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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 Jan 01 2026
Journal Name
Rsc Advances
Green biosynthesis of selenium nanoparticles by <i>Ralstonia insidiosa</i> which demonstrate effectiveness against human cancer cells, <i>Candida</i> species and multidrug-resistant <i>Acinetobacter baumannii</i>
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Green biosynthesized selenium nanoparticles from Ralstonia insidiosa show potent activity against multidrug-resistant Acinetobacter baumannii , pathogenic Candida spp. and human prostate cancer cells.

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Publication Date
Fri Oct 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Development of human resources and their role in achieving artificial intelligence A survey of the views of a sample of workers in the cement plant
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The research topic was chosen as a result of the importance of human resource in business organizations in general and the industrial process in particular. Without the human resource, business organizations cannot continue and achieve success and excellence, and the research problem has been diagnosed in the lack of sales of General Cement Company’s northern products, despite their distinctiveness, standing, and reputation in The market and its products with standard specifications, and through this problem, the following questions were raised:                                                    &nbs

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Educational And Psychological Researches
The Teaching Practices of Faculty Members in Northern Border University According to the Brain-Based Learning Theory
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The present study aims to identify the most and the least common teaching practices among faculty members in Northern Border University according to brain-based learning theory, as well as to identify the effect of sex, qualifications, faculty type, and years of experiences in teaching practices. The study sample consisted of (199) participants divided into 100 males and 99 females. The study results revealed that the most teaching practice among the study sample was ‘I am trying to create an Environment of encouragement and support within the classroom which found to be (4.4623). As for the least teaching practice was ‘I use a natural musical sounds to create student's mood to learn’ found to be (2.2965). The study results also in

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Publication Date
Thu Feb 24 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effect of using Project - Based Learning method in development intensive reading skills at middle school students
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The purpose of this research is to identify the effect of the use of project-based learning in the development of intensive reading skills at middle school students. The experimental design was chosen from one group to suit the nature of the research and its objectives. The research group consisted of 35 students. For the purpose of the research, the following materials and tools were prepared: (List of intensive reading skills, intensive reading skills test, teacher's guide, student book). The results of the study showed that there were statistically significant differences at (0.05) in favor of the post-test performance of intensive reading skills. The statistical analysis also showed that the project-based learning approach has a high

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Publication Date
Mon Aug 19 2024
Journal Name
Scientific Reports
An in-vitro evaluation of residual dentin retained after using novel enzymatic-based chemomechanical caries removal agents
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To assess the biochemical, mechanical and structural characteristics of retained dentin after applying three novel bromelain‑contained chemomechanical caries removal (CMCR) formulations in comparison to the conventional excavation methods (hand and rotary) and a commercial papain‑contained gel (Brix 3000). Seventy‑two extracted permanent molars with natural occlusal carious lesions (score > 4 following the International Caries Detection and Assessment System (ICDAS‑II)) were randomly allocated into six groups (n = 12) according to the excavation methods: hand excavation, rotary excavation, Brix 3000, bromelain‑contained gel (F1), bromelain‑chloramine‑T (F2), and bromelain chlorhexidine gel (F3). The superficial and deepe

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Publication Date
Fri Jul 24 2026
Journal Name
Al-adab Journal
Western Hermeneutics and Heritage: A Contemporary Study in the Debate of Understanding and Horizon.
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Publication Date
Wed May 31 2023
Journal Name
International Journal Of Advanced Technology And Engineering Exploration
Investigation of phase change characteristics for refrigerant R-134a flow in a double pipe heat exchanger with the use of thermal non-equilibrium model
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Almost all thermal systems utilize some type of heat exchanger. In a lot of cases, evaporators are important for systems like organic Rankine cycle systems. Evaporators give a share in a large portion of the capital cost, and their cost is significantly attached to their size or transfer area. Open-cell metal foams with high porosity are taken into consideration to enhance thermal performance without increase the size of heat exchangers. Numerous researchers have tried to find a representation of the temperature distribution closer to reality due to the different properties between the liquid and solid phases. Evaporation heat transfer in an annular pipe of double pipe heat exchanger (DPHEX) filled with cooper foam is investigated numerical

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Publication Date
Sun Jan 01 2023
Journal Name
The Egyptian Journal Of Hospital Medicine
Association of Microrna-153-3p Expression in Response to Treatment with Imatinib in Patients with Chronic Myeloid Leukemia
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The study aimed to establish the association of miR-153-3p expression with treatment response to IM in CML patients. Sixty CML patients were included and divided into two groups consistent with their response to treatment whether sensitive or resistant to IM. Ten healthy normal participants were enrolled as control group. RNA was extracted from serum to work out miR-153-3p expression utilizing real-time quantitative reverse transcription polymerase chain reaction. The primers were supplied by Macrogen Inc. Twenty seven patients were sensitive to imatinib and 33 were resistant to imatinib. The ratio of male to female was 1.14:1. The bulk (58%) of patients were within the age range of 41-60 years. Weight and gender did not significantly diffe

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Publication Date
Mon Dec 01 2008
Journal Name
Saudi Medical Journal
Treatment of perniosis with oral pentoxyfylline in comparison with oral prednisolone plus topical clobetasol ointment in Iraqi patients.
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AA Noaimi, BM Fadheel, Saudi medical journal, 2008 - Cited by 25

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Publication Date
Wed Jun 26 2019
Journal Name
Journal Of Mechanics Of Continua And Mathematical Sciences
VSM Based Models and Integration of Exact and Fuzzy Similarity For Improving Detection of External Textual Plagiarism admin June 29, 2019
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