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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
Fri Feb 01 2013
Journal Name
Journal Of Applied Research And Technology
Effectiveness of Wavelet Denoising on Electroencephalogram Signals
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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Effectiveness of Intra articular Injection of Platelet-Rich Plasma in Patients with Anterior Disc Displacement with Reduction
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Background: Anterior disc displacement with reduction (ADDWR) is the most common form of the internal derangement (ID) of temporomandibular joint (TMJ). It is a painful progressive dysfunction and clinically characterized by reciprocal clicking due to shift in the disc anteriorly in relation to the condyle and fossa during mandible elevation. Minimally invasive therapy such as intra-articular injection of platelet-rich plasma (PRP) has been used. PRP is a natural autologous product with a high platelet concentration obtained by centrifugation process to enhance tissue healing through several growth factors (GFs), which are released after endogenous activation. The aim of this study is to assess this technique which is increasingly used toda

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Tue Jun 23 2026
Journal Name
Journal Of Umm Al-qura University For Medical Science
Performance variation and implementation barriers of large language models in clinical healthcare: a systematic review
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Large language models (LLMs) are a rapidly evolving class of artificial intelligence with significant potential in clinical healthcare. Despite accelerating adoption, rigorous systematic evidence on clinical utility, patient safety, and implementation feasibility remains fragmented. To systematically review LLM applications across clinical domains, evaluate performance with appropriate contextual caveats, characterize implementation barriers, and identify ethical and regulatory considerations. Scientific databases were searched from January 2020 to January 2025. Studies evaluating transformer-based LLMs (≥10M parameters) in clinical settings were eligible. Data were independently double-extracted; quality was assessed using QUADAS-2, RE-A

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Tue Apr 01 2025
Journal Name
Georgian Medical News
THE EFFECT OF SOFT ROBOTIC GLOVE ON THE FLEXION AND EXTENSION OF HAND FOR STROKE PATIENTS: A CLINICAL TRIAL
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Background: Stroke defined by diminished cerebral blood flow, results in brain damage and neurological impairments. It often leads to considerable difficulties, such as limited mobility and compromised hand function, usually manifesting as a weakening in the ability to open and shut the hand. Objective: The study evaluates the differences between opening and closing hands when utilizing a soft robot. Methods: The study was conducted in the Mosul Specialist Rehabilitation Center which involved 68 participants, all over 20 years old, with visual impairments. The Iranian Clinical Trials Registry and Ministry of Planning approved the study, The Fugl-Meyer Assessment for Upper Extremity Action Research Arm Test, and Arm Motor Ability Test were

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Publication Date
Sat Mar 01 2025
Journal Name
Results In Engineering
Advancing asphalt binder performance through nanomaterial and polymer modification: Experimental and statistical insights
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Publication Date
Fri May 05 2023
Journal Name
International Journal Of Professional Business Review
The Effect of Emotional Intelligence on Manager Performance: a Field Study in the General Authority for Irrigation and Reclamation Projects in Baghdad
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Purpose: the purpose of this study is to investigate how managers working for the General Authority for Irrigation and Reclamation Projects react to the impact of Emotional Intelligence (EI) on their performance.   Theoretical framework: The current study includes an intellectual framework on two variables, namely EI and Manager Performance (MP), because it is essential to investigate the relationship between these two variables and the impact of EI on MP.   Design/methodology/approach: The research problem is that a manager's capacity to make wise decisions about their work or interactions with subordinates is diminished when they have inadequate EI. The questionnaire is used as a tool for gathering data for the study, and the st

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Publication Date
Thu Jan 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Self-Regulation Fluid Program on Patients with Hemodialysis Self-Efficacy for Fluid Adherence in Al-Diwaniyah Teaching Hospital
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Objectives: to evaluate patient knowledge with hemodialysis and to determine the effectiveness of Self-regulation Fluid Program on Patients with hemodialysis self-efficacy for fluid adherence in Al-Diwaniyah Teaching Hospital.

Methodology: A quasi-experimental design (two group design: pre-test and post-test) was used. This study was conducted in Al-Diwaniya Teaching Hospital for the period from (15th of October 2018 to 20th of May 2019) on a non-probability (purposive) sample consisting of (60 patients) treatment in hemodialysis units. A questionnaire was built as a data collection tool and consisted of four parts:

First part: Demographic characteristics of the pati

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Publication Date
Sun Apr 01 2018
Journal Name
Aquatic Geochemistry
The Origin and MgCl2–NaCl Variations in an Athalassic Sag Pond: Insights from Chemical and Isotopic Data
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Mon Feb 07 2022
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A partial image encryption scheme based on DWT and texture segmentation
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