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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 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) and global hydraulic elements (GHE

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Publication Date
Wed Oct 03 2012
Journal Name
Journal Of Kufa For Chemical Science
A study of Adsorption of Acetone and 2- Butanone on Iraqi Siliceouns Rocks Powder
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Adsorption of Acetone and 2-Butanone on Iraqi siliceouns rocks powder have been investigated. UV technique has been used to determine the adsorption isotherms. The results showed that the adsorption isotherms obeyed Freundlich adsorption equation. The results showed that the adsorption increases with increasing acidity of solutions. The adsorption was exothermic process, increasing temperature leads to decreasing adsorption. H,  S, G were calculated

Publication Date
Sun Sep 11 2022
Journal Name
Mathematics
Modeling and Analysis of the Influence of Fear on a Harvested Food Web System
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The food web is a crucial conceptual tool for understanding the dynamics of energy transfer in an ecosystem, as well as the feeding relationships among species within a community. It also reveals species interactions and community structure. As a result, an ecological food web system with two predators competing for prey while experiencing fear was developed and studied. The properties of the solution of the system were determined, and all potential equilibrium points were identified. The dynamic behavior in their immediate surroundings was examined both locally and globally. The system’s persistence demands were calculated, and all conceivable forms of local bifurcations were investigated. With the aid of MATLAB, a numerical simu

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
A study of the Effect of Air Inlet and Exit on Indoor Air Movement
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This work consists of a numerical simulation to predict the velocity and temperature distributions, and an experimental work to visualize the air flow in a room model. The numerical work is based on non-isothermal, incompressible, three dimensional, k turbulence model, and solved using a computational fluid dynamic (CFD) approach, involving finite volume technique to solve continuity, momentum and energy equations, that governs the room’s turbulent flow domain. The experimental study was performed using (1/5) scaled room model of the actual dimensions of the room to simulate room air flow and visualize the flow pattern using smoke generated  from burnt herbs and collected in a smoke generator to delivered through

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Publication Date
Sat May 02 2020
Journal Name
Karbala Journal Of Physical Education Sciences
The effect of using a designed device to develop the technical performance of the descending landing skill facing with half a cycle on the parallel device of the technical men&#39;s
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AS Salman, SK Hameed…, Karbala Journal of Physical Education Sciences, 2020

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Publication Date
Wed Jun 21 2023
Journal Name
Journal Of Electrochemical Science And Engineering
Phenol removal by electro-Fenton process using a 3D electrode with iron foam as particles and carbon fibre modified with graphene
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The 3D electro-Fenton technique is, due to its high efficiency, one of the technologies suggested to eliminate organic pollutants in wastewater. The type of particle electrode used in the 3D electro-Fenton process is one of the most crucial variables because of its effect on the formation of reactive species and the source of iron ions. The electrolytic cell in the current study consisted of graphite as an anode, carbon fiber (CF) modified with graphene as a cathode, and iron foam particles as a third electrode. A response surface methodology (RSM) approach was used to optimize the 3D electro-Fenton process. The RSM results revealed that the quadratic model has a high R2 of 99.05 %. At 4 g L-1 iron foam particles, time of 5 h, and

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Publication Date
Mon Sep 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Suggested Model for accounting disclosure proactive and reflect on the decisions of investors: Applied research in a sample of industrial companies listed on the Iraq Stock Exchange
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Often requires the investor to know the result of the company's activity contribute to the investor or by wanting to invest in them because profit or loss of the company affect positively or negatively in the price of shares of the company and with the end of the fiscal year delayed companies often to issue its financial statements after it is approved and audited by an observer External Auditor, From here came the idea of ​​research that appears to stakeholders of financial statements proactive appear, including actual figures for earlier stages have been prepared lists about lists and planned by the administration reflect the results of its phase remainder of the year as if they are (half a year or season or month) to offer At the

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Publication Date
Sun Jun 04 2017
Journal Name
Baghdad Science Journal
Detection of zpx gene of Cronobacter sakazakii isolated from Clinical samples for Iraqi children under Two Years
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The study included 200 samples were collected from children under two years included (50 samples from each of Cerebrospinal fluid, Blood, Stool and Urine) from, (Central Children Hospital and Children's Protections Educational Hospital) The Iraqi Ministry of Health, the Department of Health Baghdad .the period from the first of 2015 September to the first of December 2015, Were obtained isolates bacterial subjected to the cultural, microscopic and biochemical examination and diagnosed to the species by using vitek2 system .The results showed there were contamination in 6.5% of clinical samples. The diagnosed colonies which gave pink color on the MacConkey agar, golden yellow color on the Trypton Soy agar and green color on t

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Publication Date
Sun Jul 01 2001
Journal Name
.
A study of Immune Response in Golden Hamsters to Vaccinate against Leishmaniasis with Killed Promastigotes of Leishmania tropica
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Publication Date
Tue Mar 20 2018
Journal Name
Mustansiria Dental Journal
A comparative Study in the Antibacterial effect of Eugenol as Hand Wash Material with two Types of Soap
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Hands have consistently been an important vehicle in the transmission of disease (1). Thus, thorough hand-washing remains the single most important factor in preventing infection specially in hospitals and labs.Twenty-nine non-clinical volunteers (do not work or come in contact with a clinical or hospital setting) that lacked visible skin injuries, eczema or apparent skin disease were used, those subjects were all tested by a material of each of the three used in the study weekly and laboratory tests were done pre- and post washing.All three material were effective , Eugenol extract as effective as the bar and lotion soap. And this was confirmed statistically.Eugenol has a great antibacterial action even in small concentration and t

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