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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 Jul 09 2023
Journal Name
Journal Of Engineering
Solving Time-Cost Tradeoff Problem with Resource Constraint Using Fuzzy Mathematical Model
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Scheduling considered being one of the most fundamental and essential bases of the project management. Several methods are used for project scheduling such as CPM, PERT and GERT. Since too many uncertainties are involved in methods for estimating the duration and cost of activities, these methods lack the capability of modeling practical projects. Although schedules can be developed for construction projects at early stage, there is always a possibility for unexpected material or technical shortages during construction stage. The objective of this research is to build a fuzzy mathematical model including time cost tradeoff and resource constraints analysis to be applied concurrently. The proposed model has been formulated using fuzzy the

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of lactation counseling on maintenance of breastfeeding
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Objective(s): To determine the effectiveness of lactation counseling on maintenance of breastfeeding after
cesarean section for study group.
Methodology: A quasi-experimental study was conducted on non probability sample (purposive) of (60) women
who had cesarean section and sample divided in to two groups (30) of them as a study group from Fatima AlZahra'a
Maternity and Pediatric Teaching Hospital & implement lactation counseling on it and another group (30)
as control group from Baghdad Teaching Hospital in Baghdad City. Study implemented for the period of April 24th
2011 to August 2nd 2011. A questionnaire was used as a tool of data collection to fulfill with objective of the study
and consisted of three parts

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Publication Date
Sun Aug 10 2025
Journal Name
Central Asian Journal Of Medical And Natural Science
Microbial Load Comparison Between Clinical and Non-Clinical Student Environments in Al-Kindy College of Medicine
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The environmental surfaces hygiene of college premises like classrooms play role in spreading different pathogenic bacteria, furthermore a Medical students are often potential vectors for resistant bacteria to their entourage. This study aimed to assess bacterial contamination and their susceptibility to various antimicrobial agents in the educational classroom of Al-Kindy College of medicine in two classrooms: one occupied by clinical visitor and non-clinical visitor students to evaluate and determine its health risk. In this cross-sectional study, different sites of the educational classroom of Al-Kindy College of medicine were studied.&nbsp; Ninety-sex Different swab samples were collected from 8 different sites of college across bot

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Office managers skills and it's impact on the effectiveness of time management A survey of a sample of departments managers in the institutes and faculties at the middle technical university
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The objective of this study is to highlight the skills of office managers and it's impact on the effectiveness of time management in the institutes and faculties of middle technical university and a group of cognitive and practical aims. The managers skills forms mthe modern trend and the main source to provide organizations with highly skilled managers with distinctive performance and because of the sharp changes in the environment which today's organizations works in it , business organizations generally and managers especially realise the importance of time management and it's role in achieving competitive advantage . The problem of this study raised from this point which reflect the extent of departments managers realisation

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Job satisfaction and its relation to the effectiveness of performance: Applied research on a sample of employees in the Federal board of supreme Audit
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The research aimed to study the job satisfaction of the staff of the Federal board of supreme Audit and its relation to the effectiveness of their performance, The questionnaire was adopted as a main tool in the collection of data and information from a random sample of (54) employees of the Federal board of supreme Audit. In light of this, the data were collected and analyzed and the hypotheses were tested using the statistical program (SPSS).

The researchers reached a number of conclusions, the most important of which were: (1) the respondents' response to the variables of job satisfaction and the effectiveness of the performance were medium; (2) there was a significant relationship between job satisfaction and performance effe

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
The question of demand: definition, divisions, and examples from the controversy of the scholars of jurisprudence.
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research summary

Praise be to Allah، and prayers and peace be upon His Messenger and His chosen one، his family، companions and his family and his family.

After that، this is a study on the question of the claim، as one of the controversial questions that are the mainstay of debates، and I looked at it: the limit of the question of the claim، its importance، its impact، its aspects of corruption، its sections، and the representation of its sections of the fundamentalist controversy;

The research was according to the following plan:

Introduction، in which she mentioned: the importance of the research topic and the reason for its selection، its questions، its l

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Publication Date
Sat Apr 01 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical Evaluation of a Formulated Econazol Nitrate as A Topical Solution
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Econazole nitrate (EN) is considered as the most effective agent for the treatment of all forms of dermatomycosis caused by dernatophytes. It was formulated as a topical solution in our laboratories. This study was designed to evaluate the effectiveness of Econazol Nitrate in the prepared formula and compared with that of commercial brand, Pevaryl®. A total of 104 patient suffering from dermatomycoses were involved in this investigation. Both formula were applied to the affected skin region in the morning and evening from week to 16 weeks with light massage until complete healing effect was achieved. The data revealed that the percentage of cured patient treated with the prepared formula and reference formula of Ecanozol Nitrate 1% so

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Publication Date
Tue Jan 01 2013
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical and Radiographical Evaluation of Pulpotomy in Primary Molars Treated with Pulpotec ( PD ) , Formocresol and Mineral Trioxide Aggregate ( MTA )
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Publication Date
Wed Jun 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical and radiographical evaluation of pulpotomy in primary molars treated with Pulpotec (PD), Formocresol and Mineral Trioxide Aggregate (MTA)
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Background: Pulpotomy is an accepted treatment for the management of cariously exposed pulps in symptom free primary molars to achieve one of the most important goals for Pedodontists, which is the retention of the pulpally involved deciduous teeth healthy until the time of normal exfoliation. The purpose of this study was to evaluate the relative success of pulpotec, formocresol and Mineral Trioxide Aggregate (MTA) in cariously exposed primary molar teeth, using clinical and radiographical examinations. Materials and methods: Thirty nine children with 45 primary molars requiring pulpotomy were selected in this study, 15 teeth treated by each type of pulpotomy medicament. Clinical and radiographical follow up for the patients was performed

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Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of Cost awareness of activation of strategic cost management techniques of industrial units: A prospective study at the General Company for the manufacture of medicines and medical supplies in the province of Mosul
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The last ten years observed a shift enormous scientific in the method and way that it deals professional with the cost accounting and reflected the result those shift enormous scientific of increase the competitive environmental that accompanied the emergence of a modern manufacturing environmental on surface the long roductive life and emergence advanced information technology that give a central focus of his important on client with growing global markets growth on a large scale.

        The research aim to define the concept of cost awareness, the concept and methods of  strategic cost management and the role of cost awareness for managers of industrial units in strategic of cost managem

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