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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 Mar 08 2021
Journal Name
Baghdad Science Journal
Effect of Welded Joints Design on the Joint Strength During Statie and Dynamie Loading with Different Current and Type of Wire Welding
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The aim of this research is to study the effect of welded joint design (Butt joint and lap joint) on thejoint strength during tension and fatigue loading with different current of welding (40,50,60,70,80) ^per, and different type of wire welding. The result of this research is showed that the effect of fatigue loading on the type of joint is more than the effect of tension loading on it. And the butt joint welding is better than the lap joint welding during the fatigue loaded.The experimental results of the effect of W'elding current showed that more increasing and more decreasing the value of the heat input, during the welding was found to produce mechanical brittleness on the buttjoint welding during the static and dynamic loading. Also i

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Publication Date
Sat Jan 01 2022
Journal Name
Applied Ecology And Environmental Research
EFFECT OF SPRAYING WITH FOLIC ACID AND YEAST EXTRACT ON THE GROWTH, YIELD AND CALCIUM OXALATE CONCENTRATION OF SPINACH (SPINACIA OLERACEA L.)
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Publication Date
Sun Nov 09 2025
Journal Name
Journal Of Nephropharmacology
Association between anti-erythropoietin antibody levels and treatment response in hemodialysis patients with end-stage renal disease: A cross-sectional study from Iraq
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Introduction: The therapeutic efficacy of erythropoietin (EPO) may be diminished by the formation of anti-erythropoietin antibodies (AEAs), potentially resulting in therapy failure. Objectives: This retrospective study included 84 hemodialysis patients with end-stage renal disease (ESRD) treated with recombinant EPO and aimed to evaluate the association between serum AEA and treatment response. Patients and Methods: This cross-sectional study included eighty-four Iraqi patients with ESRD who had been on recombinant human EPO for more than 6 months and had hemoglobin levels below 11 g/dL. Serum AEA levels were measured in all patients to evaluate their association with treatment response and to investigate correlations with demograph

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Publication Date
Mon Sep 01 2025
Journal Name
Chinese Journal Of Analytical Chemistry
Synthesis, characterization, and evaluation of the antioxidant and anticancer activities of metal ion complexes with a novel7-(3-hydroxyphenylazo)-quinolin-8-ol ligand
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Publication Date
Wed Jul 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of surface treatments and thermocycling on shear bond strength of various artificial teeth with different denture base materials
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Background: Separation and deboning of artificial teeth from denture bases present a major clinical and labortory problem which affect both the patient and the dentist. The optimal bond strength of artificial teeth with denture base reinforced with nanofillers and flexible denture bases and the effect of thermo cycling should be evaluated. This study was conducted to evaluate and compare the shear bond strength of artificial teeth (acrylic and porcelain) with denture bases reinforced by 5% Zirconium oxide nanofillers and flexible bases under the effect of different surface treatments and thermo cycling and comparing the results with conventional water bath cured denture bases. Material and methods: Two types of artificial teeth; acrylic and

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Publication Date
Sun Mar 03 2019
Journal Name
Muthanna Journal Of Agriculture Science
EFFECT OF FOLIAR SPRAY WITH SEAWEEDS EXTRACT ON YIELD AND QUALTY FOUR CLASS OF BROAD BEAN (Vicia faba L.)
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A field experiment was carried out in one of the agricultural fields in Thi Qar governorate in Nasiriyah during the winter season 2017-2018 The aim was to investigate the effect of foliar application of seaweed extract on yield and quality of four varieties of broad bean .The design of field experiment was (RCBD) in factorial experiments with three replications in two factors. .The first factor included four broad bean cultivars (Luz de otono – Grano Violtto -local - Aquadols. ( The second factor included four sprayed extracts of the seaweed extract (1, 2, 3 and 4 g L -1) In addition to the comparison treatment in which the plants were sprayed with distilled water only. . The plants of the broad bean that were sprayed with seaweed extract

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Publication Date
Fri Jan 11 2019
Journal Name
Iraqi Journal Of Physics
Effect of water absorption on some mechanical and physical properties of epoxy/polyurethane blend reinforced with nano silica powder
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The aim of this work is to evaluate some mechanical and physical
properties (i.e. the impact strength, hardness, flexural strength,
thermal conductivity and diffusion coefficient) of
(epoxy/polyurethane) blend reinforced with nano silica powder (2%
wt.). Hand lay-up technique was used to manufacture the composite
and a magnetic stirrer for blending the components. Results showed
that water had affected the bending flexural strength and hardness,
while impact strength increased and thermal conductivity decreased.
In addition to the above mentioned tests, the diffusion coefficient
was calculated using Fick’s 2nd law.

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Publication Date
Sun Jan 01 2023
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees22fr
Preparation and study the partial substitution of aluminum with copper on some physical properties of the compound TlSr2Ca2Cu3O8+δ
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Publication Date
Thu Nov 03 2016
Journal Name
Int. J. Pharm. Sci. Rev. Res.
Impacts of simultaneous administration of omega-3 fatty acids with amoxicillin/clavulanic acid on albino rats' liver and bile
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Most drugs undergo some metabolism in the liver before excretion by the kidneys or bile. Thus, it is not surprising that liver injury may be provoked due to its exposure to various drugs and compounds. Drug-induced cholestatic liver injury may occur particularly under conditions of increased drug concentrations, genetic alterations in expression of enzymes or transporters. Additionally, the drug-induced cholestasis can be caused by direct toxic effects of drugs or their metabolites on different hepatic cell types or through an immune-mediated process. Amoxicillin/ clavulanic acid, an antibiotic that is therapeutically utilized for the treatment of a number of bacterial infections. Omega-3 fatty acids are unsaturated fatty acids that have ro

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Publication Date
Thu Feb 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using the Balanced Performance Approach to Increase the Effectiveness of Strategic Planning in order to Maximize the Job Satisfaction Rates at the Faculties of Bisha University
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Purpose: To use the balanced measurement approach as a strategic link for increasing the effectiveness of strategic planning in the direction of achieving satisfaction rates at Bisha University in Saudi Arabia

Design / methodology / approach –The questionnaire survey was used to collect the data of the study from the faculty members at University of Bisha.

Findings –Prove the assumption that the use of the balanced measurement approach - as a strategic planning tool - leads to maximize the satisfaction rates among faculty members at the University of Bisha.

Research limitations/implications-  adopt effective strategic planning in order to achieve

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