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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 May 01 2022
Journal Name
Archives Of Razi Institute
Vitamin D Level and its Relation with the Newly Diagnosed Diabetic Neuropathy in Women with Hypothyroidism
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Publication Date
Wed Nov 05 2025
Journal Name
Journal Of Oral Biology And Craniofacial Research
The effect of thermocycling on fracture resistance of zirconia crowns cemented with polylysine modified resin cements (Comparative in vitro study)
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ABSTRACT Background: resin cement type and intraoral temperature fluctuations may affect the fracture performance of successful zirconia restorations. To fill this gap, the purpose of this study is to evaluate and compare the influence of thermocycling on fracture resistance and mode of failure of monolithic zirconia crowns luted with Rely X™ U200 and BreezeTMself-adhesive resin cements as well as imply the effect of adding 2 % of polylysine (PLS) to these cements. Materials: 64 maxillary premolars were milled out of zirconia blocks using CAD/CAM milling system. They were divided into four groups (n = 16) according to the cement type. Four different resin cements were used (RelyXTMU200, Breeze™, RelyX™ U200 with 2 % PLS

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Publication Date
Wed Jun 07 2023
Journal Name
Journal Of Educational And Psychological Researches
A Proposed Training Program for School Leaders in the Sultanate of Oman on the Planning Practices of the Kaufman Model in Light of the Needs and Challenges of Reality
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The study aims to build a proposed training program for school leaders in the Sultanate of Oman on the planning practices of the Kaufman model in light of the needs and challenges of reality. It also aims to identify the challenges facing school leaders in practicing the stages of strategic planning. To achieve these objectives, the study adopted the descriptive approach due to its suitability to the nature of the study. A questionnaire was used to collect the needed data. The study sample included (225) individuals from school principals, their assistants and senior teachers in post-basic education in the Sultanate of Oman. After processing the data statistically, the study concluded that the reality of planning practices for school lea

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Publication Date
Thu Jan 04 2024
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A proposal to impose a tax on the profits of securities trading to increase tax revenues: Applied research in the General Commission of Taxes
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Abstract:

                The research aims to identify the concept of trading securities in Iraq and to propose a new mechanism for the taxation of trading profits and the extent of its impact on tax revenues, as it was observed that there are professional investors in the trading market and some of them achieve huge annual profits. and this profit should be like other taxable profits. The General Commission of Taxes and in cooperation with the Iraq Stock Exchange should identifying those profits, subjecting them to income tax, and adding them to the tax base. The researcher relied on the use of the descriptive and analytical approach bas

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Publication Date
Fri Sep 01 2023
Journal Name
Asian Pacific Journal Of Cancer Prevention
Development of a T-ARMS-PCR Assay for Detecting Genetic Polymorphism in the Catalase (rs7943316) Gene in the Iraqi Population with Breast Cancer
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Publication Date
Tue Dec 01 2020
Journal Name
Periodicals Of Engineering And Natural Sciences
Constructing a new mixed probability distribution with fuzzy reliability estimation
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This paper deals with constructing mixed probability distribution from mixing exponential

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Publication Date
Tue Sep 01 2020
Journal Name
Asian Journal Of Pharmacy And Pharmacology
Genetic polymorphisms associated with diabetic foot ulcer: A review article
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Publication Date
Tue Sep 01 2020
Journal Name
Asian Journal Of Pharmacy And Pharmacology
Genetic polymorphisms associated with diabetic foot ulcer: A review article
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Diabetic foot ulcer (DFU) or Lower limb ulcers are one of the major complications caused by diabetes mellitus especially when patients fail to maintain tight glycemic control. DFU is linked to multiple risk factors along with the genetic factors and ethnicity which play a significant role in the development of DFUs through their effects on multiple aspects of the pathophysiological process. This narrative review aimed to summarize all the previous studies within the last ten years associating gene polymorphism and DFU. Polymorphism associated with vascular endothelial growth factor (rs699947), the G894T polymorphism of the endothelial nitric oxide synthase gene, interleukin-6–174 G>C gene polymorphism, heat shock protein 70 gene polymorph

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Publication Date
Sat Sep 01 2012
Journal Name
2012 International Conference On Statistics In Science, Business And Engineering (icssbe)
A proposal method for selecting smoothing parameter with missing values
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In this paper we proposed a new method for selecting a smoothing parameter in kernel estimator to estimate a nonparametric regression function in the presence of missing values. The proposed method is based on work on the golden ratio and Surah AL-E-Imran in the Qur'an. Simulation experiments were conducted to study a small sample behavior. The results proved the superiority the proposed on the competition method for selecting smoothing parameter.

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Publication Date
Mon Dec 19 2022
Journal Name
Journal Of The College Of Languages (jcl)
Evaluation of proverb translation in Nahj al-Balagheh based on the theory of Peter Newmark (Dashti, Shahidi and Foladvand): ارزیابی ترجمه ضرب‌المثل‌ در نهج البلاغه بر اساس نظریه پیتر نیومارک. مطالعۀ موردی: (دشتی، شهیدی و فولادوند)
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In addition to being a religious book with high human and moral themes, Nahj al-Balagha is considered a mirror of Arab culture and a literary masterpiece at the height of eloquence and eloquence, and because proverbs in the form of short, concrete and understandable phrases for everyone, experiences, thoughts and convey ideas, Imam Ali (AS) used it to facilitate the understanding of various political, social and moral concepts. In this article, we intend to criticize the way Dashti, Shahidi and Foladvand translated it by using Newmark's model due to the importance and cultural reflections of proverbs in understanding the cultural atmosphere governing Nahj al-Balagheh. In his evaluation model, Newmark divides cult

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