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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 Jun 30 2024
Journal Name
Anbar Journal Of Agricultural Sciences
THE GENETIC DIAGNOSIS OF THE BACTERIA ISOLATED FROM THE AGRICULTURAL SOIL SUSTAINED FARMS BY THE POLYMERASE CHAIN REACTION TECHNIQUE QPCR
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The measurements and tests of the samples conducted in the laboratories of the College of Agriculture included isolating bio-fertilizers and testing the efficiency of isolates that fix atmospheric nitrogen and solubilize phosphorous compounds. Bacteria were isolated and identified from the rhizosphere soils of different plants collected from various agricultural areas. A total of 74 bacterial isolates were obtained based on the phenotypic characteristics of the developing colonies, as well as biochemical and microscopic traits. The results of isolation and identification showed that among the 74 bacterial isolates, there were 15 isolates of A. chroococcum, 13 of Az. lipoferum, 13 of B. megaterium, 10 of P. putida, 10 of Actinomycetes, and n

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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Educational And Psychological Researches
Analyzing the content of the two science books (the two chemistry units) for the intermediate stage according to environmental problems
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    The main goal of the current research is to know -Environmental problems included in the content of the two science books (chemistry units) for intermediate stage

A list of environmental problems had been prepared  and  consisting of (8) main areas which are (air and atmosphere pollution, water pollution, soil pollution, energy, disturbance of biodiversity and environmental balance, waste management, food and medicinal pollution, investment of mineral wealth). Of which (60) sub-problems,  at that time the researcher analyzed the two science books (two chemistry units) for the intermediate stage of the academic year (2020-2021) in light of the list that was prepared, and the validity and consisten

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Publication Date
Mon Jun 05 2023
Journal Name
Al-khwarizmi Engineering Journal
Removal of Malachite Green from Aqueous Solution using Ficus Benjamina Activated Carbon-Nonmetal Oxide synthesized by pyro Carbonic Acid Microwave
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Activated carbon derived from Ficus Binjamina agro-waste synthesized by pyro carbonic acid microwave method and treated with silicon oxide (SiO2) was used to enhance the adsorption capability of the malachite green (MG) dye. Three factors of concentration of dye, time of mixing, and the amount of activated carbon with four levels were used to investigate their effect on the MG removal efficiency. The results show that 0.4 g/L dosage, 80 mg/L dye concentration, and 40 min adsorption duration were found as an optimum conditions for 99.13% removal efficiency. The results also reveal that Freundlich isotherm and the pseudo-second-order kinetic models were the best models to describe the equilibrium adsorption data.

 

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Publication Date
Tue Oct 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
Achieving Educational Service Quality by applying international standard (ISO21001:2018) case study / university of technology – electromechanical engineering department – energy branch
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The research examines the mechanism of application of )ISO 21001: 2018( in the Energy Branch- Electromechanical Engineering at the University of Technology to achieve the quality of the educational service to prepare the branch to obtain the certificate of conformity with the requirements of) ISO 21001: 2018(, the necessary data were collected Depending on the (CHEKLIST) of (ISO 21001: 2018), field interviews and records of the concerned department, The researchers reached a number of results, the most prominent of which was the adoption of high quality leadership leaders and their willingness to implement the standard requirements, The university has a basic structure that qualifies it to implement the international standard, as

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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Improve the performance of solar cells using new designs for pelvic center wheel Type V compound mirrors encased by Vernil glasses
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Design and build a center basins new p-type four mirrors were studied its effect on all parameters evaluating the performance of the solar cell silicon in the absence of a cooling system is switched on and noted that the efficiency of the performance Hzzh cell increased from 11.94 to 21 without cooling either with cooling has increased the efficiency of the

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
The optical properties of mawsonite Cu6Fe2SNS8 [CFTS] thin films effected by red laser irradiation deposited via semi-computerized spray pyrolysis technique
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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
An Efficient Numerical Method for Solving Volterra-Fredholm Integro-Differential Equations of Fractional Order by Using Shifted Jacobi-Spectral Collocation Method
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The aim of this article is to solve the Volterra-Fredholm integro-differential equations of fractional order numerically by using the shifted Jacobi polynomial collocation method. The Jacobi polynomial and collocation method properties are presented. This technique is used to convert the problem into the solution of linear algebraic equations. The fractional derivatives are considered in the Caputo sense. Numerical examples are given to show the accuracy and reliability of the proposed technique.

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Publication Date
Wed Jan 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
Estimating the reliability function of the asymmetrical hybrid parallel-series system: Applied study at the state company for vegetable oils industry
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The research studied and analyzed the hybrid parallel-series systems of asymmetrical components by applying different experiments of simulations used to estimate the reliability function of those systems through the use of the maximum likelihood method as well as the Bayes standard method via both symmetrical and asymmetrical loss functions following Rayleigh distribution and Informative Prior distribution. The simulation experiments included different sizes of samples and default parameters which were then compared with one another depending on Square Error averages. Following that was the application of Bayes standard method by the Entropy Loss function that proved successful throughout the experimental side in finding the reliability fun

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Publication Date
Wed Jan 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluating the Impact of Pharmacist Counselling for Asthmatic Children at Karbala Teaching Hospital for Children: An Interventional Prospective Study (Conference Paper )#
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Asthma is one of the most common chronic, non-communicable diseases affecting children worldwide. The estimated prevalence of pediatric asthma in Iraq is 15.8%. Physiologic, inflammatory and structural factors contribute to the development of asthma. Assessment and monitoring of asthma control can be done by a validated children asthma control test (CACT). Management of asthma must address three components which are an appropriate management plan, the most appropriate medication if necessary, and the use of safe and effective medication. The management plan should consider patient counseling and education about the definition of asthma, signs, and symptoms, the pathophysiology of asthma, common triggers for asthma and how can avoid them,

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Publication Date
Sun Jan 01 2017
Journal Name
Food And Nutrition Sciences
Optimization of Culture Conditions to Produce Phytase from &amp;lt;i&amp;gt;Aspergillus tubingensis SKA&amp;lt;/i&amp;gt;
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The effects of nutrients and physical conditions on phytase production were investigated with a recently isolated strain of Aspergillus tubingensis SKA under solid state fermentation on wheat bran. The nutrient factors investigated included carbon source, nitrogen source, phosphate source and concentration, metal ions (salts) and the physical parameters investigated included inoculum size, pH, temperature and fermentation duration. Our investigations revealed that optimal productivity of phytase was achieved using wheat bran supplemented with: 1.5% glucose. 0.5% (NH4)2SO4, 0.1% sodium phytate. Additionally, optimal physical conditions were 1 × 105 spore/g substrate, initial pH of 5.0, temperature of fermentation 30˚C and fermentation dura

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