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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 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Treatability influence of municipal sewage effluent on surface water quality assessment based on Nemerow pollution index using an artificial neural network
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Abstract<p>Assessing water quality provides a scientific foundation for the development and management of water resources. The objective of the research is to evaluate the impact treated effluent from North Rustumiyia wastewater treatment plant (WWTP) on the quality of Diyala river. The model of the artificial neural network (ANN) and factor analysis (FA) based on Nemerow pollution index (NPI). To define important water quality parameters for North Al-Rustumiyia for the line(F2), the Nemerow Pollution Index was introduced. The most important parameters of assessment of water variation quality of wastewater were the parameter used in the model: biochemical oxygen demand (BOD), chemical oxygen dem</p> ... Show More
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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 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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Publication Date
Wed Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Adherence and Beliefs to Adjuvant Hormonal Therapy in Patients with Breast Cancer: A Cross-Sectional Study (Conference Paper) #
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  Breast cancer is the most common cancer among women over the world. To reducing reoccurrence and mortality rates, adjuvant hormonal therapy (AHT) is used for a long period. The major barrier to the effectiveness of the treatment is adherence. Adherence to medicines among patients is challenging. Patient beliefs in medications can be positively or negatively correlated to adherence. Objectives: To investigate the extent of adherence and factors affecting adherence, as well as to investigate the association between beliefs and adherence in women with breast cancer taking AHT. Method: A cross-sectional study included 124 Iraqi women with breast cancer recruited from Middle Euphrates

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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
Thu Jan 31 2019
Journal Name
Journal Of Engineering
Enhancement in Lubricating, Rheological, and Filtration Properties of Unweighted Water-Based Mud Using XC Polymer NPs
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In this research, an enhancement in lubricating, rheological, and filtration properties of unweighted water-based mud is fundamentally investigated using XC polymer NPs with 0.2gm, 0.5gm, 1gm, 2gm, and 4gm concentrations. Bentonite, that had been used in the preparation of unweighted water-based mud, was characterized using XRF-1800 Sequential X-ray Fluorescence Spectrometer, XRD-6100/7000 X-ray Diffractometer, and Malvern Mastersizer 2000 particle size analyzer, respectively. Lubricating, rheology and filtration properties of unweighted water-based mud were measured at room temperature (35°C) using OFITE EP and Lubricity Tester, OFITE Model 900 Viscometer, and OFITE Low-Pressure Filter Press, respectively. XC Polymer N

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Publication Date
Tue Oct 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Dental arches dimensions, forms and its association to facial types in a sample of Iraqi adults with skeletal and dental class II-division 1 and class III malocclusion(A cross sectional study)
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Background: The association between facial types and dental arches forms has considerable implications in orthodontic diagnosis and treatment planning. The aim was to establish the maxillary and mandibular dental arches width and length in skeletal and dental class II division 1 and class III malocclusion groups, find out the most frequent dental arch form and facial type and the association between them and to check the gender differences. Materials and Methods: Frontal and lateral facial photographs and maxillary and mandibular occlussal photographs for 90 iraqi subjects with age 18-25 years old (45 males and 45 females) divided equally into three groups, the 1st group with class II division 1malocclusion (overjet more than 3mm but less t

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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
Sun Apr 17 2016
Journal Name
Al-academy
Stimuli effectiveness of teaching aids in the development of the technical capacity of secondary school students in the technical configuration items: ليلى شويل حسين
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The importance of culture moot ( visual ) in the community , serves as the conceptual basis for the technical and aesthetic awareness , as all the fields of art represents a kind of social consciousness can not be separated from the practice of performance and awareness of it. That the link between what you do image that expresses the cognitive aspects and performance , and what is reflected on the receiver by turning the event into a set of symbols and meanings that have a correlation relationship to society , education, and other fields. Therefore must provide " material conditions and psychological " that helps the learner to interact effectively and with the active elements of the learning environment in the classroom and gain

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Publication Date
Sun Sep 01 2019
Journal Name
African Journal Of Hospitality, Tourism And Leisure
Effect of Employees' Abilities on Successful ICT Application and Sustainable Development Goals: a Descriptive Study in hospitality Organizations in Iraq
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The aim of this study is to evaluate the implementation of ICT applications in public service organizations, which is responsible for the implementation of public policy. The study examined the success of ICT in achieving its goals by meeting the main needs of the community members which is the first requirement in the success of sustainable development plans before determine the capabilities of ICT. The main pillar of success in the implementation of ICT systems is the key to improving the efficiency of the organization's performance. This is a reflection of the effectiveness and quality of the services provided to its beneficiaries. The study concluded that the current level of capabilities of individuals working in public organizations i

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