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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 26 2025
Journal Name
Plos One
Neurologists’ perspectives on management challenges and mitigation strategies for Parkinson’s disease patients: A qualitative study in Iraq
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Background Parkinson’s disease (PD) is currently the fastest-growing neurological disorder in the world. Patients with PD face numerous challenges in managing their chronic condition, particularly in countries with scarce healthcare infrastructure. Objective This qualitative study aimed to delve into neurologists’ perspectives on challenges and gaps in the Iraqi healthcare system that influence the management of PD, as well as strategies to mitigate these obstacles. Method Semi-structured interviews were conducted with neurologists from five different Iraqi provinces, working in both hospitals and private neurology clinics, between November 2024 and January 2025. A thematic analysis approach was employed to identify the main challenge

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Diversity of Morphological and Syntactic Aspects in the Holy Quran with Reference to the Verse "Have we not made the earth a receptacle"
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Diversity of the aspects of analyzing a specific linguistic issue is considered to be a
familiar phenomenon in learning Arabic in which – at different levels- various linguistic
aspects and phases – sometimes – are involved in a linguistic issue . In this paper , the
problematic issues during linguistic analysis are taken into an account. The Holy Quran
interpretation books include many Quranic expressions which have a lot of meaning described
by different interpreters , from them this paper has selected only one expression ( = كفاتا
receptacle ) from the verse "Have we not made the earth a receptacle " ( Al- Mursalat verse 25
) , this paper believes that this expression is sufficient display the interpret

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Water Process Engineering
Humic acid coated sand as a novel sorbent in permeable reactive barrier for environmental remediation of groundwater polluted with copper and cadmium ions
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Plantation of humic acid nanoparticles on the inert sand through simple impregnation to obtain the permeable reactive barrier (PRB) for treating of groundwater contaminated with copper and cadmium ions. The humic acid was extracted from sewage sludge which is byproduct of the wastewater treatment plant; so, this considers an application of sustainable development. Batch tests signified that the coated sand by humic acid (CSHA) had removal efficiencies exceeded 98 % at contact time, sorbent dosage, and initial pH of 1 h, 0.25 g/50 mL and 7, respectively for 10 mg/L initial concentration and 200 rpm agitation speed. Results proved that physicosorption was the predominant mechanism for metals-CSHA interaction because the sorption data followed

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Publication Date
Fri Feb 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
"The relationship between the profits management and profits quality and their impact on users of accounting information (A comparative study of a sample of banks listed in the Iraqi market for securities)
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The aim of the research is to determine the impact of profit management practices on the quality of profits through the use of flexibility in determining accounting methods and practices profit information is one of the most important information that concerns current users in general and observing users in particular. Some corporations managements manipulate the results of the company's profit or loss (income statement) and financial position statement with multiple reasons, including capital market motivations to raise their share prices in the stock market and attract investors, and on the other hand the motives of funding and borrowing loans, and the use of the flexibility in accounting policies and estimates to change the in

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Publication Date
Mon Jun 01 2009
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of performance of some industrial companies In the default reference comparison method Field study in the public companies of cement (Iraqi - North - South
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The increasing Global Competitive and the continuous improvement in information technology has led the way to the development of the modern systems and using modern techniques. One of these techniques is benchmarking style and Total Quality Management all of them are used to improve the production process and target rid from the losts on the other side.

The Benchmarking style has become a very important for all the industrial systems and the serving systems as well. And an instrument to improve their performance specially those which are suffering from the highness of the costs or waste in time on the other side.

This study aims to depend on virtual Benchmarking style in the eval

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Publication Date
Sun Oct 20 2024
Journal Name
Engineering Reports
A Theoretical and Experimental Investigation of the Effects of Inverted Wings Modifications on the Stability and Aerodynamic Performance of a Sedan Car at Cornering
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ABSTRACT<p>This research examines the impact of cornering on the aerodynamic forces and stability of a Nissan Versa (Almera) passenger sedan car by introducing novel modifications. These modifications included single inverted wings with end plates as a front spoiler, double‐element inverted wings with end plates as a rear spoiler, and incorporating the ground as a diffuser under the car trunk. The goal is to enhance the performance and stability of conventional passenger cars. To ensure the accuracy of the numerical data, the study utilized multiple methodologies to model the turbulence model, ultimately selecting the most suitable option. This involved comparing numerical data with wind tunnel experimental d</p> ... Show More
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Publication Date
Sun Jan 01 2017
Journal Name
Biochemical And Cellular Archives
Effect of adding wheat peat and spraying with its extract and organic nutrient vegeamino on growth and yield of red cabbage
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Publication Date
Sun Sep 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Permeability Estimation for Carbonate Reservoir (Case Study/ South Iraqi Field)
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   The heterogeneity nature of carbonate reservoirs shows sever scattering of the data, therefore, one has to be cautious in using the permeability- porosity correlation for calculating permeability unless a good correlation coefficient is available. In addition, a permeability- porosity correlation technique is not enough by itself since simulation studies also require more accurate tools for reservoir description and diagnosis of flow and non-flow units.

Evaluation of reservoir characterization  was conducted by this paper for Mishrif Formation in south Iraqi oil field (heterogeneous carbonate reservoir), namely the permeability-porosity correlation, the hydraulic units (HU’s) an

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Publication Date
Mon Nov 03 2008
Journal Name
All Days
Correlations for Optimum Separation Pressures for Sequential Field Separation System
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ABSRACT<p>A study has been done to find the optimum separators pressures of separation stations. Stage separation of oil and gas is accomplished with a series of separators operating at sequentially reduced pressures. Liquid discharged from a higher pressure separator into the lower pressure separator. The set of working separators pressures which yield maximum recovery of liquid hydrocarbon from the well fluid is the optimum set of pressures which is the target of this work.</p><p>Computer model is used to find the optimum separators pressures. The model employs the Peng-Robinson equation of state for volatile oil. Application of this model shows good improvement of al</p> ... Show More
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Publication Date
Thu Dec 28 2017
Journal Name
Al-khwarizmi Engineering Journal
Obstacles Avoidance for Mobile Robot Using Enhanced Artificial Potential Field
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In this paper, an enhanced artificial potential field (EAPF) planner is introduced. This planner is proposed to rapidly find online solutions for the mobile robot path planning problems, when the underlying environment contains obstacles with unknown locations and sizes. The classical artificial potential field represents both the repulsive force due to the detected obstacle and the attractive force due to the target. These forces can be considered as the primary directional indicator for the mobile robot. However, the classical artificial potential field has many drawbacks. So, we suggest two secondary forces which are called the midpoint

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