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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
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 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
Wed Oct 21 2026
Journal Name
University Of Anbar Sport And Physical Education Sciences
Anxiety and its relationship to the performance of the front hand hop followed by an anterior spherical flip with a half lap on the jumping platform
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Publication Date
Fri Aug 27 2021
Journal Name
Journal Of Craniofacial Surgery
The Effects of Local Alendronate With or Without Recombinant Human Bone Morphogenetic Protein 2 on Dental Implant Stability and Marginal Bone Level: A Randomized Controlled Study
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The aim of this study was to evaluate the effects of local application of bisphosphonate gel and recombinant human bone morphogenic protein 2 gel, on titanium dental implant stability and marginal bone level. Twenty-seven patients with upper and lower missing posterior tooth/teeth were included in the study with a total of 71 implants that were used for rehabilitation. The implants were randomly divided into 4 groups: 3 study groups and 1 control. Group1; local application of bisphosphonate gel, group 2; local application of recombinant human bone morphogenic protein 2 gel, group 3; local application of a mixed formula of both gels. The gel application was immediately preimplant insertion, group 4; implant insertion without application of a

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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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Scopus
Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation The Efficiency And Effectiveness of The Iraq stock Exchange -An Empirical Study From July 2004 to March 2008–
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 The aim of this study was to provide an overall assessment to the efficiency of the Iraq stocks exchanges (ISE) through specifying well –known models .First, Fama's efficient market hypothesis as a contrary concept to the random walk hypothesis, was performed and it has been found that ISE follows the random process, so the price of the shares can't be predicated on the basis of past information. Second,we use a multifactor model, which so named multiple regression, to explore the link between ISE  and the main economic indicators. our empirical analysis finds that every weak associations exists between major ISE measures and main economic indicators.

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Publication Date
Mon Nov 05 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instruction-oriented Intervention for Primipara Women upon Episiotomy and Self-perineal Care at Ibn Al-Baladi Hospital
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Objective: To identify the effectiveness of instruction oriented intervention for primipara women upon episiotomy and self
perineal care.
Methodology: A quasi-experimental study was carried out to determine the effectiveness of instruction-oriented
intervention for primipara women upon episiotomy and self-perineal care. A purposive "non-probability" sample of (60)
primipara mothers was selected from Ibn AL-Balady Pediatric and Maternity Hospital, Al-russafa, Baghdad. The sample
has been divided into two groups; (30) primipara women who were considered as a study group, and another (30) primipara
women who were considered as a control one. The study group was exposed to an instruction-oriented intervention. While,
the

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Publication Date
Tue Mar 01 2016
Journal Name
Al-academy
The effectiveness of visual intelligence strategy in the collection of students in the Department of Art Education in the perspective material: أسامة حسن عبد علي الصفار
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Select the researcher discussed problem of asking the following : Do you use visual intelligence strategy effective in the collection of students in the Department of Art Education in the foreseeable material ? The research aims to " measure the effectiveness of the strategy in the collection of visual intelligence students in the Department of Art Education in the foreseeable material ". To verify the objective of this research was identify hypotheses zero to measure the level of achievement in the foreseeable material second grade students in the Department of Art Education - Faculty of Fine Arts . The population of the research students in the Department of Art Education / Faculty of Fine Arts at the University of Baghdad who are stud

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Publication Date
Wed Jun 30 2010
Journal Name
Al-kindy College Medical Journal
Re-evaluation of lunation of the activity of somantibacterial drugs against clinical isolates of Escherichia coli in al- najaf al- ashref governorate
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ackground: Escherichia coli is one of the most
important bacterial pathogen that can cause several
disease to human being . In our study we try to
investigate the sensitivity resistance pattern of
Escherichia coli against three antibiotics ( Amikacin,
Nalidixic acid and Cephalexin).
Methods: For this purpose we collected 51 clinical
isolates of Escherichia coli from stool and urine of
outpatient and inpatient patients from different wards
of AL-SADER Teaching Hospital in AL-NAJAF
AL-ASHRAf, IRAQ, and tested by culture and
sensitivity test .
Results: The results appeared that Amikacin show
the highest percentage of sensitivity ( 66.66 % ) ,
while Cephalexin show the lowest percentage of
sensiti

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Publication Date
Thu Mar 25 2021
Journal Name
Modern Sport
The effect of physical exertion training using a vertimax device in developing the characteristic strength with speed and the skill of shooting by jumping in front - high with the hand ball for youth
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The research problem has crystallized and in light of these capabilities, the level of performance depends on the application of modern training methods based on actual experimentation, and those methods aim to develop the components of achievement in this competition, including the quantities of exerting the distinctive strength with speed for the arms and feet, which reflects on good skillful performance because the skill of shooting by jumping forward and high forms A major role in achieving goals during the competition that qualifies the team to win, and through the follow-up of the researcher in the field and academic field, I noticed that there is a weakness in some physical abilities, which affects performance and skill level

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