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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
Tue Dec 31 2024
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of Human β-defensin-3 Diagnostic Role in a Group of Iraqi Patients with Osteoporosis
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Background: Osteoporosis (OP) is a prevalent age-related condition that increases the risk of fracture and bone fragility, as result loss of bone mass as well as micro-architectural degradation of the bone, thereby reducing the mass and strength of bone. Human β-defensin (HBD-3) is ananti-inflammatory peptide andcrucial part of the human innate immune system. Giving early therapeutic intervention for OP requires an early diagnosis. Objectives: To evaluate the serum HBD-3 accuracy of diagnosis in patients with osteoporosis. Methods: The study was conducted in the National Joint Center at Yarmouk Teaching Hospital in Baghdad during September - October 2023. Eighty participants were recruited, all of whom had clinical examinations an

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Publication Date
Wed Dec 30 2015
Journal Name
Journal Of Chemical, Biological And Physical Sciences
Prevalence of Autoimmune Thyroid Disorders in a Sample of Iraqi Infertile Women with Polycystic Ovary Syndrome
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The present study aims to estimating the prevalence of autoimmune thyroid disorders in Iraqi infertile women with polycystic ovary syndrome (PCOS). Eighty-five Iraqi women, with age range (19-45) years, were divided into three groups; first group included 33 women with PCOS; second group included 30 women without PCOS; while third group included 22 fertile women as controls. The clinical data [age, body mass index (BMI), and menstrual status] have been recorded. Blood samples were collected to determine the levels of reproductive hormones [estradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH)]; and thyroid hormones [triiodothyronine (T3) and thyroxin (T4)]. Also, autoimmune thyroid antibodies assessment h

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Publication Date
Sun Dec 20 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Form a proposal to audit the mutual operations with related parties program in accordance with international standards: Proposal pattern
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The relationships between the related parties constitute a normal feature of trading and business processes. Entities may perform parts of their activities through subsidiary entities, joint ventures and associate entities. In these cases, the entity has the ability to influence the financial and operating policies of the investee through control, joint control or significant influence,  So could affect established knowledge of transactions and balances outstanding, including commitments, and relationships with related to the evaluation of its operations by users of financial statements, including the risks and opportunities facing the entity assess the parties. So research has gained importance of the importance of the availability

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Publication Date
Sat Aug 10 2024
Journal Name
American Journal Of Economics And Business Innovation
Factors Associated with Employees’ Intention to Leave in ICT Sector in Iraq: A Factor Analysis
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The current paper aims to identify potential factors associated with employees’ intentions to leave information and communication technology companies in Iraq. There is evident variability in the literature regarding these factors; hence, a factor analysis approach was employed to identify these factors within the surveyed environment. Due to the difficulty in precisely delineating the size of the research population, a purposive sampling method was employed to reach an appropriate number of respondents within the aforementioned companies. A total of 288 employees responded to the survey conducted via Google Forms. The test results revealed the presence of five primary factors associated with employees’ intentions to leave, name

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Levothyroxine Therapy Adequacy, Dose Estimation and Vitamin D Effect Assessment in a Sample of Iraqi Female Patients with Different Causes of Hypothyroidism
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Exogenous levothyroxine dose modulation and euthyroidism achievement is a persistent challenge in clinical settings. This study strives to assess the adequacy of treatment and identify the patients’ factors that can be used to estimate the euthyroid levothyroxine dose. A secondary objective was to assess vitamin D supplementation impact on thyroid status.

A review of a prospectively collected information from 142 female patients from Baghdad Center of Nuclear Medicine from June 2019 until March 2020 who were receiving levothyroxine for different causes was done. After a follow-up period, the patients’ thyroid tests were assessed and the euthyroid doses for each cause category were statistically analyzed. Thyroid function was

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Publication Date
Mon Jul 06 2026
Journal Name
Modern Sport
Design and standardization of two scoring tests for the initial selection of people with simple mental disabilities in five-a- Side Soccer
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The five-a- Side Soccer for simple mental disability is as interesting and caring as many other sporting events. Therefore, the researchers believe that their basic skills tests are compatible with then level of the tested individuals in terms of age and mental ability. As a means of selecting those who are qualified to practice this game in a simple way, the problem of research has been identified in the design and standardization of two scoring skills that belong to this category and are approved by the training staff during the initial selection process. The research community is determined by people with mental disabilities who belong to the governmental and private institutes and the Special Olympics Union in Baghdad and for the year 2

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Prevalence of bacteria isolated from patients with burn infection at a burn hospital in Baghdad and study of their antimicrobial susceptibility patterns
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Background: The skin functions as a barrier to the external environment, damage to this barrier following a burn disrupts the innate immune system and increases susceptibility to bacterial infection. Objective: This study was carried out to determine the bacterial isolates and study their antimicrobial susceptibility in burned wound infections at one burn's hospital in Baghdad.Type of study:Cross-sectional study.Methods: The bacteria were identified at species level by using Analytic Profile Index (API) system and The antimicrobial susceptibility test was performed according to Kirby-Bauer (disk diffusion) technique.Results: Over a period of one year (from October 2014 to October 2015). Out of 848 patients with different degrees of burns

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Publication Date
Mon Jul 06 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of light curing tip distance on the curing depth of bulk fill resin based composites
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Background: This in vitro study measure and compare the effect of light curing tip distance on the depth of cure by measuring vickers microhardness value on two recently launched bulk fill resin based composites Tetric EvoCeram Bulk Fill and Surefil SDR Flow with 4 mm thickness in comparison to Filtek Z250 Universal Restorative with 2 mm thickness. In addition, measure and compare the bottom to top microhardness ratio with different light curing tip distances. Materials and Method: One hundred fifty composite specimens were obtained from two cylindrical plastic molds the first one for bulk fill composites (Tetric EvoCeram Bulk Fill and Surefil SDR Flow) with 4 mm diameter and 4 mm depth, the second one for Filtek Z250 Universal Restorative

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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
Thu Feb 01 2018
Journal Name
Italian Journal Of Pure And Applied Mathematics
A note on s-acts and bounded linear operators
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