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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 Mar 18 2024
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Inflammopharmacology
The effects of cholesterol and statins on Parkinson’s neuropathology: a narrative review
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Publication Date
Sun Jul 01 2012
Journal Name
Food Chemistry
High performance liquid chromatographic determination of aflatoxins in chilli, peanut and rice using silica based monolithic column
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A simple and rapid high performance liquid chromatographic with fluorescence detection method for the determination of the aflatoxin B1, B2, G1 and G2 in peanuts, rice and chilli was developed. The sample was extracted using acetonitrile:water (90:10, v/v%) and then purified by using ISOLUTE multimode solid phase extraction. After the pre-column derivatisation, the analytes were separated within 3.7 min using Chromolith performance RP-18e (100–4.6 mm) monolithic column. To assess the possible effects of endogenous components in the food items, matrix-matched calibration was used for the quantification and validation. The recoveries of aflatoxins that were spiked into food samples were 86.38–104.5% and RSDs were <4.4%. The method was

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Publication Date
Sat Jul 01 2023
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Iop Conference Series: Earth And Environmental Science
Effect of Stimulate of Sorghum Seeds with Banana Peel Extract and Citric Acid on Seeds Viability and Vigour
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Sorghum seeds suffer from a low germination ratio, so a factorial experiment was carried out in the Seed Technology Laboratory, Department of Field Crops, College of Agricultural Engineering Sciences, University of Baghdad during 2022 according to a Completely Randomized Design with four replications to study the effect of stimulating seeds with aqueous extract of banana peels with a concentration of (0, 15, 25 and 35%) and citric acid at concentrations (0, 50, 100 and 200 mg L-1) on viability and vigour of seed properties. Seeds that soaked with banana peel extract at a concentration of 25% outperformed in first count (79.8%), final count (85.0%), radicle length (13.2 cm), plumule length (11.6 cm), and seedling vigour index (2109), noting

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Publication Date
Sat Sep 30 2017
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Permeability Prediction By Classical and Flow Zone Indictor (FZI) Methods for an Iraqi Gas Field
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The permeability is the most important parameter that indicates how efficient the reservoir fluids flow through the rock pores to the wellbore. Well-log evaluation and core measurements techniques are typically used to estimate it. In this paper, the permeability has been predicted by using classical and Flow zone indicator methods. A comparison between the two methods shows the superiority of the FZI method correlations, these correlations can be used to estimate permeability in un-cored wells with a good approximation.

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Publication Date
Sun Jan 01 2023
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Dental Hypotheses
Effect of Dentin Surface Pretreatment With Chitosan Nanoparticles on Immediate and Prolonged Shear Bond Strength of Resin Composite: An in Vitro Study
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Publication Date
Fri Dec 01 2017
Journal Name
International Journal Of Chemtech Research
The Effect of Ginger Plant (Zingiber officinale) Aqueous Extract on Function and Histological Structure of Kidney in Mice Treated with Carbon Tetrachloride
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The percent work was designed to determine the effect of ginger plant aqueous extract on function and histological structure of kidney in mice treated with carbon tetrachloride (CCl4). Ginger plant caused a protective effect against CCl4 induced kidney damage and improved the kidney weight and biochemical parameters including urea, uric acid and creatinine. The ginger plant has a protective effect against injury in the kidney of mice treated with CCL4, because the ginger plant protects the tissues of kidney from toxic effect of CCL4. The kidney of CCL4 treated mice showed many histological alterations in the kidney included: atrophy, vascular degeneration and hemorrhage, death cell, degeneration of epithelial cells, destruction of basement

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Publication Date
Sat Dec 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
Financial Variables and Their Effects on The Development of Bank Credit and Productive Sectors in Iraq Using a Path Analysis Model
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This study aims to measure and analyze the direct and indirect effects of the financial variables, namely (public spending, public revenues, internal debt, and external debt), on the non-oil productive sectors with and without bank credit as an intermediate variable, using quarterly data for the period (2004Q1–2021Q4), converted using Eviews 12. To measure the objective of the study, the path analysis method was used using IBM SPSS-AMOS. The study concluded that the direct and indirect effects of financial variables have a weak role in directing bank credit towards the productive sectors in Iraq, which amounted to (0.18), as a result of market risks or unstable expectations in the economy. In addition to the weak credit ratings of borr

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Adenoidectomy with Myringotomy and Tympanostomy Tube Versus Adenoidectomy with Myringotomy in Treatment of Otitis Media with Effusion in 5-7 Years Old Children
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Background: Adenoiditis is a common cause of otitis media with effusion (OME) in children & perhaps OME is one of the most common diseases leads to hearing impairment in children with subsequent impairment of speech development & learning difficulties , however, treatment remains controversial. Objectives: To evaluate if there is a significant advantage of tympanostomy tube insertion in association with adenoidectomy over adenoidectomy in association with myringotomy alone in treatment of children with OMEType of the study: This is a prospective study. Patients & methods: The study consisted from 63 children diagnosed as cases of bilateral OME & variable degrees of adenoid hypertrophy. The patients were divided randomly i

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Publication Date
Sun Sep 02 2007
Journal Name
Iraqi Postgraduate Medical Journal
The Efficacy of Dextran 70 on Reticuloendothelial System in Systemically Infected Mice with Klebsiella Pneumoniae
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The reticuloendothelial system (RES) play an important role in immunity against bacterial infection and Klebsiella pneumoniae one of the most common causes of hospital-acquired infections. Dextran70 (D70), a polysaccharide, may alter functions of this system through changing many biological activities in the tissues.

Publication Date
Thu Mar 30 2017
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Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Role of Chloroquine Phosphate on Acute Phase Reactant Proteins in Patients with Knee Osteoarthritis
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The acute phase response is a major pathophysiologic phenomenon that accompanies inflammation whether acute or chronic. Complement (C3 and C4) and C - reactive protein (CRP) are positive acute phase proteins (+ ve APPs ). Their production takes place in hepatocyte and the blood concentration of these parameters are increased in osteoarthritis (OA). Chloroquine (CQ) is a diprotic weak base traditionally used to treat malaria. Recently the phosphate salt of CQ is used to decrease this type of (+ve APPs) . In this study,  patients who suffered from knee osteoarthritis (KOA) are treated with oral dosage form of chloroquine phosphate (CQP) for one month, twice daily. Our results demonstrate that CQP improves the patient status by decreas

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