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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 Apr 22 2026
Journal Name
Environmental Earth Sciences
Transboundary hydrogeology and controlling factors of euphrates water chemistry: Insights from hydrochemistry, stable isotopes, and residence times in Syria and Western Iraq
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Arid and semi-arid climates are critical for water security in sustainable river systems. The Euphrates River in western Iraq has been increasingly stressed by both geogenic and anthropogenic factors. This study analyzed hydro-geochemical processes, recharge dynamics, and groundwater flow modeling in western Iraq. Additionally, stable isotope tracing (δ¹⁸O, Cl⁻) integrated with hydro-chemical parameters was used to assess water quality and river-aquifer connectivity in both Syria and western Iraq. A total of 144 groundwater samples were collected annually across 12 stations in western Iraq. Surface water and groundwater data were collected from previous studies at 13 stations in Syria. Results revealed slightly alkaline freshwater con

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Publication Date
Sat Dec 21 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical effects of Arabic gum (Acacia): A mini review
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Gum Arabic is a natural gummy exudate gained from the trees of Acacia species (Acacia senegal and Acacia seyal), Family: Fabaceae. Gum Arabic considers as a dietary fiber with a high percentage of carbohydrates and low protein content. Sugars arabinose and ribose were originally discovered and isolated from gum Arabic and it is representing the original source of these sugars. A gum emanation from trees occurs under stress conditions such as heat, poor soil fertility, drought, and injury. Mainly gum is produced in belt region of Africa, mainly Sudan, Chad, and Nigeria. In the food industry, it is used in confectionery; in the pharmaceutical industry, it is used as emulsifier, film coating and others. Traditionally the g

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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
Polygamy in light of societal changes in Iraq (A Field Study in Baghdad)
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The polygamy as a social was known before Islam, has kept Islam on this system after it organized and put his controls and conditions, as justice between wives and the ability to alimony, it was not the purpose of satisfying the instinct of man and enjoyment, but his goal nominal than that, because it addresses problems humanity has goals noble, so the pluralism overlap of the fabric of families belonging to governance and benefits for women and men and society, which leads to increased ties of love between people of the same society and thus increases the cohesion and importance of the topic and its association with financial conditions have emerged as needed so you viewed in the second scientific Conference of the Department social Ser

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
Critical Success factors of Strategic Information system and it's relation with Strategic Decisions Effectiveness
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The organization uses many techniques and methods to ensure that they will succeed and adapted with velocity change in the internal and external environment by decision taking, especially strategic decisions.

Strategic decisions are very important for organization success because it can predict the future and deal with uncertainty, in this circumstances they need accurate and comprehensive information to make effective strategic decision.

To achieve that purpose it must owned successful Strategic Information System ( SIS ) and determined the critical success factors for this system ,which can assisted the worker to focus on the important activities to develop it.

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Implementation of a Clinical Pharmacy Training Program in Iraqi Teaching Hospitals : Review Article
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Pharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit

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Publication Date
Tue Jan 10 2017
Journal Name
International Journal Of Dynamics And Control
On local approximation-based adaptive control with applications to robotic manipulators and biped robots
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Publication Date
Sat Dec 02 2023
Journal Name
Journal Of Engineering
The Cost of Technology Transfer in Construction Companies (In Iraq)
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The construction sector is considered an important and influential pivot in the national economy of any country.  Nations are working to develop this sector, receiving modern and developed techniques. So, this sector can be a carrier or a receiver of modern technologies. The cost of technology transfer between the international companies that sponsor this sector is a matter of great importance, especially since different factors affect the need for this advanced technology. The cost of technology transfer in construction is related to multiple factors presented by Knowledge, equipment, plant, hardware and software. The lack of distinguishing and evaluating the direct and indirect costs in the construction sector during

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Publication Date
Sun Jan 01 2012
Journal Name
Tikrit Journal For Dental Sciences
Microleakage Evaluation of a Silorane-Based and Methacrylate-Based Packable and Nanofill Posterior Composites (in vitro comparative study)
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This study compared in vitro the microleakage of a new low shrink silorane-based posterior composite (Filtek™ P90) and two methacrylate-based composites: a packable posterior composite (Filtek™ P60) and a nanofill composite (Filtek™ Supreme XT) through dye penetration test. Thirty sound human upper premolars were used in this study. Standardized class V cavities were prepared at the buccal surface of each tooth. The teeth were then divided into three groups of ten teeth each: (Group 1: restored with Filtek™ P90, Group 2: restored with Filtek™ P60, and Group 3: restored with Filtek™ Supreme XT). Each composite system was used according to the manufacturer's instructions with their corresponding adhesive systems. The teeth were th

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Publication Date
Mon Oct 17 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the incidence and the clinical significance of gray zone in the clinical phases of chronic hepatitis B infection
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Background: five clinical phases were described in patients with chronic (HBV) infection: HBeAg- positive HBV infection, HBeAg- positive chronic HB, HBeAg negative HBV infection, HBeAg-negative CHB and occult HBV infection. Aim: This study aimed to determine the incidence of the unclassified phase (gray zone) in chronic hepatitis B patients and its significant in the clinical practice. Patients and methods: The study was conducted retrospectively on 109 patients' who have HBsAg positive for more than 6 months. The data recorded include; HbeAg and anti-HBe Ab, ultrasound of the abdomen, HBV DNA load and alanine aminotransferase (ALT), accordingly; we classify the patients to known clinical phases. Patients who were unfit one of these phases

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Publication Date
Thu Jun 15 2023
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of a Cognitive-Behavioral Treatment Program to Reduce Nervous Fatigue for Mothers of Children with Cerebral Palsy
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Cognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided

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