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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
Baghdad Science Journal
Investigation of the association of AGTR1 A1166C rs5186 and FTO rs9939609 polymorphisms with the obesity in children and adolescents
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Obesity is a risk factor for a number of chronic conditions. Obesity is clinically defined using the body mass index (BMI) as weight in kg divided by (height)2 in m2 correlated with obesity. Currently, genetic markers of obesity are being studied. This study focused on the association between the angiotensin II receptor AGTR1 gene (A1166C) and fat mass and obesity-associated protein also known as alpha-ketoglutarate-dependent dioxygenase (FTO) (rs9939609) in obese children and adolescents patients in Rostov region, Russia.  Five-hundreds of Russian nationality child and adolescent were recruited for the obesity-control studies. The relationship between the A1166C polymorphism of the AGTR1 gene in

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
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Some coordination complexes of Co(ІІ), Ni(ІІ), Cu(ІІ), Cd(ІІ) and Hg(ІІ) are reacted in ethanol with Schiff base ligand derived from of 2,4,6- trihydroxybenzophenone and 3-aminophenol using microwave irradiation and then reacted with metal salts in ethanol as a solvent in 1:2 ratio (metal: ligand). The ligand [H4L] is characterized by FTIR, UV-Vis, C.H.N, 1H-NMR,13C-NMR, and mass spectra. The metal complexes are characterized by atomic absorption, infrared spectra, electronic spectra, molar conductance, (C.H.N for Ni(ІІ) complex) and magnetic moment measurements. These measurements indicate that the ligand coordinates with metal (ІІ) ion in a tridentate manner through the nitrogen and oxygen atoms of the ligand, octahed

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
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Some coordination complexes of Co(??), Ni(??), Cu(??), Cd(??) and Hg(??) are reacted in ethanol with Schiff base ligand derived from of 2,4,6- trihydroxybenzophenone and 3-aminophenol using microwave irradiation and then reacted with metal salts in ethanol as a solvent in 1:2 ratio (metal: ligand). The ligand [H4L] is characterized by FTIR, UV-Vis, C.H.N, 1H-NMR,13C-NMR, and mass spectra. The metal complexes are characterized by atomic absorption, infrared spectra, electronic spectra, molar conductance, (C.H.N for Ni(??) complex) and magnetic moment measurements. These measurements indicate that the ligand coordinates with metal (??) ion in a tridentate manner through the nitrogen and oxygen atoms of the ligand, octahedral structures

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Publication Date
Sun Jun 05 2016
Journal Name
Baghdad Science Journal
Synthesis, Characterization and Study of Antibacterial Activity of a New Schiff Base Ligand and Its Complexes with Co(II), Ni(II), Cu(II), Cd(II) and Hg(II) Metal Ions
...Show More Authors

Some coordination complexes of Co(??), Ni(??), Cu(??), Cd(??) and Hg(??) are reacted in ethanol with Schiff base ligand derived from of 2,4,6- trihydroxybenzophenone and 3-aminophenol using microwave irradiation and then reacted with metal salts in ethanol as a solvent in 1:2 ratio (metal: ligand). The ligand [H4L] is characterized by FTIR, UV-Vis, C.H.N, 1H-NMR,13C-NMR, and mass spectra. The metal complexes are characterized by atomic absorption, infrared spectra, electronic spectra, molar conductance, (C.H.N for Ni(??) complex) and magnetic moment measurements. These measurements indicate that the ligand coordinates with metal (??) ion in a tridentate manner through the nitrogen and oxygen atoms of the ligand, octahedral st

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Publication Date
Tue Feb 17 2026
Journal Name
Sustainable Engineering And Innovation
Morlet wavelet–based olfactory-evoked EEG features for random forest classification of normal, aMCI, and Alzheimer’s disease
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Olfactory impairment and abnormal frontal EEG oscillations are recognized as early markers of Alzheimer’s disease (AD). Using a publicly available olfactory EEG dataset of 35 subjects spanning normal cognition, amnestic mild cognitive impairment (aMCI), and AD, each with MMSE scores and demographics, stimulus-locked epochs from four electrodes (Fp1, Fz, Cz, Pz) were processed with wavelet-based time–frequency analysis. Band-limited power ratios (delta, theta, alpha, beta) were computed as log-transformed post-odor/baseline values and aggregated to subject-level features. Statistical analyses revealed graded attenuation of odor-evoked frontal (Fp1) band-power ratios across groups, with significant differences in several band–od

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Publication Date
Wed May 01 2019
Journal Name
Environmental Technology &amp; Innovation
Biomineralization based remediation of cadmium and nickel contaminated wastewater by ureolytic bacteria isolated from barn horses soil
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Publication Date
Wed Jan 28 2026
Journal Name
International Journal Of Innovations In Applied Sciences & Engineering
Design and Evaluation of an XOR Auto-Associative Memory Based Framework for Robust Iraqi License Plate Recognition
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This project presents an enhanced Iraqi vehicle plate identification system, incorporating digital processing technologies and the XOR Auto-Associative Memory advanced associative memory algorithm, towards a fast and efficient performance under diverse conditions of imagery. The system consists of three major stages: identification of the panel area, or localization, using edge transformations and morphological operations; symbol segmentation, or segmentation, based on horizontal and vertical projections for the exact extraction of numbers and letters; and finally, recognition use of XOR operations and a binary distance criterion known as Hamming Distance. The model was tested on 420 images of panels in different scenarios of lighting

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Publication Date
Sun Jul 09 2023
Journal Name
Journal Of Engineering
Improving the Performance of Construction Project Information and Communication Management Using Web-Based Project Management Systems (WPMSs)
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This paper presents a brief study undertaken for improving the performance of information and communication management of construction projects through investing in information and communication technologies (ICT). The work aims at first to investigate and diagnose the problems, challenges, weaknesses, and inefficiencies related to information and communication management in projects in the construction industry of Iraq. Studying the diagnosed matters and the different solutions of ICT to improve project management performance is following the investigation process. The research presents a technological system suggested to process a lot of the diagnosed problems, challenges, weakness, and inefficiencies of the construction projects and t

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The role of forensic accounting in resolving banking disputes: an applied research on a sample of private banks listed in the Iraq Stock Exchange
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This study aims to identify the role of forensic accounting in resolving banking disputes in the Iraqi environment, and to achieve this goal, the fiel

d survey method was used, as it is the most appropriate for studying the phenomenon in question and achieving its objectives. A sample of (50) male and female employees was selected, distributed among five banks listed on the Iraq Stock Exchange in the Baghdad governorate. The questionnaire tool prepared for this purpose was applied to them, which consisted of two main axes. The first axis included paragraphs of questions related to the importance of forensic accounting. The second axis relates to disputes At the end of the research, we reached a set of conclusions, the most import

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Publication Date
Thu Sep 24 2020
Journal Name
F1000research
Characterization of flow cytometric immuno-phenotyping of acute myeloid leukemia with minimal differentiation and acute T-cell lymphoblastic leukemia: A retrospective cross-sectional study
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Background: Acute leukemias (ALs) are a heterogeneous group of malignancies with various clinical, morphological, immunophenotypic, and molecular characteristics. Distinguishing between lymphoid and myeloid leukemia is often performed by flow cytometry. This study aimed to evaluate the immunophenotypic characterization and expression of immuno-markers in both acute myeloid leukemia (AML-M0) and acute T-cell lymphoblastic leukemia (T-ALL).

Methods: A retrospective cross-sectional study was conducted in the Pathology Department/Teaching Laboratories/Medical City/Iraq and included all patients newly diagnosed with AL from 5 January to 10 December 2018. Immunophenotypic analysis wa

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