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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 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
The role of loyal workers enhance market share center the human resource management strategies / field research in cellular telecommunication companies
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The problem for the search to identify the role of loyal workers through (emotional loyalty, moral loyalty, continued loyalty) in enhancing the market share of the corporate center the human resource management strategies, namely (selection, training and development, and performance evaluation, and returns the system) for the parent company of cellular Allotsalat in Baghdad ,, and show the importance of research through the benefit to the company, through the importance of the search results, it draws the attention of decision-makers and those in charge of managing these human resources on the importance of those resources and work to develop them and keep them in order to increase their loyalty towards their organization and the

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Publication Date
Wed Dec 24 2025
Journal Name
Baghdad Science Journal
Association of CTGF and TGF –ß1 With Glomerulus Fibrosis in Iraqi Diabetic Patients With Chronic Kidney Disease
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Publication Date
Fri May 01 2020
Journal Name
Plant Archives
Correlation study of obestatin and progranulin with liver function enzyme in Iraqi females patients with colorectal cancer
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The second most commonly diagnosed cancer is colorectal cancer (CRC) is in female. The levels of progranulin, obestatin and liver enzymes including ALT, AST and ALP were measured in forty five sera in female patients suffering from CRC before chemotherapy initiation treatment as G1, G2 after first chemotherapy cycle and G3 after second chemotherapy cycle compared with thirty female as a healthy control G4. Results showed a high significant increased in progranulin concentration and a high significant decrease in obestatin in G2 than other groups. The correlation between progranulin and ALP was a significant negative (-ve) relation while obestatin with AST gave a significant positive (+ve) correlation in G. The results also showed non signif

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Scopus
Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Investigating the Effect of Genetic Polymorphisms of Deiodinase Type 2 on Levothyroxine Dose Requirements in Patients with Hypothyroidism
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Background: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes.  Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations. Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase type 2 (rs225013 and rs225014) and le

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Investigating the Effect of Genetic Polymorphisms of Deiodinase Type 2 on Levothyroxine Dose Requirements in Patients with Hypothyroidism
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Background: Hypothyroidism is the most abundant thyroid disorder worldwide. For decades, levothyroxine was the main effective pharmacological treatment for hypothyroidism. A variety of factors can influence levothyroxine dose, such as genetic variations. Studying the impact of genetic polymorphisms on the administration of medications was risen remarkably. Different genetic variations were investigated that might affect levothyroxine dose requirements, especially the deiodinase enzymes.  Deiodinase type 2 genetic polymorphisms’ impact on levothyroxine dose was studied in different populations.

Objective: To examine the association of the two single nucleotide polymorphism (SNP)s of deiodinase t

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of Oral Supplementation of Pomegranate Peel Extract on Some serum biochemical Parameters Related with Bone in Rabbit
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Background and aim: Pomegranate is a medicinal herb that can promote healing of periodontal tissue through differentiation of mesenchymal cells both in vivo and in vitro. Therefore, this study is to investigate the effect of oral supplementation of Punicagranatum L. peel extract on bone defect in rabbit. Methods: Forty five male rabbits were divided into 3 groups; group 1; baseline group(5 rabbits) left without bone defect. Group 2; study group (20 rabbits) with bone defect model that received daily 1ml of oral supplementation of pomegranate peel extract (PoPx). Group 3; control group (20 rabbits) with bone defect model that received distilled water. Bone defect was done into facial plate of lower right central incisor. Blood biopsies by

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation the Effect of Phytosterol Fraction of Chenopodium Murale in Comparison with Tacrolimus on Mice Induced Atopic Dermatitis
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Atopic dermatitis (atopic eczema), is a common familial chronic inflammatory skin disease, determined by xerosis, itching, scaly and erythematous skin lesions, and high serum levels of IgE. Between 10 to 20% of children and 1 to 3% of adults worldwide affected by it and has negative medical and social effect on patients and their families. To evaluate the effectiveness of Phytosterol Fraction of Chenopodium Murale on induced atopic dermatitis (AD) of mice; Forty mice were included in the study, divided in to four groups (10 mice/group): apparently healthy, induced AD without treatment, induced AD treated with Tacrolimus 0.1% ointment, and induced AD treated with Phytosterol Fraction of Chenopodium Murale cream 3% topica

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Building Engineering
The influence of earthquake characteristics on the seismic performance of reinforced concrete buildings in Australia with varying heights
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In Australia, most of the existing buildings were designed before the release of the Australian standard for earthquake actions in 2007. Therefore, many existing buildings in Australia lack adequate seismic design, and their seismic performance must be assessed. The recent earthquake that struck Mansfield, Victoria near Melbourne elevated the need to produce fragility curves for existing reinforced concrete (RC) buildings in Australia. Fragility curves are frequently utilized to assess buildings’ seismic performance and it is defined as the demand probability surpassing capacity at a given intensity level. Numerous factors can influence the results of the fragility assessment of RC buildings. Among the most important factors that can affe

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Publication Date
Sun Jan 01 2023
Journal Name
Al-bayan Journal For Medical And Health Sciences
Effect of Nd:YAG Laser Surface Treatment on Wettability of Thermoplastic Acrylic in Comparison with Heat-Cure Acrylic resin
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Aim of the study: This study's goal was to determine how laser surface alteration affected wettability of injectable thermoplastic acrylic and heat cure acrylic denture base materials. Materials and methods: Injectable thermoplastic acrylic resin (Deflex) and heat cure acrylic (Procryla) were used in this study to produce forty-disc shaped specimens, 20 specimens for each material type. The control group was made up of ten samples of each type of plastic denture base material. The other ten samples were treated with a nano-pulse fiber-optic lens Nd:YAG laser. The results were looked at with the Kruskal-Wallis test and the unpaired t-test (a=.05). Results: Compared to the control groups, the laser-treated groups were more likely to sti

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Publication Date
Thu Jan 10 2019
Journal Name
Journal Of The College Of Education For Women
Tribal separation and its relation to the organization of the community from the point of view of tribal sheikhs Field study in the City of Baghdad Sadr City model))
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One of topics that occupied alarge area  in Iraqi  society  at the moment is the  issue( of tribal  separation and its  relation  to the organization of  the community ) so we see in the civilizations and heritage  of each community aset  of provisions and laws that take the form of status   customary or religious it is indicative of the great interest in Iraqi society in cotrolling the behavior of individuals to comply with values and social laws and become their behavior is consistent with the behavior of the total and adhere to the social values and be productive individuals within  the subject and this can only be  achieved  from the social co

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