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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
Wed Dec 31 2025
Journal Name
International Journal Of Economics And Finance Studies
GLOBAL GREEN FINANCE AS A CATALYST FOR ECONOMIC AND ENVIRONMENTAL SUSTAINABILITY WITH REFERENCE TO IRAQ'S AGRICULTURAL SMES
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This research aims to examine the role of global green finance as a critical driver of both economic and environmental sustainability within small and medium-sized agricultural enterprises (SMEs) in Iraq. Utilizing a convergent mixed-methods framework, the study integrates qualitative interviews with key stakeholders and a quantitative survey of 300 agricultural SMEs to assess the barriers, enablers, and institutional conditions influencing the adoption of green finance. The findings indicate that, despite growing awareness and substantial latent demand for sustainability-linked investments, adoption is significantly constrained by institutional fragmentation, regulatory ambiguity, and resource limitations at the firm level. Grounded in Ins

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Evaluation of IL17A, FGF21 and CXC12 in Post-menopause Iraqi Sample with Osteoporosis and Osteopenia
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Osteoporosis (OP) is a systemic skeletal disorder that is characterized by reduced bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The most frequent osteoporotic fractures are fractures of the hip, wrist, and spine. The exact causes of OP are still unknown; several factors contribute to the disorder. Subjects and Methods: This study consists of patient groups, this group (Group A) was composed of 80 postmenopausal women with OP and osteopenia and the patient group was subdivided into two group; First group (GroupA1) was composed of 50 postmenopausal women with OP and the second group (Group A2) composed of (30) Postmenopausal Women with oste

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Publication Date
Fri Jul 01 2011
Journal Name
Journal Of Petroleum Research & Studies
Preparation of Cross Linked PVA with MA, EDTA and a mixture of MA/EDTA for water uptake membranes at different pH
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Poly (viny1 alcohol) (PVA) of 72000 g mol -1 molar mass was cross linked through cold cast esterification with different mol % of MA and EDTA (10 % , 20 % and 30 % ), and two different mol % mixture of MA l EDTA (20 %/5% and 20%/10% .

Publication Date
Mon Apr 01 2024
Journal Name
Chemical Engineering Research And Design
Treatment of petroleum refinery wastewater by a combination of anodic oxidation with photocatalyst process: Recent advances, affecting factors and future perspectives
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Publication Date
Thu Dec 13 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Immunoglobulins Levels and Complements in Patients with Brain Tumour (Meningioma and Glioma)
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Objective(s): The present study aims at studying the relationship between immunoglobulin IgG, IgA,
IgM , as well as to C-3 and C-4 in brain tumours patients immunity (meningioms and gliomas).
Methodology: Forty sera of brain tumour patients were included 20 glioma and 20 meningioma was
tested to determine the levels of IgM, IgG IgA, C-3 and C-4 by using single radial immune-diffusion
technique and compared with 20 apparently healthy blood donors.
Results: The study revealed a significant decreasing in IgG levels in glioma as compare to meningioma
and control. The concentration of two other serum immunoglobulins and complement in both
meningioma and glioma show no significant differences with those in control group.

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Publication Date
Fri Aug 15 2025
Journal Name
Baghdad Science Journal
Synthesis, Characterization, Biological Activity and Antioxidant Studies of New Metal Ion Complexes Based on (E)-4-((benzo[d]thiazol-2-ylimino)methyl)-1,5-dimethyl-2-phenylpyrazolidin-3-one
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Publication Date
Fri Mar 29 2024
Journal Name
Iraqi Journal Of Science
Biological versus Topological Domains in Improving the Reliability of Evolutionary-Based Protein Complex Detection Algorithms
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     By definition, the detection of protein complexes that form protein-protein interaction networks (PPINs) is an NP-hard problem. Evolutionary algorithms (EAs), as global search methods, are proven in the literature to be more successful than greedy methods in detecting protein complexes. However, the design of most of these EA-based approaches relies on the topological information of the proteins in the PPIN. Biological information, as a key resource for molecular profiles, on the other hand, acquired a little interest in the design of the components in these EA-based methods. The main aim of this paper is to redesign two operators in the EA based on the functional domain rather than the graph topological domain. The perturb

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Evidence Based Updating of HbA1c Targets: Global Guidelines forGlycemic Control in Type 2 Diabetes Mellitus
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Background:Measurement of hemoglobin A1c (A1C) is a renowned tactic for gauging long-term glycemic control, and exemplifies an outstanding influence to the quality of care in diabetic patients.The concept of targets is open to criticism; they may be unattainable, or limit what could be attained, and in addition they may be economically difficult to attain. However, without some form of targeted control of an asymptomatic condition it becomes difficult to promote care at allObjectives: The present article aims to address the most recent evidence-based global guidelines of A1C targets intended for glycemic control in Type 2 Diabetes Mellitus (T2D).Key messages:Rationale for Treatment Targets of A1C includesevidence for microvascular and ma

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Publication Date
Mon Dec 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of importance in the Intellectual Capital On Internal control Systems Analytical Research in A sample of general inspectors’ offices in Iraq
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The research aims to know the influence of the intellectual capital on the internal control system in a sample of General Inspection Offices in Iraq. The research includes a sample of individuals who are working in these offices total sample (46) individuals distributed according to functional levels (General Inspector, Deputy Inspector General, and Director) , The data and information were collected by using questionnaire, which is done for this purpose, as well as personal interviews in order to reach to the results that achieve the aim of this research , Two hypotheses were formed , the first hypothesis consists of (4) secondary hypothesis , All these hypotheses were tested by using statistical tools such as (percentages, freq

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Publication Date
Sun Nov 01 2020
Journal Name
The International Journal Of Oral &amp; Maxillofacial Implants
Early Failure Rate and Associated Risk Factors for Dental Implants Placed With and Without Maxillary Sinus Augmentation: A Retrospective Study
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