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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 Jul 21 2023
Journal Name
Journal Of Engineering
Laminar Natural Convection in nonrectangular Enclosure with and without Fins
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In the present work, steady, laminar natural convection in nonrectangular enclosures is analyzed numerically with and without fin. Vertical walls insulated while horizontal walls maintained isothermal at different temperature and the fin was placed on horizontal surface. The length of fin was equal (B/L=0.22, 0.44 and 0.66) and thickness of fin was constant. Various parameters are studied: Rayleigh number (from 104 to 107 ), Prandtl number (0.7), number of fin change from (1-3) and aspect ratio (H/L= 0.15 to 0.5). The problem is formulated in terms of the vorticity-stream function procedure. A numerical solution based on program in Fortran 90 with Tec plot program. The finite difference method is used. Streamlines and isotherms are prese

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Publication Date
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
Traumatic Symptoms and Psychological Reactions Associated with Earthquakes in Iraq
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The study aims to identify the Traumatic Symptoms (physiological, emotional, and cognitive) of earthquakes among the targeted sample; it also aims to identify the significant differences between psychological, emotional, and cognitive traumatic symptoms of earthquakes according to the gender and age of participants. The study additionally seeks to identify thepsychological positive-negative reactions associated with earthquakes according to gender and age of the participants. To measure the traumatic symptoms of earthquakes, a 4-point Likert scale questionnaire with (20) items (questions) accompanied with a 4-point Likert scale questionnaire with (18) items (questions) were used to measure the Psychological positive-n

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Publication Date
Tue Mar 30 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and AMH in Iraqi Patients with Chronic Kidney Disease
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This study was conducted to investigate thyroid function and Anti-Müllerian hormone (AMH) in (Chronic kidney disease) CKD patients by evaluating their levels in CKD patients, 50 patients were diagnosed to have CKD stage-5, their ages ranged between 20-50 years (25 males and 25 females) who attended the Nephrology and Transplant Center in Medical City of Baghdad- Iraq, they were recruited from April 2018 to July 2018 and were enrolled into the study. The control group consisted of 20 healthy individuals, their ages ranged between 20-48 years (10 males and 10 females). The study showed non-significant (p>0.05) increase in AMH level in CKD patients compared to the control group. On the other hand, TSH was recorded a highly significant (

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
HLA Typing in Iraqi Patients with Obesity and Primary Osteoarthritis.
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Background: Osteoarthritis (OA) is a degenerative joint disease. It is one of the major causes of disability in developed and developing countries. Human leukocyte antigen (HLA) as part of immune system has a role in the disease process.Objectives: To investigate whether there is an association between HLA class II-DRB and OA.Methods: A case control study with 26 patients with osteoarthritis and 22 apparently healthy obese control persons matching in ethnicity were enrolled in this study during the period between October 2012 till March 2013. Direct interview was done with each patient and HLA typing was done by molecular method using Sequence Specific Primer (PCR-SSP) method using One Lambda Kit-USA. Results: The results showed that fem

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Publication Date
Fri Jul 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Entrepreneurial performance in accordance with the competitive intelligence and strategic
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 The research aims to study the entrepreneurial performance of the banks, according to the intelligence of competitive and strategic as the entrepreneurial performance is the one who does not stand the benefits of excellence in accomplished when just achieving the bank's objectives planned, but exceed it down to creativity in accomplishing these goals in a manner leads to making a entrepreneurial bank in the markets and the focus the eyes of competitors and the banks and other Following his example.

Was chosen the subject of research and strategic intelligence and competitive because of its impact on the strategic success of the banking sector, the fact is the entrepreneurial in the Iraqi banking mar

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Publication Date
Sun Jun 20 2021
Journal Name
Baghdad Science Journal
Hypothyroidism and Leptin in Iraqi Patients with Chronic Kidney Disease
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The present study aims at assessing the effects of chronic kidney disease (CKD) on thyroid hormone and leptin by evaluating the level of: leptin hormone along with thyroid hormone in CKD patients. The study has been conducted on  70 subjects, 50 patients with an age range between 20-50 years (25  males and 25 females) who were diagnosed to have CKD stage-5, and 20 normal controls whose ages ranged between 20-48 years (10  males and 10 females), who attended  the Nephrology and Transplant Center in Medical City of Baghdad- Iraq from April  2018  to July  2018. The study showed a highly significant (P<0.01) increase in TSH level in CKD patients in comparison with controls. While T3 and T4 levels observed highly significant decrea

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Publication Date
Mon Oct 01 2012
Journal Name
Al–bahith Al–a'alami
Dealing of the Providers of Sport Media Content with Crises : (The Department of Media of the Ministry of Youth and Sports a Model)
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In a report by Transparency Organization in 2010, Iraq has 200 newspapers, magazines, sixty-seven radio stations and 45 satellite TV channels. The increase in these figures is measured in days or weeks and not months and years. This fact confirms the importance of studying content providers, especially youth sports content, for two reasons: the first is that young people constitute the highest percentage in Iraqi society, with all the potential involved in shaping the future aspects; the second reason is that for years sport has become an important pillar in people's lives not only in the entertainment aspect as it was seen in the past; Rather, sport has an influential presence in politi

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Publication Date
Thu Oct 31 2019
Journal Name
Journal Of Engineering And Applied Sciences
Feasibility Study of Applying a Pattern Waterflood Without and with Peripheral Injectors for Maximizing Oil Recovery Under Limited Water Sources Availability A Case Study of Heterogeneous Giant Carbonate Reservoir
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Publication Date
Tue Jun 03 2014
Journal Name
Heat Transfer - Asian Research
CFD Simulation of Heat Transfer Augmentation in a Circular Tube fitted with Alternative Axis Twisted Tape in Laminar Flow under the Constant Heat Flux
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Publication Date
Sun Dec 01 2013
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Role of Banking Marketing Strategies in achieving Competitive Advantage: Applicatory Research on a Sample of Iraqi Private Banks
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The main purpose of this research aims to measure the role of banking strategies marketing in achieving competitive advantage within a sample of Iraqi private banks, and in order to achieve this purpose,  the researcher depend on number of sober research approaches which consisted of descriptive, analytical and practical methodologies, to strengthen concepts addressed by the research, size of the sample was (56) individuals which makes up the senior leadership represented (Chairman and members of the Board of Directors, Commissioners and their assistants and department heads) while the primary tool for research (questionnaire), which has been designed based on a number of solemn scientific metrics, after adapted these metrics commen

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