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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 Apr 20 2023
Journal Name
International Journal Of Biomaterials
Antifungal Activity of Bioactive Compounds Produced by the Endophytic Fungus Paecilomyces sp. (JN227071.1) against Rhizoctonia solani
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Biologically active natural compounds are molecules produced by plants or plant-related microbes, such as endophytes. Many of these metabolites have a wide range of antimicrobial activities and other pharmaceutical properties. This study aimed to evaluate (in vitro) the antifungal activities of the secondary metabolites obtained from Paecilomyces sp. against the pathogenic fungus Rhizoctonia solani. The endophytic fungus Paecilomyces was isolated from Moringa oleifera leaves and cultured on potato dextrose broth for the production of the fungal metabolites. The activity of Paecilomyces filtrate against the radial growth of Rhizoctonia solani was tested by mixing the filtrate with potato dextrose agar medium at concentrations of 15%,

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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
The Approximation of Weighted Hölder Functions by Fourier-Jacobi Polynomials to the Singular Sturm-Liouville Operator
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      In this work, a weighted H lder function that approximates a Jacobi polynomial which solves the second order singular Sturm-Liouville equation is discussed. This is generally equivalent to the Jacobean translations and the moduli of smoothness. This paper aims to focus on improving methods of approximation and finding the upper and lower estimates for the degree of approximation in weighted H lder spaces by modifying the modulus of continuity and smoothness. Moreover, some properties for the moduli of smoothness with direct and inverse results are considered.

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Publication Date
Wed Jun 01 2016
Journal Name
Ieee Transactions On Neural Systems And Rehabilitation Engineering
Improving the Performance Against Force Variation of EMG Controlled Multifunctional Upper-Limb Prostheses for Transradial Amputees
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Publication Date
Tue May 12 2026
Journal Name
International Journal Of Environmental Analytical Chemistry
Eco-friendly chelating Ni(II) nano-compounds for colorimetric optical fiber sensing of heavy metal ions
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A new Ni(II) nanostructured chelating system (DHN) was introduced for selective optical heavy-metal ion sensing in an aqueous medium. The cooperative chelating system comprising 8-hydroxyquinoline (8-HQ) and dimethylglyoxime (DMG) has been developed for the first time in association with fibre optic sensing for selective optical heavy-metal ion sensing in an aqueous medium. The Ni(II) nanocompound fluoresces upon 578 nm excitation, showing a highly sensitive optical response with a linear calibration curve in the range 0–100 ng/mL. The regression equation of the calibration curve is y = 0.0035x + 0.9990, which indicates very good linearity, implying R2 = 0.999 with high sensitivity (calibration slope of 0.0035) and low baseline noise (bla

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Publication Date
Mon Aug 16 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology
Statistic Assessment of Spreading Cases (Total Confirmed, Recovered, Death) From Different AreasContain Novel Coronavirus (2019-n Cov)
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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Removal of Dissolved Trivalent Chromium Ions from Contaminated Wastewater using Locally Available Raw Scrap Iron-Aluminum Waste
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The present study is to investigate the possibility of using wastes in the form of scrap iron (ZVI) and/ or aluminum ZVAI for the detention and immobilization of the chromium ions in simulated wastewater. Different batch equilibrium parameters such as contact time (0-250) min, sorbent dose (2-8 g ZVI/100 mL and 0.2-1 g ZVAI/100 mL), initial pH (3-6), initial pollutant concentration of 50 mg/L, and speed of agitation (0-250) rpm were investigated. Maximum contaminant removal efficiency corresponding to (96 %) at 250 min contact time, 1g ZVAI/ 6g ZVI sorbent mass ratio, pH 5.5, pollutant concentration of 50 mg/L initially, and 250 rpm agitation speed were obtained.

The best isotherm model for the batch single Cr(III) uptake by ZVI

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Publication Date
Fri Jan 01 2010
Journal Name
Ibn Al- Haitham J. Fo R Pure & Appl. Sci
Multipole Mixing Ratios of Gamma Rays From Fe(n,ny Reaction Using Constant Statistical Tensor Method (CST).
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The - M ultiple mixing ratios of -transitions from levels of 56Fe populated in 56 56 Fe n n Fe ( , )  reactions are calculated by using const. S.T.M. This method has been used in other works [3,7] but with pure transition or with transitions that can be considered as pure transitions، in our work we used This method for mixed  - transitions in addition to pure  - transitions. The experimental angular distribution coefficients a2 was used from previous works [1] in order to calculet - values. It is clear from the results that the - values are in good agreement or consistent, within associated errors, with those reported previously [1]. The discrepancies that occur are due to inaccuracies existing in the expe

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Publication Date
Thu May 21 2026
Journal Name
Journal Of Physical Education
Using of special exercises to mtaulp speed to pass the test (150×20) for women football referees
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Publication Date
Sun Sep 02 2012
Journal Name
Baghdad Science Journal
Evaluation of bread wheat Triticum aestivum L. callus genotypes for water stress tolerance using Polyethylene Glycol (PEG)
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A fixed callus weight of 150 mg was induced from immature embryos of three bread wheat Triticum aestivum L. genotypes (Tamos 2, El-izz and Mutant 1) cultured on nutrient medium {MS) containing Polyethylene glycol (PEG-6000) supplemented with concentrations (0.0, 3.0, 6.0, 9.0 or 12.0%) to evaluate their tolerance to water stress. Cultures were incubated in darkness at temperature of 25?1 ?C. Callus fresh and dry weights were recorded and soluble Carbohydrate and the amino acid Proline concentrations were determined. Results showed that there were significant differences in studied parameters among bread wheat genotypes of which Tamos 2 was higher in callus average fresh and dry weights which gave 353.33 and 38.46 mg/cultured tube respecti

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Publication Date
Sun Apr 02 2017
Journal Name
International Workshop In Physics Applications
Antifungal activity of wide band gap Thioglycolic acid capped ZnS:Mn semiconductor nanoparticles against some pathogenic fungi(Article)
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The manganese doped zinc sulfide nanoparticles were synthesized by simple aqueous chemical reaction of manganese chloride, zinc acetate and thioacitamide in aqueous solution. Thioglycolic acid is used as capping agent for controlling the nanoparticle size. The main advantage of the ZnS:Mn nanoparticles of diameter ~ 2.73 nm is that the sample is prepared by using non-toxic precursors in a cost effective and eco-friendly way. The structural, morphological and chemical composition of the nanoparticles have been investigated by X-ray diffraction (XRD), Scanning Electron Microscopy (SEM) with energy dispersion spectroscopy (EDS) and Fourier transform infrared (FTIR) spectroscopy. The nanosize of the prepared nanoparticles was elucidated by Scan

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