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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
Sun Jul 01 2018
Journal Name
Saudi Medical Journal
Serum anti-müllerian hormone levels in evaluation of chemotherapy effect on ovarian reserve in women with breast cancer
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Publication Date
Fri Apr 12 2019
Journal Name
Journal Of Economics And Administrative Sciences
Measuring and analysis of the impact of public budget deficit on external debt in lraq with in the framework of joint integration of the period (1990 – 2016 )
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The concept of deficit in public budget becomes a chronic economic phenomenon in most of the world, whether the advanced countries or developing countries. Despite  the difference in the visions of the economic schools to accept or reject the deficit in public budget but the opinion that prevailed is the necessity of the state to reduce the public spending which led to a continuous deficits in the public budget which consequently increased the government borrowing ,increase income taxes and wealth, consequently this weakened the in motivation in private investment which contributed to the increase of in factionary stagnation , so that governments have to cover the lack of local funding sources which become difficult to be eq

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Publication Date
Mon Dec 30 2013
Journal Name
Scholars Academic Journal Of Biosciences (sajb)
Synergistic effect of mountain honey and Argemone mexicana plant on bacteria associated with wound infections
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Forty five wound specimens were collected from patients suffering from wound infections and taken from various hospitals in Ibb city, Yemen. The study was to determine synergic antibacterial activity of between mountain honey and Argemone mexicana plant. Isolation, identification of bacterial isolates and antibiotic sensitivity test were done. Agar-disc and agar-well diffusion method were carried to determine antibacterial activity of honey, Argemone mexicana plant and a mixture of them against bacterial isolates. Out of 45 specimens, 29 (64.4%) gave positive cultures. Staphylococcus aureus was the predominant bacterial pathogens with percentage (72.4%) followed by Pseudomonas aeruginosa (17.2%) and Staphylococcus epidermidis (10.4%).

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Investigation of Load and Pressure Distribution on Wing with Wake Rollup for Low Speed Aircraft
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The presented work shows a preliminary analytic method for estimation of load and pressure distributions on low speed wings with flow separation and wake rollup phenomena’s. A higher order vortex panel method is coupled with the numerical lifting line theory by means of iterative procedure including models of separation and wake rollup. The computer programs are written in FORTRAN which are stable and efficient.

      The capability of the present method is investigated through a number of test cases with different types of wing sections (NACA 0012 and GA(W)-1) for different aspect ratios and angles of attack, the results include the lift and drag curves, lift and pressure distributions along the wing s

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Publication Date
Fri Jun 01 2018
Journal Name
Journal Of Engineering
Experimental Study on Tribological Characteristics of AA 6061 Alloy Reinforced with Al2O3 and B4C Particles
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Two different composite materials were prepared by stir casting method of AA 6061 alloy as a matrix reinforced with two addition different ceramic materials Al2O3 and B4C of grain size   20 µm by 2.5, 5, 7.5 and10% in weight. The composite material with aluminum alloy as a matrix possesses a unique mechanical properties such as: high specific strength and hardness, low density, and high resistance to corrosion and friction wear. This composite is widely used in automotive parts space and marine applications.

Pin-on-disc technique was used to calculate the wear rate for each addition of Al2O3 and B4C particles. Rockwell hardness test and

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Publication Date
Fri May 01 2020
Journal Name
Journal Of Engineering
Chemical and Thermal Investigation on Stability of Tanuma Formation Using Different Additives with Drilling Fluids
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Wellbore stability is considered as one of the most challenges during drilling wells due to the
reactivity of shale with drilling fluids. During drilling wells in North Rumaila, Tanuma shale is
represented as one of the most abnormal formations. Sloughing, caving, and cementing problems
as a result of the drilling fluid interaction with the formation are considered as the most important
problem during drilling wells. In this study, an attempt to solve this problem was done, by
improving the shale stability by adding additives to the drilling fluid. Water-based mud (WBM)
and polymer mud were used with different additives. Three concentrations 0.5, 1, 5 and 10 wt. %
for five types of additives (CaCl2, NaCl, Na2S

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Publication Date
Sun Mar 01 2020
Journal Name
Baghdad Science Journal
The Influence of Magnetohydrodynamic Flow and Slip Condition on Generalized Burgers’ Fluid with Fractional Derivative
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This paper investigates the effect of magnetohydrodynamic (MHD) of an incompressible generalized burgers’ fluid including a gradient constant pressure and an exponentially accelerate plate where no slip hypothesis between the burgers’ fluid and an exponential plate is no longer valid. The constitutive relationship can establish of the fluid model process by fractional calculus, by using Laplace and Finite Fourier sine transforms. We obtain a solution for shear stress and velocity distribution. Furthermore, 3D figures are drawn to exhibit the effect of magneto hydrodynamic and different parameters for the velocity distribution.

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Publication Date
Sun Jan 01 2023
Journal Name
Journal Of Medicine And Life
Effect of commercially pure titanium implant coated with calcium carbonate and nanohydroxyapatite mixture on osseointegration
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In this research, rabbit femurs were implanted with CP Ti screws coated with a combination of CaCO3 and nanohydroxyapatite, and the effect on osseointegration was assessed using histological and histomorphometric examination at 2 and 6 weeks. CaCO3 and nanohydroxyapatite were combined with the EPD to coat the surfaces of the CP Ti screws. The femurs of five male rabbits were implanted with coated and uncoated implant screws. Healing time was divided into two groups (2 and 6 weeks). After 2 and 6 weeks of implantation, the histological examination revealed an increase in the growth of bone cells for coated screws, and the histomorphometric analysis revealed an increase in the percentage of ne

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Publication Date
Wed Aug 30 2023
Journal Name
Baghdad Science Journal
The Influence of Obesity and IL-6 on Infertile Iraqi Women with COVID-19 Complications
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Infertility is one of the types of diseases that occur in the reproductive system. Obesity is a state that can be occurred due to excessive fats, the progression in obesity stage results in a change in adipose tissue and the development of chronic inflammation, endocrine glands disorders and women’s reproductive system, and also increase the infection with covid-19. The study aimed to investigate the effect of the obesity, lipid-profile, and IL-6 on hormones-dysregulation in infertile-women with COVID-19 complications. The current study included 70 samples: 50 infertility-women-with-covid-19-infected, 20 healthy-women/control, the ages of both patients and healthy subjects were selected within the range 18-34 years. Levels of FBS, LH,

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Publication Date
Mon Jul 01 2019
Journal Name
Plant Archives
Effect of melatonin administration with different light colors on fertility traits and hatching of local chickens
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This study was conducted at the poultry farm of the Department of Animal Production/College of Agriculture/University of Baghdad/Abu Ghraib, on 252 birds (180 females and 72 males). This study aims to observe the effect of melatonin implantation and exposure to different light colors and their interaction on characteristics of fertility and hatching of local Iraqi chickens. The birds were divided into three sections (white, red and green) each section contains two lines, one of which has been planted melatonin under the skin of the neck of birds and the other has not been planted hormones. The results showed that melatonin implantation and exposure to different light colors did not significantly affect the hatching rate of fertilized eggs a

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