it became necessary to reduce this cost by studying the pile types then decision-making in the selection of the optimal pile type in terms of cost and time of production and quality .So The main objective of this study is to solve the time–cost–quality trade-off (TCQT) problem by finding an optimal pile type with the target of "minimizing" cost and time while "maximizing" quality. There are many types In the world of piles but  in this paper, the researcher proposed five pile types, one of them is not a traditional, and   developed a model for the problem and then employed particle swarm optimization (PSO) algorithm, as one of evolutionary algorithms with t

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
Assessment of Pro Hepcidin and Related with Iron Profile on Hemodialysis Men Patients
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Patients with renal failure in the final stages undergo the treatment by hemodialysis. Hemodialysis is used to reinstate the intracellular and extracellular fluid environment, by propagation of molecules in solution through a semipermeable membrane along an electrochemical concentration gradient. Blood catching in the dialysis machine and the recurrent phlebotomy may lead to losing about 1-3 g of iron per year. Prohepcidin hormone is an acute phase protein (type II) that plays a major role in the systemic iron irregularities as it is a mediator of anemia in inflammation and regulator of iron metabolism. This study aims to evaluate the effect of hemodialysis on iron hemostasis and its relationship with prohepcidin as an inflammatory mark

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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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