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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
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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Publication Date
Tue Jan 02 2024
Journal Name
Advances In The Theory Of Nonlinear Analysis And Its Application
Properties of Capturing of Peristaltic Flow to A Chemically Reacting Couple Stress Fluid Through an Inclined Asymmetric Channel with Variable Viscosity and Various Boundaries
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The properties of capturing of peristaltic flow to a chemically reacting couple stress fluid through an inclined asymmetric channel with variable viscosity and various boundaries are investigated. we have addressed the impacts of variable viscosity, different wave forms, porous medium, heat and mass transfer for peristaltic transport of hydro magnetic couple stress liquid in inclined asymmetric channel with different boundaries. Moreover, The Fluid viscosity assumed to vary as an exponential function of temperature. Effects of almost flow parameters are studied analytically and computed. An rising in the temperature and concentration profiles return to heat and mass transfer Biot numbers. Noteworthy, the Soret and Dufour number effect resul

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Publication Date
Sun Sep 01 2024
Journal Name
Results In Engineering
Implementation of a control and monitoring system for a cathodic protection cell to mitigate localized corrosion in fixed and mobile steel structures
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Publication Date
Sun Sep 01 2024
Journal Name
Results In Engineering
Implementation of a control and monitoring system for a cathodic protection cell to mitigate localized corrosion in fixed and mobile steel structures
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The current study introduces a novel technique to handle electrochemical localized corrosion in certain limited regions rather than applying comprehensive cathodic protection (CP) treatment. An impressed current cathodic protection cell (ICCPC) was fabricated and firmly installed on the middle of a steel structure surface to deter localized corrosion in fixed or mobile steel structures. The designed ICCPC comprises three essential parts: an anode, a cathode, and an artificial electrolyte. The latter was developed to mimic the function of the natural electrolyte in CP. A proportional-integrated-derivative (PID) controller was designed to stabilize this potential below the ICCPC at a cathodic potential of −850 mV, which is crucial for prote

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Publication Date
Fri Dec 01 2023
Journal Name
Sabrao Journal Of Breeding And Genetics
EFFECT OF SEED PRIMING WITH GREEN TEA (CAMELLIA SINENSIS L.) AQUEOUS EXTRACT ON GERMINATION AND GROWTH TRAITS OF MUNG BEAN (VIGNA RADIATA L.)
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A laboratory experiment studied the effects of the green tea (Camellia sinensis L.) aqueous extract at concentrations of 10, 20, and 30 ppm on the germination and growth traits of the mung bean (Vigna radiata L.), carried out in 2021 at the Department of Biology, College of Education for Pure Sciences, Ibn Al-Haitham, University of Baghdad, Iraq. The results showed that Camellia sinensis green tea extracts played a vital role by significantly boosting all the examined characteristics compared with the control treatment. The aqueous extract of Green tea at concentrations of 10 and 20 ppm gave the best performance in increasing germination rates, germination speed, plant promoter indicator, and seedling strength compared with the control trea

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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Technical requirements for the application of economic intelligence and its impact On the dimensions of strategic success of banks: An applied research on a sample of Iraqi banks private
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This research sheds light on one of the important and vital topics for the banking sectors (technical requirements for the application of economic intelligence) namely by (Hardware, equipment, communication networks, software, databases). And the dimensions of the strategic success of the banks represented by(Customer satisfaction, customer trust, quality of service, growth) In the three Iraqi private banks, namely(Assyria International Investment, Mansour Investment, International Development Investment and Finance). Its implementation is an urgent necessity in order to improve the quality of its banking services to win the satisfaction of its customers and their confidence and then grow to achieve stra

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of Educational And Psychological Researches
Satisfy of life and it's relationship; with the bige factors of character in the university student
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This research aim to recognize
satisfy of life in the university's student and balance in satisfy of life
according to two type aveirable sex specific and find type and
relationship's director between satisfy of life and character big factors.
and known hom much that Factors in satisfy of life, the research sample
consist of (401) student male and female and from both specified in
Baghdad's University, researcher bult scale of Costa &McCrae Fore the
fire big Factors to Personality, research result That the university's
student low level of satisfy of life and there are no different statically if
they are scientific or human in their study. And there is positive and there
is positive and indicate relation

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Publication Date
Wed Nov 08 2023
Journal Name
Aip Conf. Proc.
Correlation of Mercury With Some Biochemical Parameters in Serum of Mothers and Their New Born Children
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Publication Date
Sun Sep 06 2009
Journal Name
Baghdad Science Journal
Study of Malondialdehyde Levels in sera, RBCs and Tissues homogenate of Iraqi Women With Breast Tumors
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Breast tumors patients generally have more oxidative stress than normal females. This was clear from a highly significant elevation (P<0.05) in malondialdehyde level in RBCs, serum and tissue of all patients groups with breast cancer as compared with control group. In this study we had found that free radicals in malignant breast tumors were higher than benign tumors, therefore the MDA might be used as a marker for prognosis of the disease.

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