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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 Jul 21 2026
Journal Name
Al–bahith Al–a'alami
The agenda of the French news agency AFP in dealing with the press image of the peaceful resistance The Great Return Marches as a model "an analytical study" “A analytical study”
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The study aimed to identify the treatment of the press image of the Great Return Marches in the French international news agency AFP by knowing the most important issues, their direction and the degree of interest in them. The study belongs to the descriptive research, and used the survey method, within the context of the content analysis method, and the researcher relied on the content analysis form tool and the interview tool to collect data. The study population is represented in the photos published by the French News Agency about the Great Return Marches during the period (end of March / 2018 until the end of November / 2019. The researcher chose an intentional sample using the Complete Census method. The study material represented

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Publication Date
Tue Jul 21 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of olive oil as a separating medium and its effect on some physical properties of processed acrylic resin denture base (A comparative study). Part one
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Back ground: During acrylic resin processing, the mold must be separated from the surface of the gypsum to prevent liquid resin from penetrating into the gypsum, and water from the gypsum seeping into the acrylic resin. For many years, tin foil was the most acceptable separating medium, and because it's difficult to apply, a tin-foil substitute is used. In this study, olive oil is used as an alternative to tin foil separating medium for first time, so the aim of the study was to evaluate its effect as a separating medium on some physical properties such as (surface roughness, water sorption and solubility) of acrylic resins denture base comparing it with those processed using tin-foil and tin foil substitute such as (cold mold seal) separat

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Publication Date
Wed Sep 30 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The effect of Auditing Quality on the Earnings Quality: (An applied research in a sample of private joint stock companies listed on the Iraq Stock Exchange)
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The research aims to measure the impact of the quality of the audit on the Earnings Quality, for a sample of private joint stock companies listed on the Iraq Stock Exchange, as the research sample included (14) private and listed joint stock companies in issuing their financial statements for the period from (2010-2018), as well as companies The audit offices in charge of auditing these companies, which number (18) companies or an audit office, and the research relied on two main models for measurement, as the first model reflects the assumed relationship between independent variables represented in the characteristics of external audit quality and measuring the extent of its impact on the dependent variable represented in the Ea

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Publication Date
Tue Jul 21 2026
Journal Name
Al–bahith Al–a'alami
The strategy of Marketable Public Relations Internationally Analytical study of the websites of “ Apple “ and “Samsung “ on the internet: (A research drawn from a Master Degree thesis)
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The international organizations showed their interest in the marketable public relations, with their activities, means and strategies, they play a crucial role in marketing products, services and ideas of the institution. They are considered to be the link between the company and its public, They are responsible for presenting the institution to the public, with honest transmission of the information. This gives a good impression to the institution, in a way the institution and its products become consistent with the needs and interests of the public.  Based on this, the research aims to identify the strategies used by the marketable public relations internationally.  The r

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Publication Date
Sat Dec 01 2018
Journal Name
Nano Hybrids And Composites
Specific NH&lt;sub&gt;3&lt;/sub&gt; Gas Sensor Worked at Room Temperature Based on MWCNTs-OH Network
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Functionalized Multi-Walled Carbon Nanotubes (MWCNTs-OH) network with thickness 4μm was made by the vacuum filtration from suspension (FFS) method. The morphology, structure and optical properties of the MWCNTs film were characterized by SEM and UV-Vis. spectra techniques. The SEM images reflected highly ordered network in the form of ropes or bundles with close-packing which looks like spaghetti. The absorbance spectrum revealed that the network has a good absorbance in the UV-Vis. region. The gas sensor system was used to test the MWCNT-OH network to detect NH3gas at room temperature. The resistance of the sensor was increased when exposed to the NH3gas. The sensitivities of the network w

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Publication Date
Tue Aug 03 2021
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of the forensic accounting philosophy in the transparency and quality of financial statements: : An applied study on a sample of workers at the Trade bank of Iraq and the Gulf Commercial Bank in Babylon
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This research aims to identify the role that forensic accounting plays on the transparency and quality of the financial statements in trade bank of Iraq and the Gulf Commercial Bank in Babylon. This research came to address the problem that most financial institutions suffer from, which is represented by the lack of transparency and the quality of the financial statements issued in a manner. Annual also the manipulation and fraud in the financial data, which causes a big gap between that institutions and organizational stakeholders. According to the implementation of the research hypothesis and the objectives of the research, a questionnaire was prepared consisting of three axes, the first axis dealing with the demographic distri

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Effects of 650 nm Diode Laser and 532 nm Frequency-Doubled Q-Switched Nd:YAG Laser on The Growth of Candida albicans, With and Without Photosensitizers
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This work describes an experimental setup to evaluate the photodynamictoxicity of 650 nm diode laser and 532 nm Frequency-doubled Q-Switched Nd:YAG laser on the growth of Candida albicans as well as the potential fungicidal effect when combining the laser irradiation with specific photosensitizers namely methylene blue, toluidine blue, acridine orange and safranin O. In this study the findings showed that the number of colony-forming units per millilitre (CFU/ml) of C. albicans decreased with increasing exposure time. In particular in the case of the frequency doubled Nd:YAG laser combined with safranin O, the best lethal effect occurred at 11 minutes exposure time with 2.26 J/cm² energy density (89.18% reduction) in comparison with the

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
A Spotlight on the Experience of E-learning as a Learning Method for the Undergraduate Pediatric Nursing Students in Iraq during the COVID-19 Pandemic
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    The emergence of COVID-19 has resulted in an unprecedented escalation in different aspects of human activities, including medical education. Students and educators across academic institutions have confronted various challenges in following the guidelines of protection against the disease on one hand and accomplishing learning curricula on the other hand. In this short view, we presented our experience in implementing e-learning to the undergraduate nursing students during the present COVID-19 pandemic emphasizing the learning content, barriers, and feedback of students and educators. We hope that this view will trigger the preparedness of nursing faculties in Iraq to deal with this new modality of learning and improve it should t

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Publication Date
Sun Aug 28 2022
Journal Name
Geodesy And Cartography
OBJECT-BASED APPROACHES FOR LAND USE-LAND COVER CLASSIFICATION USING HIGH RESOLUTION QUICK BIRD SATELLITE IMAGERY (A CASE STUDY: KERBELA, IRAQ)
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Land Use / Land Cover (LULC) classification is considered one of the basic tasks that decision makers and map makers rely on to evaluate the infrastructure, using different types of satellite data, despite the large spectral difference or overlap in the spectra in the same land cover in addition to the problem of aberration and the degree of inclination of the images that may be negatively affect rating performance. The main objective of this study is to develop a working method for classifying the land cover using high-resolution satellite images using object based method. Maximum likelihood pixel based supervised as well as object approaches were examined on QuickBird satellite image in Karbala, Iraq. This study illustrated that

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Publication Date
Wed Mar 29 2023
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Different Development Scenarios to Increase the Production Rates for Fauqi Oil Field Southeastern Iraq
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The Fauqi field is located about 50Km North-East Amara town in Missan providence in Iraq. Fauqi field has 1,640 MMbbl STOIIP, which lies partly in Iran. Oil is produced from both Mishrif and Asmari zones. Geologically, the Fauqi anticline straddles the Iraqi/Iranian border and is most probably segmented by several faults. There are several reasons leading to drilling horizontal wells rather than vertical wells. The most important parameter is increasing oil recovery, particularly from thin or tight reservoir permeability. The Fauqi oil field is regarded as a giant field with approximately more than 1 billion barrels of proven reserves, but it has recently experienced low production rate problems in many of its existing wells. This study

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