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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
Tue May 12 2020
Journal Name
The Fourth Annual International Conference On Languages, Linguistics, Translation And Literature (www.llld.ir), 1-2 February 2020, Iran-ahwaz, Book Of Articles, Volume Two
A Study of Susan Glaspell's Regionalism and Ideal Feminism with Special Reference to Her Play Trifles
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Abstract The main purpose of the research is to clarify and investigate in details about Susan Glaspell’s role in shedding light on the predicament of women in American society in the early twentieth century showing how sense of the place played an important role in limiting the opportunities of female protagonists who try to escape the roles imposed upon them by society. Glaspell lived in the early twentieth century in the Midwest and tackled the important issues like: women's suffrage, birth control, socialism, union organizing when women were not able to vote or sit as a member on juries. Her Feminist cause is quite obvious through her works from her first one act play Suppressed Desire to the final three act play, Alison’s House. Th

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Publication Date
Sat Mar 30 2024
Journal Name
Al-qadisiyah Journal For Engineering Sciences
Investigation of an automobile air-conditioner with a liquid-suction heat exchanger using R134a and R1234yf
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Air-conditioning systems (ACs) are essential in hot and humid climates to ensure acceptable ambient air quality as well as thermal comfort for buildings users. It is essential to improve refrigeration system performance without increasing the effects of global warming potential (GWP) and ozone depletion potential (ODP). The main objective of this study is to evaluate the performance of an air conditioning system that operates with a liquid suction heat exchanger (LSHX) through implementing refrigerants with zero OPD and low GWP (i.e., R134a and R1234yf). Liquid suction heat exchanger (LSHX) was added to an automobile air conditioning system (AACS).When Liquid suction heat exchanger was added to the cycle, primary results indicated t

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Publication Date
Sun May 01 2011
Journal Name
Information Sciences
Design and implementation of a t-way test data generation strategy with automated execution tool support
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Publication Date
Mon Jun 05 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
THE DYNAMICS OF A STAGE-STRUCTURE PREY-PREDATOR MODEL WITH HUNTING COOPERATION AND ANTI-PREDATOR BEHAVIOR
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The mathematical construction of an ecological model with a prey-predator relationship was done. It presumed that the prey consisted of a stage structure of juveniles and adults. While the adult prey species had the power to fight off the predator, the predator, and juvenile prey worked together to hunt them. Additionally, the effect of the harvest was considered on the prey. All the solution’s properties were discussed. All potential equilibrium points' local stability was tested. The prerequisites for persistence were established. Global stability was investigated using Lyapunov methods. It was found that the system underwent a saddle-node bifurcation near the coexistence equilibrium point while exhibiting a transcritical bifurcation

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Publication Date
Fri Oct 23 2020
Journal Name
Palarch’s Journal Of Archaeology Of Egypt/egyptology
A Multimodal Discourse Analysis of Visual Images in UNHCR Reports on Displaced Iraqis
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The advent of UNHCR reports has given rise to the uniqueness of its distinctive way of image representation and using semiotic features. So, there are a lot of researches that have investigated UNHCR reports, but no research has examined images in UNHCR reports of displaced Iraqis from a multimodal discourse perspective. The present study suggests that the images are, like language, rich in many potential meanings and are governed by clearly visual grammar structures that can be employed to decode these multiple meanings. Seven images are examined in terms of their representational, interactional and compositional aspects. Depending on the results, this study concludes that the findings support the visual grammar theory and highlight the va

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Publication Date
Mon Oct 06 2014
Journal Name
Journal Of Educational And Psychological Researches
The Effect of a Suggested Translation Strategy on ESP Learners’ Achievement in Translation
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In spite of the disappearing of a clear uniform textbook for teaching ESP at different departments and different colleges in both scientific and humanistic studies, the practitioners at those departments and colleges have to teach translation as one of the important requirements to pass the English language exam. The lack of defined translation activities is a noticeable problem therefore; the problem of teaching translation is diagnosed in that the students lack the ability to comprehend the text in English language and other translation knowledge and skills.

The study aims to suggest a translation strategy and then find out the effect of the translation strategy on ESP learners’ achievement in translation. A sample of 50 stud

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Publication Date
Tue Mar 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
Impact of Digital Audit on Improving performance Quality and Reduce Costs An applied research in a sample of private auditing firms and offices
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Publication Date
Thu Feb 07 2019
Journal Name
Iraqi Journal Of Laser
The Effect of 532 nm Diode Pumped Solid State (DPSS) Laser in Combination with Safranin on the Growth of Pseudomonas aeruginosa and Staphylococcus aureus in Vitro
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The effect of 532nm Diode Pumped Solid State (DPSS) laser at power density of 5.234 W/cm2 on the growth of Gram-negative Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus was evaluated. These bacteria were isolated from samples taken from burn and infected wound areas of 55 patients admitted to the burn-wound unit in Al-Kindy teaching hospital in Baghdad during the period from October 2012 to March 2013. Each isolate was identified using microscopic, cultural and biochemical methods. A standard bacterial suspension was prepared for each isolate. Serial dilutions were then prepared and a dilution of 10-5 was selected. Irradiation experiments included four groups: (L-P-) bacterial suspension in saline solution, (L-P+) bacteria

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Publication Date
Wed Jun 15 2022
Journal Name
Linguistics And Translation Studies
Metaphor as a method of forming the lexical meaning of a word (on the material of Russian and Arabic languages)
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The article aims to consider the concept of language metaphor in Russian and Arabic languages and the problem of metaphor functioning in language, since it is one of the most important figurative components of the structural organization of the text and an important means of reflecting the national culture of each people. and often in revealing the image of a metaphor one can feel the full flexibility of the language and its beauty.

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Publication Date
Sun Dec 01 2024
Journal Name
Russian Journal Of General Chemistry
Synthesis, Characterization, and Biological Evaluation for New Derivatives Based on 2Сhloro-N-[4-(5-phenyl-1,3,4-oxadiazol-2-yl)phenyl]acetamide
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