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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 Mar 26 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Design, Synthesis and Kinetic Study of Coumarin-Based Mutual Prodrug of 5-Fluorouracil and Dichloroacetic acid
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On the basis of known coumarin-based prodrug system, a novel coumarin-based mutual prodrug of 5-fluorouracil and dichloroacetic acid was designed, synthesized and evaluated as a promising oral chemotherapeutic agent basing on in vitro stability study in HCl buffer (pH 1.2) and in phosphate buffer (pH 7.4), as well as in vitro release study in human serum. The chemical structure of prodrug was confirmed by analyzing its FTIR, 1H NMR, 13C NMR and MS-ESI spectra. The results of in vitro kinetic study indicated that the prodrug was significantly stable in HCl and in phosphate buffers, and was hydrolyzed in human serum followed pseudo first order kinetics.

Keywords: Coumarin-bas

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Role of Ezetimibe in Combination with Statins(Simvastatin and Atorvastatin) in Controlling Dyslipidemia
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          Cardiovascular risk is independently increased by plasma lipids abnormalities (low- density and high density lipoprotein -cholesterol and triglycerides). Most patients have more than one lipid abnormality. Combination therapy with lipid-modifying agents could offer an important therapeutic option for improving the overall lipid profile. Combinations have demonstrated to provide additive efficacy and significant reductions in coronary events . This study was designed to evaluate the effect of ezetimibe, when used in combination with other hypolipidaemic agents ( statins) on lipid  profile as well as on liver function ,renal function, oxidative stress, and platele

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Publication Date
Sun Jun 30 2024
Journal Name
International Journal Of Intelligent Engineering And Systems
Development of Intelligent Control Strategy for an Anesthesia System Based on Radial Basis Function Neural Network Like PID Controller
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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Peptide Science
Studies on the antileishmanial properties of the antimicrobial peptides temporin A, B and 1Sa
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Given the paucity and toxicity of available drugs for leishmaniasis, coupled with the advent of drug resistance, the discovery of new therapies for this neglected tropical disease is recognised as being of the utmost urgency. As such antimicrobial peptides (AMPs) have been proposed as promising compounds against the causative Leishmania species, insect vector-borne protozoan parasites. Here the AMP temporins A, B and 1Sa have been synthesised and screened for activity against Leishmania mexicana insect stage promastigotes and mammalian stage amastigotes, a significant cause of human cutaneous disease. In contrast to previous studies with other species the activity of these AMPs against L. mexicana amastigotes was low. This suggests that ama

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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi Postgraduate Med J
Effects of herbs–containing phytoestrogens on rat testis: A histological, histochemical and biochemical study
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ABSTRACT: BACKGROUND: Estrogens has traditionally been known as the female hormone, but this idea has been challenged in early 1990’s and an essential physiological role for estrogen in male fertility was identified. Phytoestrogens are naturally occurring non-steroidal plant chemicals that can act like the female hormone estrogen. The herbs ( anise alfalfa and vervain ) chosen in this study contain phytoestrogens. OBJECTIVE: Previous studies demonstrated controversy of the effects of phytoestrogens on the rat testes .Hence, the present investigation was undertaken to investigate the influence of typical dose of herbs containing phytoestrogen on the rat testis. MATERIALS AND METHODS: Twenty-four apparently normal mature male rats we

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Publication Date
Sun Dec 01 2019
Journal Name
Baghdad Science Journal
Adsorption of Some Alephatic Dicarboxylic Acids on Zinc Oxide: A kinetic and Thermodynamic Study
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The adsorption of Malonic acid, Succinic acid, Adipic acid, and Azelaic acid from their aqueous solutions on zinc oxide surface were investigated. The adsorption efficiency was investigated using various factors such as adsorbent amount, contact time, initial concentration, and temperature. Optimum conditions for acids removal from its aqueous solutions were found to be adsorbent dose (0.2 g), equilibrium contact time (40 minutes), initial acids concentration (0.005 M). Variation of temperature as a function of adsorption efficiency showed that increasing the temperature would result in decreasing the adsorption ability. Kinetic modeling by applying the pseudo-second order model can provide a better fit of the data with a greater correla

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Publication Date
Wed Jan 01 2020
Journal Name
Journal Of Clinical And Experimental Dentistry
The effect of osseodensification on implant stability and bone density: A prospective observational study
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Background: The aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Material and methods: This prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was conside

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Publication Date
Fri Jan 01 2021
Journal Name
E3s Web Of Conferences 318, 03002 (2021)
A Comparative Study on Behavior of RC Columns Strengthened by CFRP and Steel Jacket
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This paper studies the behavior of axially loaded RC columns which are confined with carbon fiber reinforced polymers’ sheet (CFRP) and steel jackets (SJ). The study is based on twelve axially loaded RC columns tested up to failure. It is divided into three schemes based on its strengthening type; each scheme has four columns. The main parameters in this study were the compressive strength of the concrete and steel reinforcement ratio. Furthermore, the results of the experimental test showed a substantial enhancement in the column's load-carrying capacity. When compared to the original columns, the CFRP sheet had a significant effect on improving the ductility of the column by increasing the axial deformation by about 59.2 to 95.7

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Publication Date
Sun Nov 01 2009
Journal Name
Tencon 2009 - 2009 Ieee Region 10 Conference
The effect of using XCAST based routing protocol in wireless ad hoc networks
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Publication Date
Thu Jun 30 2011
Journal Name
Al-khwarizmi Engineering Journal
Performance Improvement of Neural Network Based RLS Channel Estimators in MIMO-OFDM Systems
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The objective of this study was tointroduce a recursive least squares (RLS) parameter estimatorenhanced by using a neural network (NN) to facilitate the computing of a bit error rate (BER) (error reduction) during channels estimation of a multiple input-multiple output orthogonal frequency division multiplexing (MIMO-OFDM) system over a Rayleigh multipath fading channel.Recursive least square is an efficient approach to neural network training:first, the neural network estimator learns to adapt to the channel variations then it estimates the channel frequency response. Simulation results show that the proposed method has better performance compared to the conventional methods least square (LS) and the original RLS and it is more robust a

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