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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
Thu Dec 01 2022
Journal Name
Case Studies In Construction Materials
Push-out test of waste sawdust-based steel-concrete – Steel composite sections: Experimental and environmental study
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Publication Date
Thu Dec 01 2022
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Case Studies In Construction Materials
Push-out test of waste sawdust-based steel-concrete – Steel composite sections: Experimental and environmental study
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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Water Process Engineering
Immobilization of cobalt ions using hierarchically porous 4A zeolite-based carbon composites: Ion-exchange and solidification
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Publication Date
Sun Jan 01 2023
Journal Name
Ieee Access
Fuzzy-Based Ensemble Feature Selection for Automated Estimation of Speaker Height and Age Using Vocal Characteristics
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Publication Date
Fri Oct 17 2025
Journal Name
Ieee Access
Optic Flow-Based Gait Symmetry Assessment of Center and Peak Pressure Trajectories Applied to Foot Deformities
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Analyzing plantar pressure trajectories is crucial for assessing foot behavior in dynamic gait stability. We propose the identification of foot symmetry and the detection of deformities by analyzing the trajectories of the center of pressure (CoP) and peak pressure (PP). First, using a foot pressure mapping system, plantar pressure data are acquired during a normal gait cycle. After the data have been acquired, post processing extracts both the CoP and PP trajectories over the spatiotemporal domain of foot motion for each foot independently. For this purpose, we used the optical flow technique which accurately estimates the direction of foot motion. The extracted trajectories of each foot are then segmented into, the medial and lateral regi

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Publication Date
Sun Mar 06 2016
Journal Name
Baghdad Science Journal
Isolation and Purification of a Cyclooxygenase-2 from the Blood of a Patient Suffering from Rheumatoid Arthritis and Studying the Effect of Natural Products of the Soapwort on the Activity of Purified Enzyme
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In this paper to isolate and study the properties of the cyclooxygenase-2 (EC: 1.14.99.1) enzyme in the blood of a patient suffering from rheumatoid arthritis and study the effect of natural products of the Soapwort on the activity of purified enzyme. The study involves taking 30 ml of blood from an adult woman 40 years old, who suffers from rheumatoid arthritis disease for 13 years. Serum is separated and subjected to a series of purification processes including: precipitation by ammonium sulfate, filtration by centrifugation radiator, dialysis in presence of ammonium bicarbonate, separation using the technology of ion exchange, lipholization and then estimating approximate molecular weight of the enzyme using gel filtration techni

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Publication Date
Thu Dec 31 2020
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Electronic payment methods used for salary resettlement and its impact on improving the mental image of customers: an applied study of the opinions of a sample of (private) commercial banks 'customers contracting with the Ministry of Higher Education and Scientific Research to localize employees' salaries
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The research seeks to identify the contemporary events that face the use of electronic payment methods to localize the salaries of state employees and its impact in enhancing the mental image of customers, and to achieve this purpose from the fact that a questionnaire was designed and distributed to an optional sample of (31) individual customers (employees) dealing With the researched private banks, it has been analyzed and reached a number of conclusions and recommendations, the most prominent of which is the lack of modernity of electronic payment methods by customers, which is reflected in the mental image of customers and the achievement of their satisfaction, in the Emiratization project for salaries needs an advanced leade

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Publication Date
Sun Mar 30 2014
Journal Name
Oriental Journal Of Chemistry
Electrophoresis Profile of Total Peroxidases in Saliva and Sera of Patients with Different Oral Tumors
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Publication Date
Wed Jan 09 2008
Journal Name
Iraqi Journal Of Agricultural Sciences 39 (3)‏
IFNFLUENCES OF IRRIGATION WITH MAGNETIZED WATER AND FOLIAR FERTILIZATION IN MINERAL CONTENTS OF ORANGE LEAVES.‏
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Publication Date
Thu May 15 2025
Journal Name
Journal Of Animal Health And Production
Functional and Histological Study of Liver in Adult Rats Treated with Different Doses of Melatonin
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his study aimed to evaluate the effects of different doses of melatonin on liver function in adult rats. Eighteen Wistar adult albino rats (Rattus norvegicus), approximately 13–16 weeks old and weighing 230 ± 10 g, were randomly divided into three groups (n=6 per group) and treated orally for 30 days as follows: Group A1 received 10 mg/kg body weight (B.W) of melatonin; Group A2 received 20 mg/kg B.W of melatonin; and the control group (Group A) received distilled water. At the end of the treatment period, blood samples were collected via cardiac puncture, and serum was separated for biochemical analysis. Parameters assessed included oxidative stress markers (malondialdehyde (MDA), reduced glutathione (GSH)) and liver enzymes (aspa

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