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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
Fri Jan 01 2016
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Structural and Electrical Properties Dependence on annealing temperature of a-Ge: Sb/c-Si Heterojunction
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Publication Date
Thu May 14 2020
Journal Name
Journal Of Planner And Development
Visual Pollution and its Impact on the Aesthetics: The Town of Eizariya as a Model
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This study seeks to shed light on the aspects of visual pollution and its impact on the aesthetics of the town of Al-Eizariya known to suffer from the phenomenon. In order to identify the real causes of the problem which develops in various forms and patterns, threatening not only the aesthetic appearance of the towns, but also causes the emergence of new problems and phenomena that will have negative repercussions on the population. The researcher uses the analytical descriptive method to analyze the phenomenon of visual pollution in terms of reality, development, manifestations and spread and uses photos which document the visual pollution and its impact on the aesthetics of the known. The study concluded the existence of a strong rela

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Publication Date
Fri Sep 24 2021
Journal Name
Applied Sciences
The Impact of Calcitriol on Orthodontic Tooth Movement: A Cumulative Systematic Review and Meta-Analysis
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A cumulative review with a systematic approach aimed to provide a comparison of studies’ investigating the possible impact of the active form of vitamin D3, calcitriol (CTL), on the tooth movement caused by orthodontic forces (OTM) by evaluating the quality of evidence, based on collating current data from animal model studies, in vivo cell culture studies, and human clinical trials. Methods: A strict systematic review protocol was applied following the application of the International Prospective Register of Systematic Reviews (PROSPERO). A structured search strategy, including main keywords, was defined during detailed search with the application of electronic database systems: Medline/Pubmed, EMBASE, Scopus, Web of Science, and

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Publication Date
Mon Feb 14 2022
Journal Name
Journal Of Educational And Psychological Researches
The Linguistic and Conceptual Equivalence of Conner’s Revised Scales When Applied on a Sudanese Sample
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This study investigates the Linguistic and Conceptual equivalence of Conner’s Revised Scales when applied on a Sudanese sample. Sudanese parents and teachers completed behavior-rating scales on a stratified sample of 200 children. These instruments were based on Conner’s parent -48 and teacher-28 questionnaires. Following a reliable translation into Sudanese Arabic the test-retest reliability of the items and the internal consistency of the original Conner’s' revised scales were explored. The associations between scale scores and between parents and teachers scores were also examined. Both instruments displayed good reliability and the original Conners scales had satisfactory internal consistency. The inter-correlation sugg

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Publication Date
Wed Jan 01 2014
Journal Name
Journal Of The College Of Languages (jcl)
A Contrastive Study on the Syntactic Structure of Standard English and Standard Arabic Determiner Phrase
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The determiner phrase is a syntactic category that appears inside the noun phrase and makes it definite or indefinite or quantifies it. The present study has found wide parametric differences between the English and Arabic determiner phrases in terms of the inflectional features, the syntactic distribution of determiners and the word order of the determiner phrase itself. In English, the determiner phrase generally precedes the head noun or its premodifying adjectival phrase, with very few exceptions where some determiners may appear after the head noun. In Arabic, parts of the determiner phrase precede the head noun and parts of it must appear after the head noun or after its postmodifying adjectival phrase creating a discontinu

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Publication Date
Wed Jun 01 2022
Journal Name
Journal Of Engineering
The Design and Simulation of a Novel Optical Adder Depending on Optical Tri-state Gates
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Essential approaches involving photons are among the most common uses of parallel optical computation due to their recent invention, ease of production, and low cost. As a result, most researchers have concentrated their efforts on it. The Basic Arithmetic Unit BAU is built using a three-step approach that uses optical gates with three states to configure the circuitry for addition, subtraction, and multiplication. This is a new optical computing method based on the usage of a radix of (2): a binary number with a signed-digit (BSD) system that includes the numbers -1, 0, and 1. Light with horizontal polarization (LHP) (↔), light with no intensity (LNI) (⥀), and light with vertical polarization (LVP) (↨) is represen

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Publication Date
Mon Aug 01 2011
Journal Name
Journal Of Engineering
EXHAUST ANALYSIS AND PERFORMANCE OF A SINGLE CYLINDER DIESEL ENGINE RUN ON DUAL FUELS MODE
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Generally fossil based fuels are used in internal combustion engines as an energy source.
Excessive use of fossil based fuels diminishes present reserves and increases the air pollution in
urban areas. This enhances the importance of the effective use of present reserves and/or to develop
new alternative fuels, which are environment friendly. Use of alternative fuel is a way of emission
control. The term “Alternative Gaseous Fuels” relates to a wide range of fuels that are in the
gaseous state at ambient conditions, whether when used on their own or as components of mixtures
with other fuels.
In this study, a single cylinder diesel engine was modified to use LPG in dual fuel mode to study
the performance, emis

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Publication Date
Thu May 31 2012
Journal Name
Journal Of Baghdad College Dentistry
An evaluation of water absorption of Giomer in comparison to other resin-based restorative materials
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Background: Polymeric composites have been widely used as dental restorative materials. A fundamental knowledge and understanding of the behavior of these materials in the oral cavity is essential to improve their properties and performance. The goal of this study was to measure water sorption of four composite resins containing different filler and resin matrix contents. Materials and method: Resin composite specimens giomer (Beautifil II) Filtek™ P90, Filtek™ Z350 XT, and Tetric N Ceram were prepared in a cylindrical mould of 3mm thickness and 6mm diameter (n=10) and light cured . All specimens placed in silica-gel desiccators at 37˚C for seven days, a constant weight was obtained. All samples were immersed in deionized distill

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Publication Date
Wed Jan 01 2014
Journal Name
The Scientific World Journal
An In Vitro Assessment of Gutta-Percha Coating of New Carrier-Based Root Canal Fillings
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The first aim of this paper was to evaluate the push-out bond strength of the gutta-percha coating of Thermafil and GuttaCore and compare it with that of gutta-percha used to coat an experimental hydroxyapatite/polyethylene (HA/PE) obturator. The second aim was to assess the thickness of gutta-percha around the carriers of GuttaCore and HA/PE obturators using microcomputed tomography (μCT). Ten (size 30) 1 mm thick samples of each group (Thermafil, GuttaCore, and HA/PE) were prepared. An orthodontic wire with a diameter of 0.5 mm was attached to the plunger of an Instron machine in order to allow the push-out testing of the gutta-percha coating. Five samples of (GuttaCore and HA/PE) were scanned using

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Publication Date
Fri Feb 17 2023
Journal Name
Sustainability
Sustainable Utilization of Machine-Vision-Technique-Based Algorithm in Objective Evaluation of Confocal Microscope Images
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Confocal microscope imaging has become popular in biotechnology labs. Confocal imaging technology utilizes fluorescence optics, where laser light is focused onto a specific spot at a defined depth in the sample. A considerable number of images are produced regularly during the process of research. These images require methods of unbiased quantification to have meaningful analyses. Increasing efforts to tie reimbursement to outcomes will likely increase the need for objective data in analyzing confocal microscope images in the coming years. Utilizing visual quantification methods to quantify confocal images with naked human eyes is an essential but often underreported outcome measure due to the time required for manual counting and e

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