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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
Sat Feb 12 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Prestressing Effects on Full Scale Deep Beams with Large Web Openings¨: An Experimental and Numerical Study
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Most studies on deep beams have been made with reinforced concrete deep beams, only a few studies investigate the response of prestressed deep beams, while, to the best of our knowledge, there is not a study that investigates the response of full scale (T-section) prestressed deep beams with large web openings. An experimental and numerical study was conducted in order to investigate the shear strength of ordinary reinforced and partially prestressed full scale (T-section) deep beams that contain large web openings in order to investigate the prestressing existence effects on the deep beam responses and to better understand the effects of prestressing locations and opening depth to beam depth ratio on the deep beam performance and b

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of forensic accounting in banking stability An applied research on a sample of Iraqi private banks listed on the Iraq Stock Exchange
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                 This study aims to identify the role of forensic accounting in the Iraqi environment, banking stability, and to achieve this goal, we used the field survey method, as it is the most appropriate for studying the phenomenon in question and achieving its objectives.

Where we selected a sample consisting of (50) male and female employees, distributed among five private banks in Baghdad governorate, namely (Ashur International Bank, Development Investment Bank, Iraqi Middle East Investment Bank, Hammurabi Commercial Bank, Khaleej Commercial Bank), and the questionnaire tool was applied to them Designed for this purpose, which consisted of

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Publication Date
Wed Nov 01 2023
Journal Name
Journal Of Modern Project Management
THE IMPACT OF STRATEGIC INTELLIGENCE ON ORGANIZATIONAL PERFORMANCE: A TEXTILE SECTOR PERSPECTIVE OF A DEVELOPING ECONOMY
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In today’s competitive environment, organizational efficiency and sustained growth are crucial for survival. The performance of an organization is intricately connected to strategic planning, prompting firms to gather and leverage competitive information for a competitive advantage. Senior managers, recognizing this, initiate actions accordingly. This study aims to investigate the relationship between foresight, vision, strategic partnerships, motivation, system thinking, and organizational performance. Data, gathered through a self-administered questionnaire from various textile units, were analysed using structural equation modelling (SEM). The findings indicate that sub-constructs of strategic intelligence positively impact organizatio

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Publication Date
Tue Mar 03 2020
Journal Name
Aip Conference Proceedings
Correlation study of (IL-17, IL-17RA) and some biochemical parameters with patients of Iraq colorectal cancer after and before taking a dose of chemotherapy
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Colorectal cancer CRC is the third most commonly diagnosed cancer in males and the second in female, so it is a common and life-threatening disease serum of 48 males and 40 females suffering from CRC disease as group one (G1) without taking a chemotherapy dose, the same patients group tow (G2) after taking the first chemotherapy dose, while group three (G3) whose patients in (G1) and (G2) after second taking a chemotherapy dose. and group four (G4) consist of (30 males and 30 females) healthy Iraqi control. Results showed a significant increase in IL-17, IL-17RA and CEA in G1, while there was a significant decrease in vitamin D concentration in G1 than other groups, also there was positive (+ ve) significant correlation between IL-17 and CE

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Publication Date
Thu Apr 17 2008
Journal Name
Anbar Journal Of Agricultural Sciences 6 (2)‏
Influence of foliar sprays with Copper and Zinc on the resistance of citrus rootstocks to gumosis caused by Phytophthora citropthora. ‏
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Publication Date
Thu Jun 19 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Impact of Pharmacist-Led Intervention on Adherence, Quality of Life, and Self-efficacy Among Iraqi Patients with Systemic Lupus Erythematosus
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Background: The prevalence of systemic lupus erythematosus (SLE) patients is rising in Iraq. Adherence to medications among SLE patients remains a significant problem, and nonadherence can lead to decreased quality of life (QoL) and poor disease outcomes. Objectives: To determine the efficacy of pharmacist interventions in enhancing medication adherence, QoL, and self-efficacy among SLE patients. In addition, to assess the influence of pharmacist intervention on the uptake and willingness to take the flu vaccine among patients with SLE. Methods: A pharmacist intervention study was conducted at the Rheumatology Unit in Baghdad Teaching Hospital. Participants obtained educational counseling and a self-assembled booklet. Each patient p

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Publication Date
Fri May 01 2020
Journal Name
European Journal Of General Dentistry
Effect of plant-extract disinfectant solutions on the specific properties of reinforced maxillofacial silicone elastomers with nanofiller and intrinsic pigment
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Abstract<p> Objective This study aimed to evaluate the effects of disinfectant solutions, namely, the alcoholic extract of Salvadora persica L. (A1 = 10% and A2 = 15%) and chlorhexidine digluconate (A3 = 2%), on the tear strength and hardness of room temperature vulcanizing (RTV) VST50F and heat temperature vulcanizing (HTV) Cosmesil M511 silicone elastomers before and after reinforcement with nanofillers (TiO2) and intrinsic pigment. Materials and Methods: A total of 320 specimens were prepared, with 160 specimens each for RTV and HTV silicone. Forty specimens were evaluated before disinfection and divided into two equal groups, namely, control (without additive) and experimental (with ad</p> ... Show More
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Publication Date
Sat Oct 01 2022
Journal Name
Journal Of Medicine And Life
The effect of COVID-19 on emergencies and pain among orthodontic patients attending a teaching hospital
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This study aimed to evaluate the effect of the COVID-19 outbreak on emergencies and pain among orthodontic patients attending a teaching hospital. The study was conducted among orthodontic patients receiving active orthodontic treatment or in a retention period at the College of Dentistry, University of Baghdad, Iraq. Their participation was voluntary, and they filled out an Arabic-translated questionnaire. The survey included general information, orthodontic problems, and a numerical rating scale for pain assessment. We used descriptive and inferential statistics (frequencies and intersecting frequencies), chi-square test and linear regression. Out of 75 orthodontic patients, only 54 (15 males and 39 females) were included in the s

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Publication Date
Sat Feb 01 2020
Journal Name
Optik
Composition effects on formation energies, electronic and vibrational properties of ZnCdS wurtzoid molecules: A DFT study
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Publication Date
Mon Mar 13 2023
Journal Name
Diagnostics
The Effect of a Bioactive Oral System and CO2 Laser on Enamel Susceptibility to Acid Challenge
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This study evaluated the structural changes of enamel treated by the Regenerate system and carbon dioxide (CO2) laser against acid challenge. Thirty human enamel slabs were prepared and assigned into three groups: Group I: untreated (control); Group II: treated with the Regenerate system; and Group III exposed to CO2 laser. All specimens were subjected to an acid challenge (pH 4.5–7.0) for 14 days. Specimens were evaluated and compared at 120 points using five Raman microspectroscopic peaks; the phosphate vibrations ν1, ν2, ν3, and ν4 at 960, 433, 1029, and 579 cm−1, respectively, and the carbonate at 1070 cm−1, followed by Vickers microhardness test. The ratio of carbonate to phosphate was correlated to the equivalent mic

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