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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 Oct 19 2026
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Iraqi Journal Of Agricultural Sciences
EFFECT OF TILLAGE WITH CHISEL PLOW ON SOIL MEAN WEIGHT DIAMETER AND POROSITY
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Fri Nov 01 2024
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Egyptian Journal Of Veterinary Sciences
Contamination with Proteus and Staphylococcus spp. Effect on Physical Properties of Sheep Semen
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This study was designed to determine the effect of bacterial contamination degree and type with Proteus mirabilis alone and Staphylococcus aureus alone and mixed of them species in ejaculation samples of fertile ram semen during storage quality. Semen was collected from six healthy mature rams using electro-ejaculator method, once a week, for the period 1/12/2022 to 1/2/2023. PH, motility (mass and individual), live sperm percentage and abnormal acrosomes of sperms were studied. Isolation and identification of Proteus mirabilis and Staphylococcus aureus species viable bacterial was recorded with routine bacterial detection work and molecular using PCR technique. Semen samples were divided into four groups: Group 1 (G1) was used as control w

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Wed Jun 02 2021
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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 Dec 18 2019
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Baghdad Science Journal
A Modified Approach by Using Prediction to Build a Best Threshold in ARX Model with Practical Application
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The proposal of nonlinear models is one of the most important methods in time series analysis, which has a wide potential for predicting various phenomena, including physical, engineering and economic, by studying the characteristics of random disturbances in order to arrive at accurate predictions.

In this, the autoregressive model with exogenous variable was built using a threshold as the first method, using two proposed approaches that were used to determine the best cutting point of [the predictability forward (forecasting) and the predictability in the time series (prediction), through the threshold point indicator]. B-J seasonal models are used as a second method based on the principle of the two proposed approaches in dete

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Publication Date
Sun Dec 21 2025
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International Journal On Humanities And Social Sciences
Motivation-based Human Needs and their Disclosure Prompts in Chris Cleave’s Little Bee
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The present work folds two qualitative objectives; the first focuses on investigating the multiplicity of motivation-based human needs in Little Bee. The second objective involves examining the linguistic forms adopted to disclose such needs. Consequently, the researchers are to adapt eclectically Alderfer's Existence, Relatedness, and Growth Theory (1969) and Langacker’s theory of Domains (1987) together with his Active Zone Operation (1991). Such a study helps to embody the connectivity between the social and psychological aspects, and the way these two aspects are disclosed using particular linguistic The study has concluded that Bee needed Alderfer’s basic human needs: existence, relatedness, and growth. Besides, satisfying

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Fri Dec 01 2017
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2017 11th Asian Control Conference (ascc)
ESO-based repetitive control for rejecting periodic and aperiodic disturbances in piezoelectric actuators
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This paper presents the Extended State Observer (ESO) based repetitive control (RC) for piezoelectric actuator (PEA) based nano-positioning systems. The system stability is proved using Linear Matrix Inequalities (LMIs), which guarantees the asymptotic stability of the system. The ESObased RC used in this paper has the ability to eliminate periodic disturbances, aperiodic disturbances and model uncertainties. Moreover, ESO can be tuned using only two parameters and the model free approach of ESO-based RC, makes it an ideal solution to overcome the challenges of nano-positioning system control. Different types of periodic and aperiodic disturbances are used in simulation to demonstrate the effectiveness of the algorithm. The comparison studi

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Sat Jun 01 2024
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Design and optimization of a household photovoltaic/thermal collector with serpentine tube: Energy and exergy analysis
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Publication Date
Thu Jun 29 2023
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Prediction of Hydraulic Flow Units for Jeribe Reservoir in Jambour Oil Field Applying Flow Zone Indicator Method
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The Jeribe reservoir in the Jambour Oil Field is a complex and heterogeneous carbonate reservoir characterized by a wide range of permeability variations. Due to limited availability of core plugs in most wells, it becomes crucial to establish correlations between cored wells and apply them to uncored wells for predicting permeability. In recent years, the Flow Zone Indicator (FZI) approach has gained significant applicability for predicting hydraulic flow units (HFUs) and identifying rock types within the reservoir units.    This paper aims to develop a permeability model based on the principles of the Flow Zone Indicator. Analysis of core permeability versus core porosity plot and Reservoir Quality Index (RQI) - Normalized poros

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Wed Feb 01 2017
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Journal Of Economics And Administrative Sciences
Evaluating the performance of inspectors general offices in reducing corruption According to global indicators(Field research comparative)
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Abstract

        This research aims to evaluate the application of the inspectors general of global indicators offices according to the axles (leadership, strategy and planning, employees, partners and resources, process management) and through the assumption main research which states that (there is an application for global indicators to evaluate performance in the offices of the ministries under study) which are subdivided into five sub-hypotheses according to the classification and division of the five axes of the checklist.

The researchers have taken refuge in the process of assessing the performance of the check list which included global i

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Crossref
Publication Date
Tue Jan 01 2013
Journal Name
Journal Of College Of Education
The Construction of Complete (k, n)-arcs in 3-Dimensional Projective Space Over Galois Field GF (4)
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In this work, we construct the projectively distinct (k, n)-arcs in PG (3, 4) over Galois field GF (4), where k 5, and we found that the complete (k, n)-arcs, where 3 n 21, moreover we prove geometrically that the maximum complete (k, n)-arc in PG (3, 4) is (85, 21)-arc. A (k, n)-arcs is a set of k points no n+ 1 of which are collinear. A (k, n)-arcs is complete if it is not contained in a (k+ 1, n)-arcs