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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 Aug 03 2020
Journal Name
Rawal Medical Journal
Surgical fixation and grafting of traumatic distal tibia atrophic nonunion with or without platelet-rich plasma: A comparative study
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Objective: To compare distal tibia nonunion plating and grafting with and without platelet-rich plasma (PRP) regarding union rate, union time and complications Conclusion: Combining PRP with autologous bone graft results in a higher union rate, less healing duration, less post-operative pain, and more callus formation. (Rawal Med J 202;45:629- 632). Methodology: In this prospective comparative study, 32 patients with nonunion tibia from July 2017 January 2019 were divided into two groups: group A (16 cases) were treated by plating and grafting with PRP and group B (16 cases) were treated by plating and grafting only. Keywords: Tibial nonunion, bone graft, plateletrich plasma. Results: There was higher union rate in group A related to group

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Publication Date
Mon Feb 06 2023
Journal Name
Journal Of The College Of Basic Education
Synthesis and Characterization of some biologically active transition metal complexes for a ligand derived from dimedone with mixed ligands.
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The aim of the work is synthesis and characterization of bidentate ligand [3-(3-acetylphenylamino)-5,5-dimethylcyclohex-3-enone][HL], from the reaction of dimedone with 3-amino acetophenone to produce the ligand [HL], the reaction was carried out in dry benzene as a solvent under reflux. The prepared ligand [HL] was characterized by FT-IR, UV-Vis spectroscopy, 'H, 8C-NMR spectra, Mass spectra, (C.H.N) and melting point. The mixed ligand complexes were prepared from ligand [HL] was used as a primary ligand while 8-hydroxy quinoline [HQ] was used as a secondary ligand with metal ion M(IT).Where M(IT) = (Mn ,Co ,Ni ,Cu ,Zn ,Cd and Pd) at reflux ,using ethanol as a solvent, KOH as a

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Publication Date
Wed Jul 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary gland tumors: A review of 171 cases, with particular reference to histological types, site, age and gender distribution
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Background: Salivary tumors are uncommon, being of low incidence worldwide. This study aimed to assess cases collected in this series of salivary gland tumors in regard to histopathological typing, in relation to age, site and gender. Materials and methods: This is a retrospective study; cases were collected from public and private laboratories. A total number of 171 cases were collected. The slides were reviewed and reclassified for histopathological typing according to WHO classification 2005. Results: Benign tumors were more common than malignant tumors. The most common histological type was benign mixed tumor, followed by Warthin’s tumor. The most common malignant tumor was adenoid cystic carcinoma. One hundred twenty three cases ou

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Publication Date
Sat Dec 21 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synthesis, Characterization and Preliminary Anticancer Study of Novel 5-fluorouracil Conjugate with Pyrrolidine Dithiocarbamate as a Mutual Anticancer Prodrug
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 5-Fluorouracil is one of the commonly used chemotherapy drugs in anticancer therapy; unfortunately treatment with 5-FU by solely has many drawbacks  low lipophilicity, low permeability, low molecular weight, and its relatively poor plasma protein binding; also a brief half-life therefore frequent administration is required to maintain the optimal therapeutic plasma level which in addition to its poor selectivity, drug resistance and limited penetration to cancer cells; leads to increased incidence of side-effects to healthy cells/tissues and low response rates. In order to minimize these drawbacks; 5-FU was chemically  conjugated with pyrrolidine dithiocarbamate (PDTC) in a mutual prodrug moiety (S-(9H-purin-6-yl) 3-(

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Publication Date
Wed Jan 01 2025
Journal Name
Special Topics &amp; Reviews In Porous Media: An International Journal
EXPERIMENTAL AND NUMERICAL INVESTIGATION OF A DOUBLE PASS SOLAR AIR HEATER PROVIDED WITH POROUS ABSORBER PLATE FOR DRYING APPLICATIONS
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This investigation integrates experimental and numerical approaches to study a novel solar air heater aimed at achieving an efficient design for a solar collector suitable for drying applications under the meteorological conditions of Iraq. The importance of this investigation stems from the lack of optimal exploitation of solar energy reaching the solar collector, primarily attributable to elevated thermal losses despite numerous designs employed in such solar systems. Consequently, enhancing the thermal performance of solar collectors, particularly those employed in crop drying applications, stands as a crucial focal point for researchers within this domain. Two identical double-pass solar air heaters were designed and constructed for

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Publication Date
Sat Feb 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
A reflection of the integration of accounting income and economic value added on the decisions of investors
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           The support qualitative information regards as an additional step in the process of decision-making where the method following by companies to provide information help in the creation of value because it is very important to deliver information to investors about their stratigies and what happen truly inside the companies i.e.  every case relating with the expectations of stockhotslder and the prices of markets depending on those expectation ,and if the matter isn’t that there will be lack of confidence thate couldn’t be backed again. The decisions of the investors effected by security ,economic ,political, psychological, emotional ,and financial factors .

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Education And Scientific Studies
Studying the effect of laser stress in combination with mannitol on some morphological parameters of cabbage (Brassica oleracea var L. capitata) In vitro
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Publication Date
Sun Jan 01 2017
Journal Name
Indian Journal Of Pathology And Microbiology
Assessment of topoisomerase II-alpha gene status by dual color chromogenic in situ hybridization in a set of Iraqi patients with invasive breast carcinoma
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Abstract Background: The human epidermal growth factor receptor 2(HER2) proto-oncogene is overexpressed or amplified in approximately 15%-25% of invasive breast cancers. Approximately 35% of HER2-amplified breast cancers have coamplification of the topoisomerase II-alpha (TOP2A) gene encoding an enzyme that is a major target of anthracyclines. Hence, the determination of genetic alteration (amplification or deletion) of both genes is considered as an important predictive factor that determines the response of breast cancer patients to treatment. The aims of this study are to determinate TOP2A status gene amplification in a set of Iraqi patients with breast cancer that have had an equivocal (2+) and positive HER2/neu by immunohistochemistry

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Publication Date
Wed Sep 01 2021
Journal Name
Meta Gene
Genetic polymorphism of IL-17A (rs2275913) in Iraqi women with recurrent abortion and its relationship with susceptibility to toxoplasmosis
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Publication Date
Mon Mar 07 2022
Journal Name
Journal Of Educational And Psychological Researches
The Degree of Focus of The Science Curriculum for the First Intermediate Grade on National, Health, Environmental And Economic Values in Light of the Education Policy in The Kingdom of Saudi Arabia and a Suggested Scenario for a Mechanism to Be Strengthe
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The study aimed to reveal the extent of the first intermediate grade science curriculum focus on the national values, health, environmental, economic values, in the light of the education policy in the Kingdom of Saudi Arabia, in addition to present a proposed vision to strengthen it in the science curriculum for the first intermediate grade. The study was applied to the two books student and the two books of activity on the first-second semesters for the academic year 1441 AH. To analyze the curriculum content, the study used a verified card prepared by the researchers and a criterion for interpreting percentages. The study reached the following results: environmental values ranked first with a concentration of (43%), i.e. with an avera

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