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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
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Integrated Problem Based Learning (PBL) Evaluation by Students in Kerbala Medical College
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Background: Scientific education aims to be inclusive and to improve students learning achievements, through appropriate teaching and learning. Problem Based Learning (PBL) system, a student centered method, started in the second half of the previous century and is expanding progressively, organizes learning around problems and students learn about a subject through the experience of solving these problems.Objectives:To assess the opinions of undergraduate medical students regarding learning outcomes of PBL in small group teaching and to explore their views about the role of tutors and methods of evaluation. Type of the study: A cross-sectional study.Methods: This study was conducted in Kerbala Medical Colleges among second year students

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Publication Date
Sun Dec 25 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The correlation between CYP2C19 Polymorphisms and recurrent risk in Patients with Ischemic Stroke treated with Clopidogrel in Kurdistan region-Iraq
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    Clopidogrel is a prodrug that must be transformed into an active metabolite by hepatic cytochrome P450 (CYP) isoenzymes to prevent platelet clotting. Polymorphisms of the CYP2C19 gene can cause a reduction or complete loss of CYP2C19 enzyme activity resulting in inhibiting clopidogrel metabolism, effectiveness and increase stroke recurrence risk in ischemic stroke patients. This study aims to investigate the correlation between genetic polymorphisms in CYP2C19*2 and*3 and recurrent risk in patients with ischemic stroke taking clopidogrel 75mg in Kurdistan region –Iraq. This retrospective case-control study was carried out at Kurdistan, Erbil, Medicina medical center, and Rizgary general hospital from January 2021 to

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Publication Date
Sat Apr 25 2020
Journal Name
International Journal Of Research In Social Sciences And Humanities
THE EFFECT OF CAPITAL ADEQUACY AND ASSET QUALITY ON THE VALUE OF THE BANK AN APPLIED STUDY ON A SAMPLE OF IRAQI BANKS LISTED ON THE IRAQ STOCK EXCHANGE
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As the banking sector is a strong influence on the country's economic growth,The solid financial well-being of anybank does not mean only a guarantee for its investors, It is also important for both owners and workers and for theeconomy in all its joints.The elements of capital adequacy and quality of assets are important to the functioning of thebanking business.In this study, the research sample included four private banks. Quarterly data were used for the period(2011 - 2018).Moreover, data is also collected from articles, papers, the World Wide Web (the Internet) and specializedinternational journals.In this research, an effort was made to try to find out the effect of (the ratio of the capital owned todeposits on the value of the bank),

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Publication Date
Thu Dec 01 2022
Journal Name
Baghdad Science Journal
Studying the genotype of Aryl Hydrocarbon Receptor-Interacting Protein (AIP) Gene (rs641081C>A) in ‎Iraqi Samples with Acromegaly Pituitary Adenoma
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Pituitary adenomas are the anterior pituitary tumors. Patients with an Aryl Hydrocarbon Receptor-Interacting Protein (AIP) mutation (AIP- mut) tend to have more aggressive tumors occurring at a younger age. Single nucleotide polymorphisms (SNPs) in many studies have been related to metabolic comorbidities in the general population. Study aims investigated the role of AIP gene SNPs with susceptibility to acromegaly pituitary- adenoma, with levels of LH, FSH, TSH, Testosterone, IGF1,GH, FT4 , Prolactin hormones and blood sugar levels.  The study ‎was conducted on a group of acromegaly patients, including 50 patients) both Genders( with ‎hyperplasia of the ends, and apparently healthy control group. Genotyping of

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Publication Date
Sun Jul 08 2018
Journal Name
Journal Of Global Pharma Technology
Association of Insulin-Like Growth Factor 2 Apa 1 A820G (rs680) Polymorphism with Thyroid Dysfunction in a Sample Iraqi Patien
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Publication Date
Mon Apr 06 2020
Journal Name
Asian Journal Of Civil Engineering
Integrated project delivery (IPD) method with BIM to improve the project performance: a case study in the Republic of Iraq
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Publication Date
Wed Oct 01 2025
Journal Name
Civil Engineering Journal
Study on Shear Behavior of Reinforced Concrete Beams Confined with Reinforcing Meshes
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This study reveals the results of a numerical simulation performed using the ABAQUS/CAE finite element program. The study aimed to provide a simulation model that can forecast the shear behavior of reinforced concrete beams confined with reinforcing meshes. Limited numerical studies have been conducted using geogrid or FRP mesh as shear reinforcement, with limited representation accuracy and limited material quality. The results were compared to published experimental findings in the literature. The finding of the finite element model and the experimental results were highly comparable; consequently, the model was determined to be valid. Following this, the domain of numerical analyses was broadened to include the investigation of m

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Publication Date
Fri Dec 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
COLOR VARIATION OF STREPTOPELIA DECAOCTO (AVIS, COLUMBIDAE) WITH SOME NOTES ON ENDOPARASITES
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The present paper includes a study of color variation in Iraqi Collared dove Streptopelia decaocto. Three different populations have been recognized: the southern population which belongs to the Indian race, the northern population to the Eurasian race; the dark and light color variation occurs in the Baghdad population because of hybridisation between the two races, found infected with two cestodes,  Raillietina echinobothrida found  in most of our specimens, while the dark face found beside R. echinobothrida infected with Idiogenes sp. getting it probably from vertebrate sources. We believe that most of the Baghdad population was intermediate between north and south races.

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Publication Date
Sat Mar 30 2024
Journal Name
Iraqi Journal Of Science
On Certain Subclass of Meromorphic Multivalent Functions Associated with Fractional Calculus Operator
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     In this paper, the class of meromorphic multivalent functions of the form by using fractional differ-integral operators is introduced. We get Coefficients estimates, radii of convexity and star likeness. Also closure theorems and distortion theorem for the class ,  is calculaed.

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Publication Date
Thu Mar 01 2018
Journal Name
2018 Tenth International Conference On Advanced Computational Intelligence (icaci)
On low-level control strategies of lower extremity exoskeletons with power augmentation
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