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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
Wed Apr 30 2025
Journal Name
Iraqi Journal Of Science
Effect of Lupeol on Inducing the Nitric Oxide Production in Macrophages Infected with Leishmania Donovani
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Visceral leishmaniasis is a neglected tropical disease on the rise in different regions of Iraq, especially in areas with poor hygiene and among refugee populations. The effectiveness of existing chemotherapy for leishmaniasis is constrained by its high toxicity, cost, and the development of drug resistance. The current research examined various concentrations (ranging from 125 to 1000 μM) of lupeol to evaluate its ability to boost the generation of nitric oxide, which has anti-leishmanial properties, in an ex-vivo macrophage model. Griess assay was used to detect the nitric oxide (NO) production in Leishmania donovani infected U937 cell-line macrophages along 24 and 48 hours post treated. The nitric oxide concentration was signifi

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
A prospective study on sexual deviation deployed in Baghdad crimes
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The current research aims to identify the types and rates and the reasons for the crimes that are with the origin and sexual scattered deviation between the fabric of Iraqi society, which reticent about because of the culture of the community, where he offered a researcher investigator justice and tribal leaders and lawyers about proportion and the types and causes of crime is the origin of sexual deviance and finally a question asked a researcher in 1000 young lived their adolescence days of the former regime (1979-2003) from going to brothels researcher found that 920 people and 92% had gone to the house to practice adultery and that 70 of them, and by 7% had engaged in masturbation only and that 10 of them have not committed anything

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Study on Cosmetic Products Marketed in Iraq: Microbiological Aspect
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Cosmetic products contain variable amounts of nutrients that support microbial growth. Most contaminants   in   cosmetic   products   include bacteria such as Staphylococcus, Pseudomonas, Klebsiella,   Achromobacter   and   Alcaligenes. Contaminated water  is  a  likely  source  of organisms found in cosmetic products. Products such as shampoo, hand and body lotion, facial cleanser,  and liquid soaps were analyzed. In this study, out of 60 cosmetic products analyzed, 26.4% were found to be contaminated.    Most of the contamination was from bacteria and no fungal contamination was detected.  The highest level o

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Publication Date
Fri Jan 01 2021
Journal Name
Biochemical & Cellular Archives
A COMPARATIVE STUDY ON SOME BIOCHEMICAL PARAMETERS IN INFERTILE PATIENTS.
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Publication Date
Tue Aug 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of Stimulating Maize Seeds with Potassium Nitrate and Licorice Extract on the Seed Viability and Vigor
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Germination and field emergence are delayed and their duration is prolonged due to the declining soil temperature during the spring season, which is reflected in the subsequent stages of crop growth, therefore, this study aimed to improve germination. Under a wide range of environmental conditions, a laboratory factorial experiment was carried out to study the effect of seed stimulation with potassium nitrate (distilled water only (0), 2, 4, and 6 mg L-1) and with an aqueous extract of licorice roots (distilled water only (0), 3, 6, and 9 g L-1) on the seed viability and vigor. The laboratory experiment was carried out according to the Completely Randomized Design (CRD) with four repetitions. The results showed the superiority of the intera

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Publication Date
Tue Dec 31 2024
Journal Name
مـجـلــة الـدراســات التربــويــة والعـلـمـيــة - كلـيــة الـتــربـيــة - الجــامـعـة العـراقـيــة ال
Synthesis, Characterization and Studies on Thermal, Antioxidant, Docking and Biological of New Ligands with Some Metal Complexes
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Publication Date
Wed Sep 01 2021
Journal Name
Egyptian Journal Of Petroleum
Identification of the best correlations of permeability anisotropy for Mishrif reservoir in West Qurna/1 oil Field, Southern Iraq
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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Relation of ?-Amylase Activity with Glucose and Anti-Gliadin IgA and IgG in Sera of Patients with Celiac Disease
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Celiac disease (CD) is an inflammatory small intestinal disorder that can lead to severe villous atrophy, and malabsorption . Since the measurement of α-amylase activity is the most widely used biochemical test for the diagnosis of pancreatic and non pancreatic disease , therefore serum α-amylase were studied in the present study in an attempt to evaluate the usefulness of this enzyme in the diagnosis of celiac disease and its relationship with anti gliadin IgA and IgG and serum glucose . Thirty one patients with celiac disease were studied and compared with twenty four healthy individuals . Significant elevation of α-amylase activity , glucose and anti gliadin IgA and IgG were observed in the sera of patients with celiac diseas

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Effect of Radioactive Iodine Therapy on Interleukin-2 (IL-2), IL-17 and Physiological Parameters in Iraqi Patients with Graves’ Disease
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Publication Date
Mon Mar 01 2010
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Mechanical Combined Contact Stress with Buckling Load on the Stress Distribution in the Ball and Socket Joint Mechanism
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The design of components subjected to contact stress as local compressive stress is important in engineering application especially in ball and socket Joining.  Two kinds of contact stress are introduced in the ball and socket joint, the first is from normal contact while the other is from sliding contact. Although joining two long links (drive shaft in steering cars) will cause the effect of flexural and tensional buckling stress in hollow columns through the ball and socket ends on the failure condition of the joining mechanism. In this paper the consideration of the combined effect of buckling Load and contact stress on the ball and socket joints have been taken, epically on the stress distribution in the contact area. Different

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