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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
Tue Dec 22 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Continuous improvement of technology and its role In reducing the costs in accordance with the management style On the basis of the activities (ABM): Applied Research in the General Company for Textile Industries / hula
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The administration on the basis of the activities designed to evaluate the performance of activities in terms of cost, time and quality by identifying activities that add value and those that are no add value and  enables the administration of making up their own continuous improvement in production, through lower costs and reduce the time and improve the quality   and reduce the incidence of spoilage and waste, y based search Ally premise that (the continuous improvement of the adoption of management style on the basis of the activities helps management in decision-making wise to reduce  costs) to prove the hypothesis has sought research to achieve its goal of  Alkadivh and Alkoppelan     &nb

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Publication Date
Tue Nov 01 2016
Journal Name
Research Journal Of Pharmaceutical, Biological And Chemical Sciences
Treating of oil-based drill cuttings by earthworms
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This study assessed the advantage of using earthworms in combination with punch waste and nutrients in remediating drill cuttings contaminated with hydrocarbons. Analyses were performed on day 0, 7, 14, 21, and 28 of the experiment. Two hydrocarbon concentrations were used (20000 mg/kg and 40000 mg/kg) for three groups of earthworms number which were five, ten and twenty earthworms. After 28 days, the total petroleum hydrocarbon (TPH) concentration (20000 mg/kg) was reduced to 13200 mg/kg, 9800 mg/kg, and 6300 mg/kg in treatments with five, ten and twenty earthworms respectively. Also, TPH concentration (40000 mg/kg) was reduced to 22000 mg/kg, 10100 mg/kg, and 4200 mg/kg in treatments with the above number of earthworms respectively. The p

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Publication Date
Wed Jun 24 2020
Journal Name
Neuroimaging - Neurobiology, Multimodal And Network Applications
Electroencephalogram Based Biomarkers for Detection of Alzheimer’s Disease
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Alzheimer’s disease (AD) is an age-related progressive and neurodegenerative disorder, which is characterized by loss of memory and cognitive decline. It is the main cause of disability among older people. The rapid increase in the number of people living with AD and other forms of dementia due to the aging population represents a major challenge to health and social care systems worldwide. Degeneration of brain cells due to AD starts many years before the clinical manifestations become clear. Early diagnosis of AD will contribute to the development of effective treatments that could slow, stop, or prevent significant cognitive decline. Consequently, early diagnosis of AD may also be valuable in detecting patients with dementia who have n

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Engineering
EMG-Based Control of Active Ankle-Foot Prosthesis
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 Most below-knee prostheses are manufactured in Iraq without considering the fast progress in smart prostheses, which can offer movements in the desired directions according to the type of control system designed for this purpose. The proposed design appears to have the advantages of simplicity, affordability, better load distribution, suitability for subjects with transtibial amputation, and viability in countries with people having low socio-economic status. The designed prosthetics consisted of foot, ball, and socket joints, two stepper motors, a linkage system, and an EMG shield. All these materials were available in the local markets in Iraq. The experimental results showed t

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Publication Date
Thu May 02 2013
Journal Name
Al-mustansiriyah
Synthesis, Spectroscopic and Biological Studies of a New some Complexes with N-Pyridine-2-Y1 methyl-benzene-1, 2-diamine.
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Publication Date
Mon Dec 01 2025
Journal Name
International Communications In Heat And Mass Transfer
Design optimization and performance analysis of a PCM-to-air heat exchanger with optimized fin configuration for building heating applications
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Publication Date
Sat Aug 01 2020
Journal Name
Surgical Neurology International
Unilateral absence of the internal carotid artery associated with anterior communicating artery aneurysms: Systematic review and a proposed management algorithm
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Background:

Absence or hypoplasia of the internal carotid artery (ICA) is a rare congenital anomaly that is mostly unilateral and highly associated with other intracranial vascular anomalies, of which saccular aneurysm is the most common. Blood flow to the circulation of the affected side is maintained by collateral pathways, some of which include the anterior communicating artery (Acom) as part of their anatomy. Therefore, temporary clipping during microsurgery on Acom aneurysms in patients with unilateral ICA anomalies could jeopardize these collaterals and place the patient at risk of ischemic damage. In this paper, we review the literature on cases with a unilaterally absent ICA associa

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Publication Date
Mon Jun 01 2026
Journal Name
Journal Of Trace Elements In Medicine And Biology
Synthesis, structural characterization, biological activity of trace metal complexes with a 2-aminobenzothiazole-derived schiff base: Experimental and docking studies
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Publication Date
Mon Jan 01 2018
Journal Name
Portugaliae Electrochimica Acta
A Kinetic Study of Oxalic Acid Electrochemical Oxidation on a Manganese Dioxide Rotating Cylinder Anode
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Publication Date
Thu May 31 2012
Journal Name
Al-khwarizmi Engineering Journal
An Experimental Study on the Effect of Shape and Location of Vortex Generators Ahead of a Heat Exchanger
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An experimental study is carried out on the effect of vortex generators (Circular and square) on the flow and heat transfer at variable locations at (X = 0.5, 1.5, 2.5 cm) ahead of a heat exchanger with Reynolds number ranging from 62000< Re < 125000 and heat flux from 3000 ≤ q ≤ 8000 W/m2 .

In the experimental investigation, an apparatus is set up to measure the velocity and temperatures around the heat exchanger.                     

The results show that there is an effect for using vortex generators on heat transfer. Also, heat transfer depends on the shape and location. The circular is found t

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