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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 Dec 01 2024
Journal Name
The Medical Journal Of Tikrit University
ChemiluminescenceMicroparticle Immunoassay in the Diagnosis of Hepatitis C Virus among Patients on Hemodialysis: A Comparative Study
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Browse Iraqi academic journals and research papers

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Nonparametric statistical study for the crime motives on a sample of inmates in Khartoum State prisons
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The aim of the research was to investigate the use of non-parametric tests in the analysis of the questionnaire and how to choose the appropriate test for testing the hypothesis of the study of crime motives in Khartoum State. The data were collected through the primary sources by designing a questionnaire and distributed to a sample of inmates in Khartoum state; the data were analysis by SPSS program using the analytical statistical method through using some of the suitable non-parametric tests for each case. The most important results of the research were: there was significant relationship between the type of crime and the age group therefore, we found that the age group (20-29) was the most frequent crime particularly, the fi

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Publication Date
Sat Dec 31 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Workplace Respect on Employee Performance: A Survey Study in Abu Ghraib Dairy Factory
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This paper aims to explain the effect of workplace respect on employee performance at Abu Ghraib Dairy Factory (AGDF). For achieving the research aim, the analytical and descriptive approach was chosen using a questionnaire tool for collecting data.  It covers 22 items; ten of them for the workplace respect variable and twelve items for the employee performance variable. The research population involved human resources who work at AGDF in Baghdad within two administrative levels (top and middle). We conducted a purposive stratified sample approach. It was distributed 70 questionnaire forms, and 65 forms were received. However, six of them had missing data and did not include in the final data analysis. The main results are t

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Publication Date
Wed Dec 27 2017
Journal Name
Al-khwarizmi Engineering Journal
The Effect of Restriction Shape On Laminar Natural Convection Heat Transfer In A Vertical Circular Tube
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Natural convection heat transfer is experimentally investigated for laminar air flow in a vertical circular tube by using the boundary condition of constant wall heat flux in the ranges of (RaL) from (1.1*109) to (4.7*109). The experimental set-up was designed for determining the effect of different types of restrictions placed at entry of heated tube in bottom position, on the surface temperature distribution and on the local and average heat transfer coefficients. The apparatus was made with an electrically heated cylinder of a length (900mm) and diameter (30mm). The entry restrictions were included a circular tube of same diameter as the heated cylinder but with lengths of (60cm, 120cm), sharp-edge and

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Publication Date
Wed Jun 25 2025
Journal Name
Tikrit Journal Of Pure Science
Exploring the Impact of Anthropometric Measurements on Kidney Cancer Progression in Iraqi Patients: A Comprehensive Analysis
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Despite not being digested, trace elements and/or heavy metals are important for the activity of enzymes, physiological processes, and homeostasis. If certain trace elements are present in excess, they can have harmful effects and pose major health hazards. Objective: The aims to examine the connection between serum zinc, copper levels, and the Cu/Zn ratio, and several anthropometric parameters, including an index of body mass and the waist-hip ratio. In our study, we used atomic absorption spectrometry (AAS) to measure serum levels of copper (Cu) and zinc (Zn) in 60 individuals, 30 patients with kidney cancer and 30 healthy controls. We assessed serum uric acid, creatinine, and urea using the semi-auto analyzer BA-88A (Korea). The results

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Publication Date
Mon Jan 01 2024
Journal Name
Malaysian Journal Of Nursing
Experiences of Nurses in Providing Care for Patients on the Cancer Journey: A Cross-Sectional Survey
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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Engineering
A Mathematical Model of a Thermally Activated Roof (TAR) Cooling System Using a Simplified RC-Thermal Model with Time Dependent Supply Water Temperature
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This paper presents a computer simulation model of a thermally activated roof (TAR) to cool a room using cool water from a wet cooling tower. Modeling was achieved using a simplified 1-D resistance-capacitance thermal network (RC model) for an infinite slab. Heat transfer from the cooling pipe network was treated as 2-D heat flow. Only a limited number of nodes were required to obtain reliable results. The use of 6th order RC-thermal model produced a set of ordinary differential equations that were solved using MATLAB - R2012a. The computer program was written to cover all possible initial conditions, material properties, TAR system geometry and hourly solar radiation. The cool water supply was considered time

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Publication Date
Wed Jan 01 2025
Journal Name
Heliyon
Treatment of hospital wastewater by anodic oxidation using a new approach made by combining rotation with pulsed electric current on Cu-SnO2–Sb2O5 rotating cylinder anode
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Publication Date
Thu Apr 07 2016
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets: Isolate and diagnose Mycotoxins associated with some producers of Indomie and Chips that available in local markets
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Abstract
This study aimed to survey fungi associated with the product Indomie and Chips being the trades Iargely by a very important segment of society who are the children, beside consumed by adults, but less so, as the survey results to accompany some fungui samples sterile showed proportions presence included various fungi like. Aspergillus flavus, Aspergillus niger, Penicillium Spp., Fusarium graminearum, F.moniliforme, Alternaria alternate and Rhizopus Spp., and other fungi sterile are not diagnosed. The results showed large dominion fungi A. niger by presence sterile samples of both producers, followed by infection in Fusarium Spp., Penicillium Spp., and A. alternata by infection percentage 55, 20 and 17% respectively for the pr

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Publication Date
Thu Jul 31 2025
Journal Name
مجلة واسط للعلوم الانسانية
A Schizoanalytic Reading of Crimp’s Attempts on Her Life
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The concept of Assemblage appeared obviously in Postdramatic works, where a character or a text may stand as an assemblage of potentialities in the sense that it signifies unidentified subjectivity. Assemblages are constituted essentially of heterogeneous elements yet fused without specific demarcations. In order to enjoy the desired productivity at a "smooth pace," the regularities of political and societal institutionalization are disseminated. To achieve this dissemination, Deleuze-Guattari suggest an unsatiated platform of a "Body without Organs' (BwO), where desire escapes identification. Martin Crimp (b. 1956) defines his off-stage characters in Attempts on Her Life (1997), Anne, or whatever the name is, as a 'BwO', upon which

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