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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 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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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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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Faithful representation of accounting information according requirements width financial statements depending on international standard (IFRS-15) revenue from contracts with customers: Applied research in a sample of the joint stock companies listed on the Iraq Stock Exchange
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This study seeks to identify the possibility of achieving the property of faithful representation of accounting information and measure it by using the standard approach based on mathematical and statistical equations by comparing two financial periods before and after the application of (IFRS-15) Revenue from contracts with customers, during the period. (2014-2018), for the financial statements of the mixed joint stock companies listed on the Iraq Stock Exchange, which is one of the main pillars of the economic structure of the country, as a joint investment between the state and the private sector, and has importance in many aspects, including support for projects of public companies, S Absorption and employment of labor, as well as ra

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Publication Date
Mon Feb 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
A Critical Review of Subgrade Soil Reinforced with Geo-synthetics
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Abstract<p>Recently, the application of geosynthetics in the reinforcement of weak subgrade is expanded dramatically. However, selection of the geo-material that fits site conditions and soil type is crucial to achieving the success of the overall performance of such improvement. Also, the road life and cost construction are significant keys for evaluating this type of ground treatment. This paper presents an overview of the subgrade strengthening with geosynthetics to acquire a better understanding of the technique and to provide a clear guide for transportation and geotechnical engineers. The rutting failure along with its main causes are highlighted briefly. The types of geosynthetics, their applications and</p> ... Show More
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Publication Date
Sun Aug 15 2021
Journal Name
Annals Of R.s.c.b.
Versatile Applications of Complexes with Some Lanthanide Elements: A Review
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Cerium (III), Neodymium (III) and Samarium (III) Complexes existent a wide range of implementation that stretch from their play in the medicinal and pharmaceutical area because of their major significant pharmacological characteristic such as antifungal, anti-cancer, anti-bacterial ,anti-human immunodeficiency virus ,antineoplastic, anti-inflammation,inhibition corrosion,in some industrial (polymers, Azo dye).It is likely to open avenuesto research among various disciplines such as physics, electronics, chemistry and materials science by these complexes that contain exquisitely designed organic molecules.This paper reviews the definition, importance and various applications of Cerium (III), Neodymium (III) and Samarium (III) Complexes anddi

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Publication Date
Fri Aug 06 2021
Journal Name
Annals Of The Romanian Society For Cell Biology
Versatile Applications of Complexes with Some Lanthanide Elements: A Review
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Cerium (III), Neodymium (III) and Samarium (III) Complexes existent a wide range of implementation that stretch from their play in the medicinal and pharmaceutical area because of their major significant pharmacological characteristic such as antifungal, anti-cancer, anti-bacterial ,anti-human immunodeficiency virus ,antineoplastic, anti-inflammation,inhibition corrosion,in some industrial (polymers, Azo dye).It is likely to open avenuesto research among various disciplines such as physics, electronics, chemistry and materials science by these complexes that contain exquisitely designed organic molecules.This paper reviews the definition, importance and various applications of Cerium (III), Neodymium (III) and Samarium (III) Complexe

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Publication Date
Wed Mar 15 2023
Journal Name
International Journal Of Biomaterials
A Novel Coating of Orthodontic Archwires with Chlorhexidine Hexametaphosphate Nanoparticles
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Statement of the Problem. The use of orthodontic fixed appliances may adversely affect oral health leading to demineralizing lesions and the development of gingival problems. Aims of the Study. The study aimed to coat orthodontic archwires with chlorhexidine hexametaphosphate nanoparticles (CHX-HMP NPs) and to evaluate the elusion of CHX from CHX-HMP NPs. Materials and Methods. A solution of CHX-HMP nanoparticles with an overall concentration of 5 mM for both CHX and HMP was prepared, characterized (using atomic force microscope and Fourier transformation infrared spectroscopy), and used to coat orthodontic stainless steel (SSW) and NiTi archwires (NiTiW). The coated segments were characterized (using scanning electron microscopy

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Publication Date
Thu Apr 01 2021
Journal Name
Biochem. Cell. Arch
Biological Therapy for Patients With Rheumatoid Arthritis and Its Effect on Periodontal and Immunological Parameters
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Rheumatoid arthritis and periodontitis use analogous effector destructive procedures, in that the inflammatory cells and pro-inflammatory cytokines that drive chronic bone erosion in RA and chronic periodontal destruction in Periodontitis are alike. Periodontitis (PD) has appeared as a hazard factor in a number of health situations as rheumatoid arthritis (RA). To determine the effect of anti-tumor necrosis factor alpha biological treatment (methotrexate and Enbrel or infliximab) on periodontal status of patients having rheumatoid arthritis with periodontitis in comparison to those having periodontitis without rheumatoid arthritis and control healthy subjects and to determine the serum levels of anti-cyclic citrullinated peptide (ACCP) in t

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Publication Date
Sat Apr 30 2022
Journal Name
Sport Tk-revista Euroamericana De Ciencias Del Deporte
Effect of a training program on the development of physical abilities in football goalkeepers
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The primary aim of this study was to find out the effect of a training program on the development of physical abilities in football goalkeepers. The current study was conducted on goalkeepers of the Academy of Espanyol Sports Club in the premises of Haifa Sports Club Stadium. The study was completed by the researchers within the timeline of May 2021 to August 2021. A total of 7 goalkeepers falling within the age group of 15-17 years were recruited as the sample participants for the study. Out of 7 goalkeepers, 5 goalkeepers were included in the primary experiment and 2 of them were excluded. The training program applied had a positive effect on the development of physical abilities in the football goalkeepers of the sa

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Publication Date
Fri Apr 29 2022
Journal Name
Sar Journal Of Surgery
Variation of Sphenoid Sinus Pneumatization on CT scan in A Sample of Iraqi Patients
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Background: Computerized tomography scan can show the detailed anatomy of the nose and paranasal sinuses. The sphenoid sinus is a very important corridor for the skull base because of its central position. This sinus has a great range of variation and can put structures around at risk during surgery. This study aims to examine the variation of the sphenoid sinus, and its relation to other structures around it, in this sample of Iraqi patients. Materials and Methods: CT scans of 122 patients, were obtained, and submitted for examination and measurements, during the period between September 2020 and September 2021. Observation of The sphenoid sinus pneumatization pattern, clival extension, Onodi cell, and lateral pneumatization of SS.

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