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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
Mon Jan 18 2016
Journal Name
Publications Of The Astronomical Society Of The Pacific
Extreme Contrast Ratio Imaging of Sirius with a Charge Injection Device
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Publication Date
Wed Apr 01 2020
Journal Name
Plant Archives
Effect of applying selenium element and ascorbic acid on reducing the harmful effect of environmental stress on wheat plants irrigated by water contaminated with lead and cadmium
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Publication Date
Mon Apr 01 2024
Journal Name
Indonesian Journal Of Chemistry
Synthesis, Structure and Biological Activity Studies of New Metal Ion Complexes Based on 3-[(3-Hydroxynaphthalene-2-yl-ethylidene)-hydrazono]-1,3-dihydro-indol-2-one
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In the present study, a novel ligand (L) made of 2-hydroxynaphthaldehyde and 3-hydrazone-1,3-dihydro-indole-2-one(3-[(3-hydroxynaphthalen-2-yl-ethylidene)-hydrazono]-1,3-dihydro-indol-2-one). The ligand was characterized by FTIR, UV-vis, mass, 1H-NMR, 13C-NMR, and CHN elemental analysis. New complexes of this ligand were created by treating methanol and a drop of DMF solution of the produced ligand with the hydrated metal salts of Mn(II), Co(II), Ni(II), Cu(II), and Zn(II) in a molar ratio of 2:1 (L:M). As a result, complexes have been emerged and identified FTIR, UV-vis, C.H.N., chloride-containing, molar conductance, magnetic susceptibility, and atomic absorption. The characterization result for each complex indicated complexes wi

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Publication Date
Tue Feb 12 2019
Journal Name
Iraqi Journal Of Laser
Experimental Study of Spatial Self-Phase Modulation (SSPM) Based on Laser Beam and Hybrid Functionalized Carbon Nanotubes/Silver Nanoparticles (F-Mwcnts/Ag-Nps) Acetone Suspensions
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Focusing of Gaussian laser beam through nonlinear media can induce spatial self- phase modulation which forms a far field intensity pattern of concentric rings. The nonlinear refractive index change of material depends on the number of pattern rings. In this paper, a formation of tunable nonlinear refractive index change of hybrid functionalized carbon nanotubes/silver nanoparticles acetone suspensions (F-MWCNTs/Ag-NPs) at weight mixing ratio of 1:3 and volume fraction of 6x10-6 , 9x10-6 , and 18x10-6 using laser beam at wavelength of 473nm was investigated experimentally. The results showed that tunable nonlinear refractive indices were obtained and increasing of incident laser power density led to increase the nonlinear refractive inde

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Publication Date
Sun Apr 27 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
CD40 Gene Variants and Disease Susceptibility: A Comprehensive Review of Associations with Immune-Mediated Inflammatory Diseases, Cancer, and Infectious Diseases
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CD40 is a type 1 transmembrane protein composed of 277 amino acids, and it belongs to the tumor necrosis factor receptor (TNFR) superfamily. It is expressed in a variety of cell types, including normal B cells, macrophages, dendritic cells, and endothelial cells, as a costimulatory molecule. This study aims to summarize the CD40 polymorphism effect and its susceptibility to immune-related disorders. The CD40 gene polymorphisms showed a significant association with different immune-related disorders and act as a risk factor for increased susceptibility to these diseases.

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Publication Date
Fri May 01 2015
Journal Name
Journal Of Engineering
A Real-Coded Genetic Algorithm with System Reduction and Restoration for Rapid and Reliable Power Flow Solution of Power Systems
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The paper presents a highly accurate power flow solution, reducing the possibility of ending at local minima, by using Real-Coded Genetic Algorithm (RCGA) with system reduction and restoration. The proposed method (RCGA) is modified to reduce the total computing time by reducing the system in size to that of the generator buses, which, for any realistic system, will be smaller in number, and the load buses are eliminated. Then solving the power flow problem for the generator buses only by real-coded GA to calculate the voltage phase angles, whereas the voltage magnitudes are specified resulted in reduced computation time for the solution. Then the system is restored by calculating the voltages of the load buses in terms

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Publication Date
Mon Mar 08 2021
Journal Name
Journal Of Physics: Conference Series
Design and Implementation of a Moving Robot Equipped with an Arm and an FPGA to Deliver Objects between Two Positions
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Abstract<p>In this paper a system is designed and implemented using a Field Programmable Gate Array (FPGA) to move objects from a pick up location to a delivery location. This transportation of objects is done via a vehicle equipped with a robot arm and an FPGA. The path between the two locations is followed by recognizing a black line between them. The black line is sensed by Infrared sensors (IR) located on the front and on the back of the vehicle. The Robot was successfully implemented by programming the Field Programmable Gate Array with the designed system that was described as a state diagram and the robot operated properly.</p>
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Publication Date
Tue Jan 01 2008
Journal Name
J Bagh College Of Dentistry
A comparative study of the sealing ability of two different obturation techniques with and without the use of sealers.
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Background: The final stage of endodontic therapy is complete obturation of the root canal system to provide as perfect as possible at the cementodentinal junction of the apical foramen. The purpose of this in vitro study was to evaluate the sealing ability of injection molded thermoplasticized gutta percha and lateral condensation techniques with and without the use of sealers. Materials and Methods: Forty freshly extracted adult human maxillary central incisors with complete formed apices were utilized in this study. The teeth were randomly divided into four groups for evaluation of the apical seal. Group (1) lateral condensation gutta percha technique without sealer, (2) lateral condensation gutta percha technique with sealer, (3) Inject

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Publication Date
Sun Jul 12 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of dental implant stability during healing period and determination of the factors that affect implant stability by means of resonance frequency analysis(Clinical study)
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Background: Implant stability is considered one of the most important factors affecting healing and successful osseointegration of dental implants. The aims of the study were to measure the implant stability quotient (ISQ) values during the healing period and to determine the factors that affect implant stability. Materials and methods: Thirty patients enrolled in the study (17 female, 13 male). They received 44 Implantium® Dental Implants located as the following: 22 implants in maxillary jaw, 22 implants in mandibular jaw from them 17 implants in anterior segment and 27 in posterior segment. The bone density determined using interactive CT scan and classified according to the Misch bone density classification (29 implants in (D3), 15 i

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Publication Date
Sun Oct 31 2021
Journal Name
Iraqi Geological Journal
Optimizing Water Injection Performance by Using Sector Modeling of the Mishrif Formation in West Qurna-1 Oil Field, Southern Iraq
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The regular job of a reservoir engineer is to put a development plan to increase hydrocarbon production as possible and within economic and technical considerations. The development strategy for the giant reservoir is a complex and challenging task through the decision-making analysis process. Due to the limited surface water treatment facility, the reservoir management team focuses on minimizing water cut as low as possible by check the flow of formation and injected water movement through the Mishrif reservoir. In this research, a representative sector was used to make the review of water injection configuration, which is considered an efficient tool to make study in a particular area of the entire field when compared with the ful

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