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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
Thu Jun 01 2023
Journal Name
Iraqi Journal Of Physics
D-Shaped Photonic Crystal Fiber Toxic Metal Ions (Arsenic) Sensor Based on Surface Plasmon Resonance
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In this work, a Photonic Crystal Fiber (PCF) sensor based on the Surface Plasmon Resonance (SPR) technology was proposed. A thin layer of gold (Au) was deposited on a D-shaped Photonic Crystal Fiber (PCF), which was coated with plasmonic chemically stable gold material with a thickness of 40nm. The performance parameters like sensitivity including wavelength sensitivity and amplitude sensitivity and resolution were evaluated by simulation using COMSOL software. The proposed sensor was created by using the finite element approach, it is numerically examined. The results show that the surface of D-shaped Photonic Crystal Fiber coated with Au behaves as a sensor to detect the refractive index (IR) of toxic metal ions. The impacts of the str

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Publication Date
Sat Apr 20 2024
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Studying Sex Effect on CTGF, TGF-B1 Levels and Some Relevant Parameters in Iraqi Diabetic Patients with Glomeruli and Renal Tubules Fibrosis
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Due to high blood sugar over long periods, the incidence and prevalence of type 2 diabetes are increasing throughout the world. Diabetic complications include microvascular and macrovascular complications that target the kidneys, nerves, eyes, and heart. Hence, the current study aimed to investigate the levels of (CTGF) and (TGF-β1) for both men and women and to demonstrate the effect of sex on it. In addition, some related biochemical factors in patients with diabetes and diabetic nephropathy are compared with those in healthy controls. The study included 120 males and females with an age range of (30-65) years old. Ninety patients with type 2 diabetes were subdivided into three groups on the basis of ACR criteria. All the individ

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Publication Date
Sun Dec 03 2017
Journal Name
Baghdad Science Journal
Synthesis of Silver Nanoparticles from Malva parviflora Extract and Effect on Ecto-5'- Nucleotidase(5'-NT), ADA and AMPDA Enzymes in Sera of Patients with Arthrosclerosis
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The present research included synthesis of silver nanoparticle from(1*10-3,1*10-4 and1*10-5) M aqueous AgNO3 solution through the extract of M.parviflora reducing agent. In the process of synthesizing silver nanoparticles we detected a rapid reduction of silver ions leading to the formation of stable crystalline silver nanoparticles in the solution.

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Publication Date
Tue Oct 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Relationship Between The Internal Marketing and Quality Services : a Filed Study on Samples of Customers and Employees In Iraqi Commercial Banks
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Abstract

The Paper highlights on one of the main activities in marketing management. That is the internal marketing in the commercial banks and its relationship with the quality services offered to satisfy customers needs and wishes in order to reach he ultimate objectives of those banks. Two state and five private banks in Basrah city (Iraq) were taken in a field study. The survey covered the opinions of (184) state bank employees and (158) clients . The analysis of the survey shows that there is a strong relationship between the internal marketing ( in the banks covered by the survey) and the quality of banking objective services and the private banks show greater interest and concern to the internal ma

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Publication Date
Tue Jan 02 2018
Journal Name
Journal Of Educational And Psychological Researches
The effectiveness of educational design design according to the theory of Ozbal in the acquisition of geographical concepts among the pupils of the fourth primary in the geography and development of their habits of mind
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Summary The objective of the research is to learn the design of a learning educational learning according to the theory of Ausubel in the acquisition of geographical concepts among the students of the fourth primary in the field of geography and the development of their habits of mind. To achieve this, the researcher relied on the two hypotheses the researcher used the design of equal groups the first experimental group was studied according to the design educational educational learning according to the theory and the other is an officer according to the traditional method. The research community consists of fourth grade pupils in primary school day for girls in the Directorate of Education Baghdad, Al-Rusafa, the third academic year 20

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
The role of sialic acid in the immune response of patients with acute leukemia Almufaawi the subject and is on treatment Alkamiawi this
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The focus of this research revolves around the importance level of sialic acid in the reasoning of cases, including tumors and then evaluate the patient's response to treatment and its impact on the immune response there are a lot of evidence showing that parts Alkrbu ???????? in peptides sugary and glycoproteins play an important role in Alfalitin life and responsiveness

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Publication Date
Sun Dec 01 2019
Journal Name
Restaurant Business
The role of using fair value on relevance and representation faithfulness of accounting information in accordance with the common conceptual framework (FASB-IASB)
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The global trend towards the use of fair value accounting is increasing, so the current study aimed to maximize the impact of fair value application on achieving relevance and representation faithfulness of accounting information in accordance with the common conceptual framework. To achieve the objective of this study, the researcher has determined in the theoretical framework the relationship of fair value with the characteristics of relevance and representation faithfulness of accounting information and the extent of achieving these characteristics, as well as conducting a field study by preparing a questionnaire distributed to a sample of academics (50) and auditors (50) with a total number of selected participants (100) of acad

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Publication Date
Tue Dec 21 2021
Journal Name
Journal Of Engineering Mathematics
Fluid inflow from a source on the base of a channel
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Publication Date
Sun Sep 07 2014
Journal Name
Baghdad Science Journal
Exponential Function of a bounded Linear Operator on a Hilbert Space.
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In this paper, we introduce an exponential of an operator defined on a Hilbert space H, and we study its properties and find some of properties of T inherited to exponential operator, so we study the spectrum of exponential operator e^T according to the operator T.

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Publication Date
Sat Apr 01 2023
Journal Name
Baghdad Science Journal
A Theoretical Study of the Docking of Medicines with some Proteins
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A set of ten drug compounds containing an amino group in the structure were determined theoretically. The parameters were entered into a model to forecast the optimal values of practical (log P) medicinal molecules. The drugs were evaluated theoretically using different types of calculations which are AM1, PM3, and Hartree Fock at the basis set (HF/STO-3G). The Physico-chemical data like (entropy, total energy, Gibbs Free Energy,…etc were computed and played an important role in the predictions of the practical lipophilicity values. Besides, Eigenvalues named HOMO and LUMO were determined. Linearity was shown when correlated between the experimental data with the evaluated physical properties. The statistical analysis was used to analy

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