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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
Sat May 30 2026
Journal Name
Iraqi Journal Of Science
Simultaneous determination of a mixture of beta-lactam drugs in their pure forms and pharmaceutical preparation using high performance liquid chromatography with an ultraviolet detecto
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A modern, rapid RP-HPLC-UV method was developed and validated in compliance with FDA and EMA guidelines for simultaneous quantification of 15 βlactam antibiotics) Ampicillin, Amoxicillin, cephalexin, cefotaxime, cefoxitin, cefamandole, cephalothin, piperacillin, penicillin, oxacillin, cloxacillin, nafcillin Carbenicillin, Mezlocillin and Dicloxacillin) in pharmaceutical formulations and pure forms. The method employs Column NEUCLEODUR C-18 (4.0 mm x 100 mm, 5µm particle size), at a temperature of thirty degrees Celsius, and the mobile phase was acetonitrile and KH2PO4 using gradient elution with a total separation time of 13 minutes, a flow rate of 1.3 ml/min, at = pH 4.5 for the buffer solution and the λ max was 220 nm. The met

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Publication Date
Sat Jul 01 2023
Journal Name
Iop Conference Series: Earth And Environmental Science
A Statistical Analysis of the Effects of Afforestation on the Environment in Iraq (Northern Iraq)
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Abstract<p>The significance of the research conducted in northern Iraq comes despite the expansion of afforestation projects; yet, the suffering of the forests has increased due to their lack of scientific study, unpredictability of the climate, and adverse effects on the spread and growth of plant species Therefore, the goal of the study is to understand the effects of afforestation through a statistical analysis of plant diversity in northern Iraq and its distinctivenessThe analysis revealed that natural groupings had improved qualitatively more than other groups, particularly some dwindling species that are able to compete and occupy new areas. drought-prone vegetation, vegetation, and climat</p> ... Show More
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Publication Date
Sun Dec 30 2007
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Effect of Feed Concentration on the Production of Pregelatinized Starch in a Double Drum Dryer
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Double drum dryer is operated for producing pregelatinized maize starches using feed starch slurries of different
solids(7, 10 and13 g/100 g )content . Steam pressure (2,3,and 4 bar), the level of pool between the drums (4,7,and 10
cm) , and speed of drums rotation (3,4,and 6 rpm) are varied together with the feed solids content in a practical range of
values. The response of the dryer is registered by measuring several output variables, i.e. external drum temperature,
product moisture content, mass flow rate.

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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
Level of uric acid and its, relationship with lipid peroxidation in sera of patients with acute coronary syndrome
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Unstable angina pectoris often leads to acute myocardial infarction. Since uric acid is thought to be risk factor for cardiovascular disease and considered a major antioxidant in human blood .The level of uric acid and lipid peroxidation in the sera of patients with unstable angina and myocardial infarction were measured and compared to the healthy individuals. Twenty-nine patients with unstable angina and twenty-nine patients with myocardial infarction were studied and compared to twenty-five healthy individuals. Uric acid was measured by using Human Kit. Malondialdelyde (MDA) a lipid peroxidation marker, was measured by thiobarbituric acid method .Significant elevation of uric acid and MDA were observed in the sera of pati

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Publication Date
Thu Jun 01 2023
Journal Name
Electronics
Downlink Training Sequence Design Based on Waterfilling Solution for Low-Latency FDD Massive MIMO Communications Systems
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Future generations of wireless communications systems are expected to evolve toward allowing massive ubiquitous connectivity and achieving ultra-reliable and low-latency communications (URLLC) with extremely high data rates. Massive multiple-input multiple-output (m-MIMO) is a crucial transmission technique to fulfill the demands of high data rates in the upcoming wireless systems. However, obtaining a downlink (DL) training sequence (TS) that is feasible for fast channel estimation, i.e., meeting the low-latency communications required by future generations of wireless systems, in m-MIMO with frequency-division-duplex (FDD) when users have different channel correlations is very challenging. Therefore, a low-complexity solution for

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering
The Intelligent Auto-Tuning Controller Design Based on Dolphin Echo Location for Blood Glucose Monitoring System
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This paper presents an enhancement technique for tracking and regulating the blood glucose level for diabetic patients using an intelligent auto-tuning Proportional-Integral-Derivative PID controller. The proposed controller aims to generate the best insulin control action responsible for regulating the blood glucose level precisely, accurately, and quickly. The tuning control algorithm used the Dolphin Echolocation Optimization (DEO) algorithm for obtaining the near-optimal PID controller parameters with a proposed time domain specification performance index. The MATLAB simulation results for three different patients showed that the effectiveness and the robustness of the proposed control algorithm in terms of fast gene

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Publication Date
Mon Feb 06 2023
Journal Name
Journal Of Kufa-physics
No-Core optical fibers sensor for detecting hemoglobin concentration (HB) based on the Surface Plasmon resonance.
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In this work, a fiber-optic biomedical sensor was manufactured to detect hemoglobin percentages in the blood. SPR-based coreless optical fibers were developed and implemented using single and multiple optical fibers. It was also used to calculate refractive indices and concentrations of hemoglobin in blood samples. An optical fiber, with a thickness of 40 nanometers, was deposited on gold metal for the sensing area to increase the sensitivity of the sensor. The optical fiber used in this work has a diameter of 125μm, no core, and is made up of a pure silica glass rod and an acrylate coating. The length of the fiber was 4cm removed buffer and the splicing process was done. It is found in practice that when the sensitive refractive i

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Publication Date
Mon Feb 10 2025
Journal Name
Journal Of Optics
Implementing quantum key distribution based on coincidence detection captured from two different single photon detection modules
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Quantum key distribution (QKD) provides unconditional security in theory. However, practical QKD systems face challenges in maximizing the secure key rate and extending transmission distances. In this paper, we introduce a comparative study of the BB84 protocol using coincidence detection with two different quantum channels: a free space and underwater quantum channels. A simulated seawater was used as an example for underwater quantum channel. Different single photon detection modules were used on Bob’s side to capture the coincidence counts. Results showed that increasing the mean photon number generally leads to a higher rate of coincidence detection and therefore higher possibility of increasing the secure key rate. The secure key rat

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Publication Date
Sat Nov 22 2014
Journal Name
Indian Journal Of Physics
Comparison between shell model and self-consistent mean field calculations for ground charge density distributions and elastic form factors of 12C and 16O nuclei
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Publication Date
Sat Nov 22 2014
Journal Name
Indian Journal Of Physics
Comparison between shell model and self-consistent mean field calculations for ground charge density distributions and elastic form factors of 12C and 16O nuclei
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Scopus (5)
Crossref (3)
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