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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 Apr 05 2011
Journal Name
Global Journal Of Health Science
Analysis of Acute Viral Hepatitis (A and E) in Iraq
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Hepatitis, an inflammation of the liver, has a number of infectious and non-infectious causes. Two of the viruses that cause hepatitis (hepatitis A and E) can be transmitted through water and food; hygiene is therefore important in their control. First, to assess the importance of HAV and HEV as a possible diagnosis for clinically diagnosed patients with acute viral hepatitis. Second, to assess the prevalence of hepatitis A and E in all provinces of Iraq and study its association with age, gender. This study consisted of two groups: The first group consisted of 2975 patients with a clinical diagnosis of acute viral hepatitis. The second group consisted of a total of 9610 persons, which were recruited by surveying a nationally representative

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Publication Date
Sat Oct 01 2016
Journal Name
Al–bahith Al–a'alami
Semiotics of Joseph Curtis… A Study in Perspective and Concept
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Joseph Curtis wrote in his book (Introduction to Semiotics narrative and rhetoric) on the development of a semiotic project in exploring the meaning of communion. The book is rich in theoretical and analytical benefits both in the approach of texts and in the pursuit of letters in search of mechanisms of scriptural and scriptural generation and mechanics in narrative production, especially as the book offers exercises that help to assess the distance separating the narrative spread from the sin of the text, for the semiotics, Refers to the theoretical developments of the science of relations, through the combination of conventional definitions and the representative and comparative limitations, to provide an approach to the application o

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Publication Date
Wed Feb 01 2023
Journal Name
Journal Of The World Federation Of Orthodontists
Validity and reliability of three-dimensional modeling of orthodontic dental casts using smartphone-based photogrammetric technology
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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Synthesis and evaluation of B-cyclodextrin Based Nanosponges of 5- Fluorouracil by Using Ultrasound Assisted Method
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CD-nanosponges were prepared by crosslinking B-CD with diphenylcarbonate (DPC) using ultrasound assisted technique. 5-FU was incorporated with NS by freeze drying, and the phase solubility study, complexation efficiency (CE) entrapment efficiency were performed. Also, the particle morphology was studied using SEM and AFM. The in-vitro release of 5-FU from the prepared nanosponges was carried out in 0.1N HCl.

5-FU nanosponges particle size was in the nano size. The optimum formula showed a particle size of (405.46±30) nm, with a polydispersity index (PDI) (0.328±0.002) and a negative zeta potential (-18.75±1.8). Also the drug entrapment efficiency varied with the CD: DPC molar ratio from 15.6 % to 30%. The SEM an

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Publication Date
Tue Mar 28 2023
Journal Name
International Journal Of Dentistry
The Effect of Different Obturation Techniques in Primary Teeth on the Apical Microleakage using Endoflas: A Comparative In Vitro Study
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Objectives. This study was carried out to quantitatively evaluate and compare the sealing ability of Endoflas by using differentobturation techniques. Materials and Methods. After 42 extracted primary maxillary incisors and canines were decoronated, theircanals were instrumented with K files of size ranging from #15 to #50. In accordance with the obturation technique, the sampleswere divided into three experimental groups, namely, group I: endodontic pressure syringe, group II: modified disposable syringe,and group III: reamer technique, and two control groups. Dye extraction method was used for leakage evaluation. Data wereanalyzed using one-way ANOVA and Dunnett’s T3 post hoc tests. The level of significance was set at p<0:05. Results.

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
The Numerical Technique Based on Shifted Jacobi-Gauss-Lobatto Polynomials for Solving Two Dimensional Multi-Space Fractional Bioheat Equations
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This article deals with the approximate algorithm for two dimensional multi-space fractional bioheat equations (M-SFBHE). The application of the collection method will be expanding for presenting a numerical technique for solving M-SFBHE based on “shifted Jacobi-Gauss-Labatto polynomials” (SJ-GL-Ps) in the matrix form. The Caputo formula has been utilized to approximate the fractional derivative and to demonstrate its usefulness and accuracy, the proposed methodology was applied in two examples. The numerical results revealed that the used approach is very effective and gives high accuracy and good convergence.

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Publication Date
Fri Nov 01 2013
Journal Name
Radioelectronics And Communications Systems
Erratum to: “BER Performance Enhancement for Secure Wireless Communication Systems Based on DCSK-MIMO Techniques under Rayleigh Fading Channel”
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There has been a growing interest in the use of chaotic techniques for enabling secure communication in recent years. This need has been motivated by the emergence of a number of wireless services which require the channel to provide low bit error rates (BER) along with information security. The aim of such activity is to steal or distort the information being conveyed. Optical Wireless Systems (basically Free Space Optic Systems, FSO) are no exception to this trend. Thus, there is an urgent necessity to design techniques that can secure privileged information against unauthorized eavesdroppers while simultaneously protecting information against channel-induced perturbations and errors. Conventional cryptographic techniques are not designed

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Publication Date
Thu Feb 23 2023
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
A Training Program According to Interactive Teaching Strategies and its Impact on Achievement and Creative Problem Solving for Fourth-Grade Preparatory Students in Chemistry
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The aim of the research is to know the effect of a training program based on interactive teaching strategies on achievement and creative problem solving among fourth-grade students in chemistry of the directorate of education Rusafa first, the sample was divided into two groups, one experimental and numbering (29) students and the other control group numbering (30) students. The experimental group underwent the training program in the first semester of the year (2021-2022) and the control one studied according to the usual method. Two tools were built, the first being an academic achievement test consisting of (40) multiple-choice items, and the second a test of creative problem-solving skills in a chemistry subject and consisting o

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Publication Date
Sat Jul 18 2026
Journal Name
Journal Of Physical Education
The Effect of Taking Amino Acids Associated with Muscle Strength Training On the Development of Some Physiological Indicators In Badminton Players
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The aim of the research was designing a nutritional program with amino acids well as designing exercises for muscular strength training for youth female badminton players. In addition to that the researcher aimed at identifying the effect of amino acid accompanied with muscular training on some physiological indicators in youth female badminton players. The researcher used the experimental method. The subjects were (7) youth female badminton players from the Armenian badminton club. Many physiological tests were conducted including PWC170 and Vo2Max. The data was collected and treated using proper statistical operations to conclude that amino acid accompanied with muscular ability training have a positive effect on some physiological indica

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of real estate investment projects with framework theory of real options: A case study in the shopping center project (Baghdad Mall)
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Focused research aims to provide a framework cognitive analytical nature of real estate investments and how they evaluated in the light of the assessment tools of modern theory of real options, and the possibility to rely on that theory in the detection of the true value of projects, real estate investments that would maximize the value of the investment decision taken, and the analysis of those projects that arise in the real estate markets and environments is the organization, which she was to make sure cases and high-risk, compared with entrances techniques, discounted cash flow (net present value). Based on the assumption lies in the possibility of the application of the implic

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