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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 Jun 03 2019
Journal Name
Al-kindy College Medical Journal
A Case Report -Bilateral Giant Achilles Tendon Xanthomas Resection with a Tendon transverse Technique
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Background : Xanthomatosis is a disease in which large tendon tumors can occur, especially in the Achilles tendon. This disease is a rare interesting orthopaedic condition. Case Report:A case of a twenty eight year old girl patient with giant bilateral Achilles tendon xanthomas in which both tumors were resected. There was no ulceration on the both sides. The patient was treated by total resection of the lesion and reconstruction using tendon transfer of the Peroneus brevis and Flexor hallusis longus. Postoperative treatment consisted of six weeks lower leg cast immobilization followed by partial weight bearing. After 4 months the patient was able to walk pain free without any difficulties. It has been suggested that total resection with au

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Publication Date
Sun Jan 01 2017
Journal Name
Al-mustansiriyah
Synthesis, Spectroscopic and Biological Studies of a New Some Complexes with N-Pyridin-2-Ylmethyl-Benzene-1, 2Diamine
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Publication Date
Sun Jul 12 2026
Journal Name
Mustansiria Dental Journal
Soft tissue measurements of Iraqi individuals with Cl I and Cl III skeletal pattern: a comparative cephalometric study
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Publication Date
Thu Feb 01 2024
Journal Name
Structures
Accelerating reliability analysis of deteriorated simply supported concrete beam with a newly developed approach: MCS, FORM and ANN
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Reliability analysis methods are used to evaluate the safety of reinforced concrete structures by evaluating the limit state function 𝑔(𝑋𝑖). For implicit limit state function and nonlinear analysis , an advanced reliability analysis methods are needed. Monte Carlo simulation (MCS) can be used in this case however, as the number of input variables increases, the time required for MCS also increases, making it a time consuming method especially for complex problems with implicit performance functions. In such cases, MCS-based FORM (First Order Reliability Method) and Artificial Neural Network-based FORM (ANN FORM) have been proposed as alternatives. However, it is important to note that both MCS-FORM and ANN-FORM can also be time-con

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Publication Date
Sun Sep 04 2016
Journal Name
Baghdad Science Journal
A Study the Effect of TiO2 Nanoparticles Combination with Antibiotics and Plant extracts Against Some Gram Negative Bacteria
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Titanium dioxide TiO2 has been widely utilized in cleaning and sterilizing material for many clinical tools sanitary ware, food tableware and cooking and items for use in hospitals. Titanium dioxide TiO2 non toxicity and long term physical and chemical stability. It has been widely used decomposition of organic compounds and microbial organisms such as cancer cell, viruses and bacteria as well as its potential application in sterilization of medical devices. The aim of the study the effect of titanium dioxide TiO2 on some Gram negative bacteria and study their effects on some virulence factors and chromosomal DNA.In this study, we obtained (E. coli ? Proteus mirabilis, Proteus vulgaris ? Pseudomonas aeruginosa ? Klebsiella pneumonia and Ac

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Publication Date
Tue Jan 01 2019
Journal Name
Molecular Biology Research Communications
Association study of two single nucleotide polymorphisms rs10757278 and rs1333049 with atherosclerosis, a case-control study from Iraq
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Publication Date
Tue Jan 03 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Knowledge, Attitudes, and Perceptions about COVID-19 and its Vaccine among Patients with Rheumatoid Arthritis: A Qualitative Study
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Background: Despite the importance of vaccines in preventing COVID-19, the willingness to receive COVID-19 vaccines is lower among RA patients than in the general population. Objective: To determine the extent of COVID-19 knowledge among RA patients and their attitudes and perceptions of COVID-19 vaccines. Methods: A qualitative study with a phenomenology approach was performed through face-to-face, individual-based, semi-structured interviews in the Baghdad Teaching Hospital, Baghdad, Iraq, rheumatology unit. A convenient sample of RA patients using disease-modifying anti-rheumatic drugs was included until the point of saturation. A thematic content analysis approach was used to analyze the obtained data. Results: Twenty-five RA pa

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Implementation within strategic planning and its impact on banking service quality: (An applied research on a sample of Iraqi banks)
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In the midst of rapid changes and difficultiesand the tough competition faced by the Iraqi banks, it has become necessary to focus on a significant aspect of administrative work; that is strategic planning and the key role of implementation within this process in improving the banking service quality. It has emerged as a critical and main competitive weapon for distinguishing the services provided by banks from each other in an effort to participate in increasing market share of the bank in question in question; in its growth, continuation and profit increase.

The research has addressed the relation between the independent variable (implementation within strategic planning), and the dependent variable (banking service quality and

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Publication Date
Mon Jan 01 2018
Journal Name
Research Journal Of Pharmacy And Technology
Impact of Human Cytomegalovirus Infection associated with the expressed protein of mutated <i>BRCA1</i> gene in breast tissues from a group of Iraqi Female Patients with Breast Carcinoma
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Publication Date
Mon Oct 06 2025
Journal Name
Engineering, Technology &amp; Applied Science Research
Encased Pultruded GFRP Beams with Shear Connectors: A Review
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This study examines the structural performance of concrete-encased pultruded Glass Fiber Reinforced Polymer (GFRP) I-sections with shear connections. It specifically focuses on how different parameters affect the latter’s ductility, flexural strength, and load-carrying capacity. The key variables studied include various shear connector types, spacing, and geometries, as well as the compressive strength of concrete and the properties of GFRP. The finite element modeling and experimental validation show that the shear connectors significantly improve the ductility, ultimate capacity, and load transmission efficiency. The present review emphasizes that the shear connectors greatly enhance the structural performance when they are prop

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