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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 Jul 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Periodontal health status of heavy and light smokers and its correlation with salivary superoxide dismutase enzyme (A comparative study)
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Background: Periodontal disease is a chronic bacterial infection that affects the gingiva and bone supporting the teeth. Smoking, which is an important risk factor for periodontitis, induce oxidative stress in the body and cause an imbalance between reactive oxygen species (ROS) and antioxidants, such as superoxide dismutase (SOD). This study aimed to evaluate the influence of smoking on periodontal health status by estimating the levels of salivary SOD level in non-smokers (controls) and light and heavy smokers and to test the correlation between the SOD enzyme level and the clinical periodontal parameters in each group. Materials and Methods: The study sample consisted of 75 male, with age ranged from 35 to 50 years. Clinically, the perio

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Publication Date
Thu Dec 15 2022
Journal Name
Journal Of Petroleum Research And Studies
Selection of an Optimum Drilling Fluid Model to Enhance Mud Hydraulic System Using Neural Networks in Iraqi Oil Field
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In drilling processes, the rheological properties pointed to the nature of the run-off and the composition of the drilling mud. Drilling mud performance can be assessed for solving the problems of the hole cleaning, fluid management, and hydraulics controls. The rheology factors are typically termed through the following parameters: Yield Point (Yp) and Plastic Viscosity (μp). The relation of (YP/ μp) is used for measuring of levelling for flow. High YP/ μp percentages are responsible for well cuttings transportation through laminar flow. The adequate values of (YP/ μp) are between 0 to 1 for the rheological models which used in drilling. This is what appeared in most of the models that were used in this study. The pressure loss

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Publication Date
Sat Feb 01 2025
Journal Name
Pharmaceutical Nanotechnology
Preparation, <i>In-vitro, Ex-vivo</i>, and Pharmacokinetic Study of Lasmiditan as Intranasal Nanoemulsion-based <i>In Situ</i> Gel
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Background:

Lasmiditan (LAS) is a recently developed antimigraine drug and was approved in October, 2019 for the treatment of acute migraines; however, it suffers from low oral bioavailability, which is around 40%.

Objective:

This study aimed to improve the LAS bioavailability via formulation as nanoemulsionbased in situ gel (NEIG) given intranasally and then compare the traditional aqueous-LASsuspension (AQS) with the two successful intranasal prepared formulations (NEIG 2 and NEIG 5) in order to determine its relative bioavailability (F-relative) via using rabbits.

Method:
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Publication Date
Fri Jul 07 2023
Journal Name
Journal Of Obstetrics, Gynecology And Cancer Research
Evaluation of Maternal and Fetal Complications in Pregnant Women with Polycystic Ovary Syndrome (PCOS) with Severe and Mild Phenotype
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An essential issue in obstetrics is the prevalence of maternal and fetal complications in pregnant women with polycystic ovary syndrome (PCOS). The purpose of the present study was to investigate the prevalence of pregnancy complications among various phenotypes of pregnant women with PCOS.

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Publication Date
Tue Dec 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of the efficiency and effectiveness of the accounting system of the Department of Missions and Cultural Relations (*) at the Office of the Ministry of Higher Education and Scientific Research
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The evaluation and efficiency and effectiveness of account system for the department of delegation and cultural Relationships in the center of ministry of higher Education and Scientific research Considered as a very important and active subjects in the modification of accounting system in this department and to develop it and make it able to make available important and accurate information for the planning requirements and monetary and evaluation performance and to make decisions, besides to develop the performance of Iraqi Cultural departments working abroad and to render its role effective to serve the students of higher education in the progressive Countries to facility its growing in scientific and professional and technica

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Publication Date
Thu Jun 10 2021
Journal Name
Journal Of Mechanical Engineering Research And Developments
Study on the effect of diesel engine oil contaminated with fuel on engine performance
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An experiment was conducted to study how SAE 50 engine oil contaminated with diesel fuel affects engine performance. The engine oil was contaminated with diesel fuel at concentrations of 0%, 1%, and 3%. The following performance characteristics were studied: brake-specific fuel consumption, brake thermal efficiency, friction power, and exhaust gas temperature. Each treatment was tested three times. The three treatments (0%, 1%, and 3%) were analyzed statistically with a one-way ANOVA model at the 5% probability level to determine if the three treatments produced significant differences in engine performance. The statistical results showed that there were significant differences in engine performance metrics among the three treatments. The 3

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Publication Date
Thu May 18 2023
Journal Name
College Of Islamic Sciences
a base The origin of permissive things And its impact on Islamic law
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So I present in the hands of the honorable reader what God Almighty has made easy for me in terms of what I dealt with in the rule (the principle of permissive things) and what branches from it and what is related to it.
This research was divided into an introduction, a preface, three demands, and a conclusion.
The preamble is to explain the meaning of the rule in language and terminology and the definition of the legal rule and what is related to it. The first requirement is to explain the rule that we have in our hands and the words related to its text - and is it a fundamentalist or jurisprudential rule? .
As for the second requirement - in the difference of scholars and their opinions in whether the origin of things is permi

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A review on Active Constituents and Pharmacological Effects of Eriobotrya Japonica Lindl. (Loquat)
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Eriobotrya japonica Lindl., named as loquat, is a subtropical fruit tree of the family Rosaceae which is well known medical plant originated in  Japan and China. Loquat portions, like leaves, peels and fruits have been shown to possess various health usefulnesses.  In Chinese classical medicine, it is vastly utilized in many illnesses, like gastroenteric disorders, diabetes mellitus, pulmonary inflammatory diseases and chronic bronchitis. Loquat plant contain many active constituents, such as flavonoids, carotenoids, vitamins, polyphenolic compounds, other that have many biological effects like anti-tumor, anti-diabetic, anti-inflammatory, anti-mutagenic, antioxidant, antiviral, antitussive, hepatoprotective and hypoli

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Publication Date
Fri Jul 30 2021
Journal Name
Coatings
A Past, Present, and Prospective Review on Microwave Nondestructive Evaluation of Composite Coatings
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Recent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p

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Publication Date
Fri Jun 06 2025
Journal Name
Discover Education
A qualitative study on the beliefs and perceptions of inaugural PharmD program graduates
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Background There is an increasing need for pharmacists to incorporate more patient care targeting. Consequently, the productivity of pharmacy programs can be enhanced by evaluating the advantages and disadvantages of pharmacy curriculum. Objectives To assess the beliefs, perceptions, and challenges of the College of Pharmacy –The University of Baghdad PharmD graduates regarding the PharmD program. Method Qualitative research methodology was implemented. Graduate PharmD candidates were interviewed either inperson or via telephone. The interviews were conducted in a semi-structured format, utilizing a predetermined interview guide that included open-ended questions. Thematic analysis was implemented to analyze the data. Results A total of 2

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