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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 31 2024
Journal Name
Anbar Journal Of Agricultural Sciences
EFFECT OF ACIDS AND ORGANIC NUTRIENTS ON CAULIFLOWER GROWTH AND YIELD AND WATER USE EFFICIENCY AND FERTILIZER PRODUCTIVITY OF A MODIFIED NFT HYDROPONICS SYSTEM
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Publication Date
Tue Jun 20 2023
Journal Name
Baghdad Science Journal
Visible-Light-driven Photocatalytic Properties of Copper(I) Oxide (Cu2O) and Its Graphene-based Nanocomposites
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In this study, an improved process was proposed for the synthesis of structure-controlled Cu2O nanoparticles, using a simplified wet chemical method at room temperature. A chemical solution route was established to synthesize Cu2O crystals with various sizes and morphologies. The structure, morphology, and optical properties of Cu2O nanoparticles were analyzed by X-ray diffraction, SEM (scanning electron microscope), and UV-Vis spectroscopy. By adjusting the aqueous mixture solutions of NaOH and NH2OH•HCl, the synthesis of Cu2O crystals with different morphology and size could be realized. Strangely, it was found that the change in the ratio of de-ionized water and NaOH aqueous solution led to the synthesis of Cu2O crystals of differen

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Publication Date
Mon Jun 01 2020
Journal Name
Journal Of Engineering
Improve Rheological Properties of Palygorskite Water-Based Drilling Fluid by Caustic Soda and Soda Ash
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In drilling fluid program, selecting the drilling fluid that will reduce the lost time is the first objective, and will be economical regardless of its cost. The amount and type of solids in drilling fluid is the primary control of the rheological and filtration properties. Palygorskite clay (attapulgite) is an active solid that has the ability to reactive with its environment and form a gel structure within a fluid and due to its stability in the presence of brines and electrolytes this type of clay is preferred for use. The aim of this study is to improve properties of Iraqi palygorskite (PAL) by adding different chemical additives such as caustic soda NaOH and soda ash Na2CO3 with a different con

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Publication Date
Fri May 01 2026
Journal Name
Journal Of Engineering
Electronic Circuit Design and Modeling of Biodegradable Mxene-Based Wireless Biosensor for Deep Wound Monitoring
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One of the most significant challenges of medical care is the infection of postoperative wounds, and conventional visual examination often fails to detect it early. This research proposes the design of an innovative, passive wireless telemetry system for non-intrusive monitoring of the wound-healing process.  The system integrates a biocompatible resonance circuit (LC) with a high-sensitivity piezoresistive sensor based on MXene (Ti3C2Tx). It operates within the standard industrial and medical (ISM) band at 13.56 MHz.The detection mechanism in the system is based on the principle of "impedance modulation" (Impedance Modulation), which arises from changes in the sensor's resistance under physiological tissue pressure. The system was

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Publication Date
Sat Dec 30 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Evaluating Filtration and Thermal Stability of Water-Based Mud Using Green Synthesized Zinc Oxide Nanoparticles
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   Nanoparticles (NPs) have unique capabilities that make them an eye-opener opportunity for the upstream oil industry. Their nano-size allows them to flow within reservoir rocks without the fear of retention between micro-sized pores. Incorporating NPs with drilling and completion fluids has proved to be an effective additive that improves various properties such as mud rheology, filtration, thermal conductivity, and wellbore stability. However, the biodegradability of drilling fluid chemicals is becoming a global issue as the discharged wetted cuttings raise toxicity concerns and environmental hazards. Therefore, it is urged to utilize chemicals that tend to break down and susceptible to biodegradation. This research presents the pra

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Publication Date
Sun Jun 21 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Nanotechnology-Based Topical Drug Delivery Systems for Management of Dandruff and Seborrheic Dermatitis: An overview
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Dandruff and seborrheic dermatitis (SD) are common skin disorders affecting the scalp and extending to other body sites in the case of SD. They are associated with pruritus and scaling, causing an esthetical disturbance in the population affected.   Treatment of such conditions involves using a variety of drugs for long terms, thus optimizing drug formulation is essential to improve therapeutic efficacy and patient compliance. Conventional topical formulations like shampoos and creams have been widely used but their use is associated with disadvantages. To overcome such effects, novel topical nanotechnology-based formulations are currently under investigation. In the following article, we highlight recently published formulatio

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation, Characterization and Ex vivo Permeability Study of Transdermal Apixaban O/W Nanoemulsion Based Gel
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This study designed to prepare ultrafine apixaban (APX) o/w nanoemulsion (NE) based gel with droplet size below 50 nm as a good method for transdermal APX delivery without using permeation enhancer, alternatively, the formulation components itself act as permeation enhancer. APX, a potent oral anticoagulant drug that selectively and directly inhibit coagulation factor Xa, was selected as a good candidate for transdermal delivery as it displays poor water solubility (0.028 mg/mL) and low bioavailability (50%). APX-NE gel was prepared using triacetin, triton-x-100 and carbitol as oil phase, surfactant and cosurfactant respectively, while Carbopol 940 used as a gelling agent. Ex vivo permeation of APX-NE gel through human stratum c

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Publication Date
Tue Aug 16 2022
Journal Name
Heat Transfer
Experimental study on thermo‐hydraulic performance of metal foam twisted tape in a double pipe heat exchanger
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Abstract<p>A recent study compared experimentally the hydraulic and thermal activity of twisted tape inserts for two types, metal foam twisted tape (MFTT) and traditional twisted tape (TTT), in a double pipe heat exchanger. The investigation goal of the innovatively designed MFTT is to enhance the heat transfer process, which provides a higher thermal enhancement factor over those of TTT under the same conditions. Heat transfer activity in terms of Nusselt number (<italic>Nu</italic>) and Nusselt number ratio (<italic>Nu</italic>/<italic>Nu</italic><sub>o</sub>) as the heat exchanger equipped with the proposed MFTT and TTT inserts with various tape‐twist ratios (<i></i></p> ... Show More
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Publication Date
Sun Mar 07 2010
Journal Name
Baghdad Science Journal
The Effect of Cyperus esculentus on Sperm Function Parameters in Prepubertal Mice as a Model for Human
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The objective of this work was to study the effect of oral administration of Cyperus esculentus (CE) and its alcoholic extract on sperm function parameters in prepubertal mice as a model for human .The animals were divided into three groups each contains 6 animals .Group 1 was treated with 150 mg/ kg body weight /day of crude CE, group 2 was treated with same dose of alcohol extract of CE and group 3 regarded as control throughout six weeks period. The results showed a significant (p> 0.05) increase in the mean of sperm concentration ,sperm motility percent and progressive sperm motility between treated groups and control . There was no differences among groups in the mean of sperm normal morphology and sperm viability . No significa

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Publication Date
Thu Dec 01 2022
Journal Name
Journal Of Medicine And Life
Renal stone density on native CT-scan as a predictor of treatment outcomes in shock wave lithotripsy
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Extracorporeal shock wave lithotripsy (ESWL) is considered a standard treatment for nephrolith or kidney stones measuring less than 20 mm. Anatomical, machine-related, and stone factors play pivotal roles in treatment outcomes, the latter being the leading role. This paper examined the relationship between stone density on native CT scans and ESWL treatment to remove renal stones concerning several treatments. One hundred and twenty patients (64 males and 56 females) were enrolled and completed the study from April 2019 to September 2020. Inclusion criteria were a single renal pelvis stone of 5–20 mm to be treated for the first time in adult patients with no urinary or musculoskeletal anatomical abnormalities. We assessed patients

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