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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
Thu Apr 15 2010
Journal Name
International Journal Of Poultry Science
Effect of Dietary Supplementation with Different Oils on Productive and Reproductive Performance of Quail
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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The annual regulations r0le in achieving justice in tax accounting in the field of income tax: Applied Research in the General Commission of Taxes
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The research gets its importance through the importance of the annual regulations in the taxation accounting and its efficiency  to fulfill accounting justice under the effect of  the financial changes and the truth of the activity of the taxable businesses .This through the problem of the research which is found in many objections about taxation accounting according to the annual regulations issued by the General Commission of Taxes , Their aim is to get the real benefits and to decrease the difference in opinions during the estimation to fulfill justice in distributing the burden of taxation .

The research expose many conclusions and recommendations  namely , the taxation justice fulfillment is not only in justic

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Publication Date
Mon Dec 31 2012
Journal Name
Al-khwarizmi Engineering Journal
Genetic Algorithm Based PID Controller Design for a Precise Tracking of Two-Axis Piezoelectric Micropositioning Stage
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 In this paper, an intelligent tracking control system of both single- and double-axis Piezoelectric Micropositioner stage is designed using Genetic Algorithms (GAs) method for the optimal Proportional-Integral-Derivative (PID) controller tuning parameters. The (GA)-based PID control design approach is a methodology to tune a (PID) controller in an optimal control sense with respect to specified objective function. By using the (GA)-based PID control approach, the high-performance trajectory tracking responses of the Piezoelectric Micropositioner stage can be obtained. The (GA) code was built and the simulation results were obtained using MATLAB environment. The Piezoelectric Micropositioner simulation model with th

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Publication Date
Thu Nov 01 2018
Journal Name
Computers &amp; Fluids
Assessing moment-based boundary conditions for the lattice Boltzmann equation: A study of dipole-wall collisions
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Publication Date
Tue Feb 13 2018
Journal Name
Journal Of Optics
Solar selective performance of metal nitride/oxynitride based magnetron sputtered thin film coatings: a comprehensive review
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Publication Date
Thu Apr 03 2025
Journal Name
Journal Of The American Oil Chemists' Society
A novel deep eutectic solvent‐based liquid membrane for the extraction of glycerol from crude biodiesel
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Abstract<p>This study used deep eutectic solvent (DES) as the liquid membrane in a bulk liquid membrane system (BLM) to remove glycerol from waste cooking oil‐based biodiesel. The DES was prepared from choline chloride and tetraethylene glycol at a molar ratio of 1:5. Diethyl ether was employed as a novel strip phase for the glycerol in BLM. The effects of the DES: biodiesel ratio, stirring speed, and extraction time on the extraction and stripping efficiencies were investigated. The results showed that BLM could give better glycerol removal from biodiesel than mechanical shaking. Increasing the DES: biodiesel ratio, stirring speed, and extraction time can enhance glycerol removal from the feed phase, achievi</p> ... Show More
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Publication Date
Sun Jun 01 2008
Journal Name
Baghdad Science Journal
Laboratory study on the effects of nutrient enrichment on a phytoplankton population in Sawa Lake, Iraq
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Nutrient enrichment of Sawa lake water was made using different nitrogen and phosphorus concentrations during autumn and spring at three stations. Different concentrations of nitrogen, phosphorus and N: P ratios were used to test variations in phytoplankton population dynamics. Nitrogen at a concentration of 25 µmole.l-1 and N: P ratio of 10:1 gave highest phytoplankton cell number at all stations and seasons. A total of 64 algal taxa dominated by Bacillariophyceae followed by Cyanophyceae and Chlorophyceae were identified. The values of Shannon index of diversity were more than one in the studied stations.

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Publication Date
Thu Oct 01 2020
Journal Name
Biochemical And Cellular Archives
Study on the effect of methotraxate drug on Retinol-Binding Protein 4 (RBP4), nesfatin and some trace elements in Iraqi male patients with rheumatoid arthritis
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Methotrexate (MTX) is one of the most effective medications to treat rheumatoid arthritis (RA).Aserum of 60 Iraqi male patients suffering from RA as (G1) was newly diagnosis and the same patient in G1 after taking MTX as G2 and 40 Iraqi male healthy control as G3. Nesfatin-1 (Nf-1) is belong to the adipokine family withpleiotropic effect. Nf-1 has been found in different tissues, including stomach, pancreas, bone cells, cartilage and heart. Retinol binding protein (RBP4) was known as transpoter of retinol from its storage sites in the liver to the extrahepatic tissues. Moreover, RBP4 acts as adipokine and contributes in the pathophsyology of prototypic inflammatory disease, rheumatoid arthritis (RA). The results showed a significant increas

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Publication Date
Thu Jan 01 2026
Journal Name
Open Veterinary Journal
Effect of intravaginal probiotics and enrofloxacin on vaginal microbiota, pH, vaginitis, and fertility in black Iraqi goats synchronized with progesterone impregnated sponges
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Background: The prolonged retention of progesterone-infused intravaginal sponges in estrous synchronization protocols, results in alteration of vaginal microflora, disturbance of vaginal pH, and increased vaginitis in goats. These changes lead to the growth of opportunistic pathogenic bacteria, such as Escherichia coli and Staphylococcus aureus, which need antibiotics to treat this condition. Probiotics have recently been suggested as an alternative method for the maintenance of vaginal health and improving animal fertility. Aim: To investigate the effects of probiotics (Lactobacillus plantarum and L. acidophilus), in compared with enrofloxacin and a control group, on vaginal microflora, vaginal pH, vaginitis incidence, and fertility in

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Publication Date
Wed Dec 01 2021
Journal Name
Journal Of Physics: Conference Series
Analytical Study of the Royal-Jelly Effect on Sperms Morphological Characteristics and some Liver Function Parameters and their Correlation with some Antioxidants in Male Albino Rats Treated with Pregabalin Drug
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Abstract<p>In recent years, the consideration of natural products as anti-inflammatory and antioxidative treatments has more interested worldwide. Moreover, natural products are easily obtained and are relatively safe the Royal jelly (RJ) is one of them. The current study was carried to evaluate the effects of pregabalin (PGB) on physiological activity of sperms, reproductive hormones assay and some biochemical analysis. Forty (40) male albino rats (10-weeks-old) were divided into four groups (10 rats each): G1 (treated with PGB drug, 150 mg/kg B.wt (Lyrica-Pfizer-Pharmaceutical Industries), G2 (treated with RJ 1g/kg), G3 (treated with PGB drug and RJ together), and G4 control treated with norma</p> ... Show More
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