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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 Jun 30 2023
Journal Name
The International Tinnitus Journal
Adenoidectomy and Endoscopic Myringotomy with and without ventilation tube insertion for Treatment of Otitis Media with Effusion in 6-12 years old Children
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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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Publication Date
Fri Jan 01 2016
Journal Name
International Journal Of Surgery Case Reports
Myositis ossificans: A rare location in the foot. Report of a case and review of literature
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Publication Date
Wed Jan 23 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Internal banking supervision requirements and their impact on the development of electronic accounting information systems: Applied research in a sample of Iraqi private banks
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      Despite the availability of information technology banking features and benefits of the banking sector, they involve many risks and challenges and put in the face of the administrative authorities and regulatory institutions in the banking system, organizational matters and control sensitive and bear direct responsibility for conducting independent assessments of their regulatory and information and determine the degree of its durability and its ability to confront problems imposed by the technical challenges and technological .
And the success of the administrative authorities and regulatory institutions in achieving its objectives in the management of risks and threats oversight resulting from the act

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Publication Date
Thu Dec 30 2004
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
The Influence of Temperature and Flow Velocity on the Corrosion Inhibition of Low Carbon Tubes in Recirculating Water System by a Dicomponent Inhibitor Blend
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Publication Date
Sat Sep 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Reflection of knowledge workers characteristics on knowledge acquision “Survey Study of the views of a sample of engineers and technicians in the Directorate of Electricity In the city of Sulaymaniyah
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Purpose: The research aims to diagnose the current availability of knowledge workers characteristics and the role of these characteristics in knowledge acquision in the city of Sulaimaniya Directorate of Electricity, and to identify the differences between personal and occupational characteristics of a sample of research and its impact on the availability of such properties.

Design/methodology/approach :to achieve the objectives of the research questionnaire was developed especially for it and then distributed to a sample of engineers and technicians working in the Directorate of Electricity city of Sulaimaniya, where the sample of the research (52) respondents.

Findings:  the most important conclusions reached

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Publication Date
Wed Jan 01 2020
Journal Name
Dental Research Journal
Impact of a mixture of nanofiller and intrinsic pigment on tear strength and hardness of two types of maxillofacial silicone elastomers
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Background: The ideal maxillofacial prosthesis should have fine and thin boundaries that bindwith the surrounding facial structures and possess high tear strength.This study aims to determinethe best percentages of nanofiller (TiO2) and intrinsic pigment (silicone functional intrinsic) thatcould be mixed in as additives to improve the tear strength of Cosmesil M511 andVST50F siliconeelastomers with the least effect on their hardness.Materials and Methods: In this in vitro experimental study, a total of 80 samples, 40 for eachelastomer, were fabricated. Each elastomer sample was split into two equal groups to test for tearstrength and Shore A hardness. Each group consisted of 20 samples, including 10 control sampleswithout additives and 10 e

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Publication Date
Wed Jul 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Relationship of maximum bite force with craniofacial morphology, body mass and height in an Iraqi adults with different types of malocclusion
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Background: Information concerning the maximum bite force in human population is important to clinical orthodontics. Additionally, the influence of bite force on the vertical stability of any treatment result is important. The new position of the dentition should be compatible with the dynamics of the muscular and occlusal forces in all planes. This study was conducted to 1) to measure and compare maximum bite force, body height and weight among normal occlusion and malocclusion groups (cl I,cl II,cl III) in both gender 2) to evaluate the correlation between bite force and craniofacial morphology, body height and weight. Materials and Methods: The sample consists of 100 Iraqi adult subjects aged 18-25 years. It was classified in to four gr

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Efficacy of Combination of Meropenem with Gentamicin, and Amikacin against Resistant E. coli Isolated from Patients with UTIs: in vitro Study
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         Seventy five E. coli isolates were collected from urine of patients with urinary tract infections in AL-Kadhimia and AL-Yarmook teaching hospitals in Baghdad for a period between 22/11/2009 to 15/3/2010,  from these samples twenty five isolates were selected according to their pattern of the highest resistance as these showing multi-drug resistances and tested to specify their minimum inhibitory concentration for (meropenem, gentamicin and amikacin), meropenem was found having the lowest MIC comparing with others. This study also includes in vitro effects of various combinations of three types of antimicrobials (meropenem, gentamicin and amikacin) against twenty five E. c

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Publication Date
Thu Dec 22 2022
Journal Name
Fine Art Journal
Spatial relationships and their impact on monumental sculptures (arab capitals as a model)
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The current research deals with spatial relations as a tool to link urban landmarks in a homogeneous composition with monumental sculptures, by identifying these landmarks and the extent of their impact on them, which constitutes an urgent need to evaluate the appropriate place and its effects on them, so that this analytical study is a critical approach adopted in artistic studies of monumental models in Arabcapitals .The current research came in four chapters, the first chapter of which dealt with the research problem, its importance and the need for it, then its objectives that were determined in revealing the spatial relations and their impact on

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