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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
Magazine Aldhakwat Albedh
The impact of atheism on the individual and society, Iraq as a model
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Atheists have spread in the modern era, so that atheism has become a bad phenomenon in the world in general and in Islamic societies in particular, so the research aims to study the individual and social effects left by atheism on the atheists themselves, and the research included multiple axes: atheism linguistically and idiomatically, atheism in the Qur’an Noble and Modern (and Contemporary) Atheism Statistics: and the reasons for atheism: Studying the phenomenon of atheism in Iraq as a model, then studying the effects of atheism: on the individual first, then atheism and its impact on society, then the conclusion, recommendations, sources and references

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Publication Date
Sun Feb 10 2019
Journal Name
Iraqi National Journal Of Nursing Specialties
Psychological Burdens of Children with Anorectal Malformation on Mothers at Pediatric Teaching Hospitals in Baghdad City
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Objective(s): The main aim of the study is to determine the level of burden on mothers toward children with anorectal malformation.
Methodology: A descriptive study was carried out at Welfare Pediatric Teaching Hospital and Central Pediatric Teaching Hospital in Baghdad City. From November 15th, 2017 to April 29th, 2018. Convenient sample comprised of (140) children mothers with anorectal malformation were interviewed for the study. The instrument of study is composed of six domains related mothers' burden toward psychosocial burden as a result of child with anorectal malformation. Validity of the study instrument was determined through a panel of experts and the reliability of the questionnaire is determined in a pilot study among (1

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Bactericidal Effect of CO2 Laser on Bacteria Associated With Dental Implant Infection: An In Vitro Study
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One of the most popular causes for implant infection is dental plaque bacteria. Previous studies have shown the bactericidal effect of CO2 laser irradiation on bacteria associated with soft tissue surrounding the implant materials. No published studies have examined the effect of irradiation by CO2 laser on Streptococcus oralis and Staphylococcus aureus.The aim of this study was to evaluate the bactericidal effect of CO2 laser on bacteria that are causing dental implant infections. This study was carried out on two isolates of bacterial species out of 25 samples, isolated from patients having soft tissue infections around the dental implant. These two pure isolates including Streptococcus oralis and Staphylococcus aureus were identified

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Publication Date
Sun Jul 21 2024
Journal Name
Cureus
The Effect of Maternal Blood Glucose on Umbilical Cord Blood Fibrinogen in Women With Gestational Diabetes
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Publication Date
Mon Jun 19 2023
Journal Name
Journal Of Engineering
PARAMETRIC STUDY OF LAMINAR FREE CONVECTION IN INCLINED POROUS ANNULUS WITH FINS ON THE INNER CYLINDER
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An experimental and numerical study has been carried out to investigate the heat transfer by natural convection in a three dimensional annulus enclosure filled with porous media (silica sand) between two inclined concentric cylinders with (and without) annular fins attached to the inner cylinder under steady state condition; The experiments were carried out for a range of modified Rayleigh number (0.2 ≤Ra*≤ 11) and extended to Ra* =500 for numerical study, annulus inclination angle of (δ = 0˚, 30˚, 60˚ and 90˚). The numerical study was to write the governing equation under an assumptions used Darcy law and Boussinesq’s approximation and then solved numerically using finite difference approximation. It was found that the averag

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effects of Losartan versus Enalapril on Serum Uric Acid Levels in Hypertensive Patients with Metabolic Syndrome
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To investigate the effects of losartan and enalapril on serum uric acid in hypertensive patients with metabolic syndrome, one hundred and twenty six newly diagnosed mild hypertensive patients, having markers of metabolic syndrome included  in the study. The patients were divided into two groups. Group 1 (60 patients) was given losartan (50 mg/ day) and group 2 (66 patients)  enalapril (20 mg/ day) for a duration of 2 months. A control group of seventy apparently healthy individuals were included. Metabolic syndrome was diagnosed according to diagnostic criteria of metabolic syndrome related to the American National Cholesterol Education Program-Adult Treatment Panel III. Serum uric acid levels were measured bef

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Publication Date
Tue Jun 01 2021
Journal Name
International Medical Journal
Visibility of mandibular canal on CBCT cross-sectional images in comparison with panoramic radiograph: Retrospective study
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Publication Date
Sun Jul 21 2024
Journal Name
Cureus
The Effect of Maternal Blood Glucose on Umbilical Cord Blood Fibrinogen in Women With Gestational Diabetes
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Publication Date
Wed Jun 01 2022
Journal Name
Physics And Chemistry Of The Earth, Parts A/b/c
The impact of climate change on land degradation along with shoreline migration in Ghoramara Island, India
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Sea level rise (SLR) due to climate change is affecting the coastline, causing shoreline changes, the degradation of mangrove forests, and the destruction of coastal resources. This is the cause of a huge amount of mangrove degradation in many parts of the Ganges–Brahmaputra–Meghna delta. A total of 90% of people have been forced to migrate from the island due to extreme weather conditions. In this study, remote sensing (RS) and geographic information system (GIS) techniques were used for LULC change and shoreline shift analyses of Ghoramara Island. LULC classification was carried out using thirty years of Landsat datasets with intervals of ten years (1990 and 2000) and intervals of five years (2005, 2010, 2015, and 2020). The classific

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Publication Date
Sun Feb 14 2021
Journal Name
Biochemical And Cellular Archives
A RETROSPECTIVE STUDY TO EVALUATE SOME POTENTIAL RISK INDICATORS ON OSSEOINTEGRATED DENTAL IMPLANTS IN A SAMPLE OF IRAQI PATIENTS
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Determining risk indicators for dental implants is an essential strategy for preventing peri-implant diseases and effective diagnosis of dental implant success. To investigate the impact of certain potential factors on the osseointegrated dental implant. Eighty-four individuals were included in our study, 50 cases as a patient’s group and 34 participants as a control group. All cases were diagnosed based on certain criteria, 30 (60%) of patients had peri-implantitis, 20 (40%) with severe periimplantitis, 36(72%) were generalized, and 15 (30%) as localized peri-implantitis cases. The study has indicated that 44.7% of dental implants were in the anterior maxilla, followed by (27.3%) posterior maxilla, (17.4%) posterior mandible, and (10.4%)

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