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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
Fri Jul 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
The effect of autologous bone marrow-derived stem cells with estimation of molecular events on tooth socket healing in diabetic rabbits (Immunohistochemical study)
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Background: Healing of a tooth extraction socket is a complex process involving tissue repair and regeneration. It involves chemotaxis of appropriate cells into the wound, Transformation of undifferentiated mesenchymal cells to osteoprogenitor cells, proliferation and differentiation of committed bone forming cells, extracellular matrix synthesis, mineralization of osteoid, maturation and remodeling of bone. These cellular events are precisely controlled and regulated by specific signaling molecules. Some of these like transforming growth factor beta (TGF-?), vascular endothelial growth factor (VEGF), bone morphogenetic proteins (BMP) and insulin like growth factors (IGF) are well conserved proteins involved in the initial response to injur

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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
Tue Jun 25 2024
Journal Name
African Journal Of Biological Sciences
Toxic effect of Thiamethoxam and Lambda cyhalothrin on Nephrotoxicity and Hematological in rats
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Thiamethoxam is a synthetic organic insecticide belong to The most significant new class of pesticides created in the last thirty years is neonicotinoids. This study's objective was to determine the effect of thiamethoxam, lambda cyhalothrin and their combination on biochemical parameters, the levels of free radicals and enzymes activities liver of male.Forty Rats ( 150-170 g ) were used. animals Were separated into four groups, each with ten rats.The Gp1 was used as control, the Gp2 was used to study the effect of thiamethoxam for 3weeks, the Gp3 was employed to examine the impact of lambda cyhalothrin for 3 weeks and the Gp4 was used to research the impact of thiamethoxam and lambda cyhalothrin for 3 weeks. thiamethoxam and/or lambda cyha

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Publication Date
Sat Jan 27 2024
Journal Name
Caspian Journal Of Environmental Sciences,
Morphological study on the form and number of eyes in scorpions and spiders
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Scorpions and spiders belong to the class Arachnida in phylum Arthropoda. Scorpions are easily distinguished by median eyes on obvious the center of the carapace and have one pair, and lateral eyes have 2-8 in some species. Scorpions do not have good eyesight so the median eyes have always been simple and they are more sensitive than the lateral pairs. They have anterior median eyes (AME) with narrow field of view and pairs of lateral eyes (LE) with more sensitivity and response to light. Family Buthidae have 2-6 lateral eyes in Compsobuthus Mesobuthus, Hottentotta, while Vaejovidae, Chactidae and Chaerilidae have 2 pairs of lateral eyes. In addition, 3 pairs are found in Orthochirus and Androctonus. Spiders have six eyes in family Pholicid

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Publication Date
Thu Mar 30 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Electronic Customer Trust Building Tools On Excellent Performance An analytical study of the opinions of a sample of individuals in the administrative and leadership positions in the Northern Cement Company
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The current study aims to overcome the conflicts facing the company in its way of staying and continuing to maintain its performance excellent in light of the intense competition, which made it seek to find strong ways and links with its customers through electronic communication using electronic platforms, and this put confidence and safety in The place of suspicion and fear of not fulfilling credibility or violating the privacy, so this research comes to answer about the question:  “Can the company achieve an excellent performance by relying on the customer's electronic confidence?”.

The study followed the descriptive and analytical approaches by providing a virtual model and testing the zero hypotheses, which stipulat

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Crossref
Publication Date
Mon Sep 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Modeling of a Sulfonation Reactor in a Detergent Factory
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Publication Date
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
Study the effect of fish on the optical properties of CuO membranes prepared in a way that thermal spraying chemical
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In this research study the effect of fish on the properties optical films thickness 1200-1800 and calculated energy gap Basra direct transport permitted and forbidden to membranes and urged decreasing values ??of Optical Energy Gap increase fish included accounts optical also calculate the constants visual as factories winding down and the refractive index and reflectivity membranes also by real part and imaginarythe dielectric constant

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Publication Date
Fri Jul 24 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of the Efficacy of Different Gingival Retraction Materials on the Gingival Tissue Displacement (A Comparative In Vivo Study)
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Background: An accurate adaptation of the crown to the finish line is essential to minimize cement dissolution and to preserve periodontium in fixed partial denture cases. An accurate adaptation of crown is possible only when preparation details are captured adequately in the impression and transferred to cast. For these reasons, gingival displacement is necessary to capture subgingival preparation details.The aim of the present study is to measure in vivo the horizontal displacement of the gingival sulcus obtained by using three new cordless retraction materials (Magic Foam Cord®, Racegel and Astringent Retraction Paste) in comparison to medicated retraction cord. Materials and method: Thirty-two patients requiring porcelain fused to me

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Publication Date
Tue Nov 18 2014
Journal Name
Conference: First International Engineering Conference (iec2014)at: Ishik University, Erbil, Krg, Iraq
Visualization of People Attraction from Mobile Phone Trace Database: A Case study on Armada 2008 in French City of Rouen
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The mobile phone is widespread all over the world. This technology is one of the most widespread with more than five billion subscriptions making people describe this interaction system as Wireless Intelligence. Mobile phone networks become the focus of attention of researchers, organizations and governments due to its penetration in all life fields. Analyzing mobile phone traces allows describing human mobility with accuracy as never done before. The main objective in this contribution is to represent the people density in specific regions at specific duration of time according to raw data (mobile phone traces). This type of spatio-temporal data named CDR (Call Data Records), which have properties of the time and spatial indications for th

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Publication Date
Tue Jun 30 2020
Journal Name
Kuwait International Law School Journal
The Duration of the Contract – A Study in Light of French Decree No. 131-2016 Issued on February 10, 2016
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After the Napoleonic Code of 1804 came without any legal rules specific to the duration of the contract, and was content to refer to it in scattered legal texts, Legislative Decree No. 2016-131 came to establish a comprehensive legal system for the duration of the contract, starting from the period of its formation, through the period of its implementation, and ending with its continuation after the expiration of its term, in the third section of the fourth chapter related to the effects of the contract (Articles 1210 - 1215), relying on judicial precedents on the one hand - which are many, as will be shown through the research pages - and contractual practices on the other hand. Perhaps the main motive that prompted the French legislator t

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