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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
Mon Jun 19 2023
Journal Name
Journal Of Engineering
Study of Some Mechanical Properties for a Polymer Material Reinforcement with Chip or Powder Copper
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In this paper, chip and powder copper are used as reinforcing phase in polyester matrix to form composites. Mechanical properties such as flexural strength and impact test of polymer reinforcement copper (powder and chip) were done, the maximum flexural strength for the polymer reinforcement with copper (powder and chip) are (85.13 Mpa) and (50.08 Mpa) respectively was obtained, while the maximum observation energy of the impact test for the polymer reinforcement with copper (powder and chip) are (0.85 J) and (0.4 J) respectively  

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Publication Date
Sat Aug 21 2021
Journal Name
Engineering, Technology &amp; Applied Science Research
The Response of a Highly Skewed Steel I-Girder Bridge with Different Cross-Frame Connections
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Braces in straight bridge systems improve the lateral-torsional buckling resistance of the girders by reducing the unbraced length, while in horizontally curved and skew bridges, the braces are primary structural elements for controlling deformations by engaging adjacent girders to act as a system to resist the potentially large forces and torques caused by the curved or skewed geometry of the bridge. The cross-frames are usually designed as torsional braces, which increase the overall strength and stiffness of the individual girders by creating a girder system that translates and rotates as a unit along the bracing lines. However, when they transmit the truck’s live load forces, they can produce fatigue cracks at their connection

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Publication Date
Mon May 01 2017
Journal Name
Energy Procedia
A Coupled Model of the Linear Joule Engine with Embedded Tubular Permanent Magnet Linear Alternator
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Publication Date
Thu Aug 01 2019
Journal Name
مجلة العلوم الاقتصادية والإدارية
Improving" Jackknife Instrumental Variable Estimation method" using A class of immun algorithm with practical application
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Improving" Jackknife Instrumental Variable Estimation method" using A class of immun algorithm with practical application

Publication Date
Fri Jun 03 2016
Journal Name
Iraqi Medical Journal
EVALUATION OF PATIENTS WITH CARPAL TUNNEL SYNDROME TREATED BY MINIMAL PALMAR INCISION (A PRELIMINARY STUDY)
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Background : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity

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Publication Date
Mon Jun 30 2025
Journal Name
Scripta Medica
Case Report: A Rare Presentation of Sigmoid Volvulus During Pregnancy With an Integrative Postoperative Approach
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Publication Date
Thu Jan 23 2020
Journal Name
Acoustics Australia
Absorption Coefficient of a Double-Layer Inhomogeneous Micro-perforated Panel Backed with Multiple Cavity Depths
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Double-layer micro-perforated panels (MPPs) have been studied extensively as sound absorption systems to increase the absorption performance of single-layer MPPs. However, existing proposed models indicate that there is still room for improvement regarding the frequency bands of absorption for the double-layer MPP. This study presents a double-layer MPP formed with two single MPPs with inhomogeneous perforation backed by multiple cavities of varying depths. The theoretical formulation is developed using the electrical equivalent circuit method to calculate the absorption coefficient under a normal incident sound. The simulation results show that the proposed model can produce absorption coefficient with wider absorption bandwidth compared w

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The impact of financing structure on bank profits : Applied research on a sample of commercial banks listed in the Iraq Stock Exchange for the period (2011-2020)
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The research aims to identify the concept of financing structure and what are the determinants that affect it and the goals achieved by financing in commercial banks in addition to the sources upon which the financing structure depends consisting of internal financing sources and external financing sources and their connection to the profits of commercial banks. Baghdad, Khaleeji Commercial Bank) registered in the Iraq Stock Exchange during the period for the years (2011-2020) published in the Iraq Stock Exchange from and the research relied on financial analysis tools to analyze the independent variable the following financing structure (the ratio of equity to total assets, the ratio of deposits to Total liabilities, the ratio of loans

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Publication Date
Thu Aug 01 2024
Journal Name
Al-kindy College Medical Journal
The Correlation of Serum Periostin Level with Disease Severity in Patients with Covid -19
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Background: Coronavirus disease 2019 (COVID-19) is an emerging zoonotic disease caused by the new respiratory virus SARS-CoV2. It has a tropism in the lung tissues where excess target receptors exist. Periostin plays a role in subepithelial fibrosis associated with bronchial asthma. Since the Coronavirus's target is the human respiratory system, Periostin has been recently described as a valuable new biomarker in the diagnosis and evaluation of disease in patients with COVID-19 lung involvement. Objectives: To assess the level of Periostin in the serum of COVID-19 patients and to correlate its role in disease severity and prognosis. Subjects and Methods: Periostin serum levels were measured for 63 patients attending three main COVID

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Publication Date
Thu Nov 01 2018
Journal Name
Iraqi Journal Of Community Medicine
Leg alopecia in Patients with Coronary Heart Diseases in comparison with Healthy Control in Adult Males.
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KE Sharquie, JR Al-Rawi, AA Noaimi, RA Al-Khammasi, Iraqi Journal of Community Medicine, 2018

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