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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
Sun Dec 22 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Assessment of Causality, Severity and Seriousness of Adverse Event Following Immunization in Iraq: A Retrospective Study Based on Iraqi
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Immunization is one of the most cost-effective and successful public health applications. The results of immunization are difficult to see as the incidence of disease occurrence is low while adverse effects following the immunization are noticeable, particularly if the vaccine was given to apparently healthy person. High safety expectations of population regarding the vaccines so they are more prone to hesitancy regarding presence of even small risk of adverse events which may lead to loss of pub

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Publication Date
Thu Jun 01 2023
Journal Name
Medicinal Chemistry
New Niflumic Acid Derivatives as EGFR Inhibitors: Design, Synthesis, In silico Studies, and Anti-proliferative Assessment
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Background:

1,3,4-oxadizole and pyrazole derivatives are very important scaffolds for medicinal chemistry. A literature survey revealed that they possess a wide spectrum of biological activities including anti-inflammatory and antitumor effects.

Objectives:

To describe the synthesis and evaluation of two classes of new niflumic acid (NF) derivatives, the 1,3,4-oxadizole derivatives (compounds 3 and (4A-E) and pyrazole derivatives (compounds 5 and 6), as EGFR tyrosine kinase inhibitors in silico and in vitro.

Methods:

The designed compounds were synthesized using convent

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Publication Date
Wed Mar 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Expired Colxacillin, Amoxicillin, and Ceflaxin Drugs as Inhibitors for Low Carbon Steel Corrosion in Sodium Chloride
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The ability to inhibit corrosion of low carbon steel in a salt solution (3.5%NaCl) has been checked with three real expired drugs (Cloxacillin, Amoxicillin, Ceflaxin) with variable concentrations (0, 250, 500, 750) mg/L were examined in the weight loss. The inhibition efficiency of the Cloxacillin 750 mg/L showed the highest value (82.8125 %) and the best inhibitor of the rest of the antibiotics. The different concentrations of Cloxacillin drug (0, 250, 500, 750) mg/L and temperature (25, 35, 45, 55) oC were studied as variables with potentiodynamic polarization, Scanning Electron Microscopy (SEM) for surface morphology and electrochemical impedance spectroscopy (EIS) depending on current values and the resistance of charge to

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Publication Date
Fri Dec 14 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Teaching Program on Nurses' Knowledge Concerning the Side Effects of Chemotherapy among Children with Leukemia at Oncology Wards in Baghdad City
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Objective(s): to assess the effectiveness of educational program on nurses' knowledge concerning the side
effects of chemotherapy among children with leukemia.
Methodology: A descriptive analytic (quasi – experimental) design study was carried out at Baghdad City from
2
nd of October to 27th of June 2015. Non-probability sample of (35) male and female nurses was selected from
the Oncology Wards in Children Welfare, Child's Central and Baghdad Teaching Hospital. The study
instruments consisted of two major parts to meet the purposes of study. The first part is related to nurses'
demographic characteristics and the second part (four domains) is related to nurses' knowledge concerning the
side effects of chemothera

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Publication Date
Mon Jun 30 2025
Journal Name
Zanin Journal Of Science And Engineering
Preparation and Spectral Characteristics of Various Transition Metal Complexes with Novel Azo-dye Based on Tryptamine.
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Novel azo ligand based on tryptamine, and its metal complexes with antioxidant properties were synthesized through chemical methods and characterized through various techniques, including IR, Mass, UV-Vis spectroscopy, elemental analysis, conductivity, magnetic sensitivity, and thermogravimetric analysis. According to the IR spectra of the complexes, the azo-ligand, [5-(2-(3H- 1-indol-3-yl) ethyl) diazenyl) quinolin-8-ol] coordinates with metal ions through the nitrogen atom in the quinoline ring and the oxygen atom of the hydroxyl group. Thermal analysis techniques were employed to investigate the thermal behavior of the compounds. The results revealed that the metal complexes possess higher thermal stability compared to the free ligand. T

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Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study the Efficiency of Drilling With Casing Operation in an Iraqi Oil Field
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Drilling with casing (DWC) can be considered as a modern drilling technique in which both of drilling and casing operations done in the same time by using the casing to transfer the hydraulic and mechanical power to the bit instead of traditional drilling string. To overcome oil well control, minimizing the total cost through enhancing drilling efficiency, drilling with casing was proposed as an enabling technology.

   Two surface sections (17 1/2 - and 12 1/4- inch) were drilled successfully in Rumaila oil field with  casing strings which reached 655m and 1524m measured depths respectively.

   By using DWC technique, the total drill/case phase time was reduced up to 20% comparing to conventional

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Topic Management in Selected Dementia Patients' Speeches: A Clinical Discourse Analysis Study
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Topic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic

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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Regeneration of Pain, Touch, Cold, and Warmth, sensations in split thickness human skin grafts in adults (A clinical study)
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Back ground: Skin grafting is the most common form
of reconstructive surgery, and regeneration of
sensations in skin grafts is a complex process
influenced by many factors such as , the thickness of
the graft, the depth of the grafted bed, meshing of the
graft, the condition of the bed and the surrounding
area. So many studies performed on this subject, some
of them clinically based on subjective type of sensation
tests, and others histological to detect the presence of
nerve fibers in the grafted skin
Objectives: To detect return of sensations to split
thickness skin grafts by clinical methods.
Methods: From Oct. 1995 to Oct. 2010, a clinical
prospective study performed in Al wasity Hospital for

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Publication Date
Tue Apr 28 2026
Journal Name
Baghdad Science Journal
Clinical Implications of Circulating miRNA-200a and Mucin 16 in Late-Stage Colorectal Cancer: A Study in Iraqi Patients
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Background: Colorectal cancer, the most common gastrointestinal cancer, is a significant health issue globally. Mucin 16 plays a critical role in cancer signal transduction pathways and is a potential glycoprotein target for cancer therapy. The miRNA-200 family also regulates the expression of numerous genes that play vital roles in cancer cells. This study aimed to investigate the changes in mucin 16 and miRNA-200a in patients with colorectal cancer (CRC). Subjects and Methods: Fifty-six patients with CRC, including 26 in stage 3 and 30 in stage 4, were included in this study, along with 38 healthy volunteers as a control group. Parameters such as mucin 16, miRNA-200a, total protein, albumin, globulin, and the albumin/globulin rati

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Publication Date
Mon Aug 22 2022
Journal Name
World Bulletin Of Management And Law
THE IMPACT OF OUTSOURCING OF HUMAN RESOURCE ACTIVITIES ON ORGANIZATIONAL WINNING(FIELD RESEARCH IN A SAMPLE OF PREMIUM CLASS HOTELS -IN IRAQ)
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The aim of the research is to test the effect of outsourcing human resources activities (independent variable) with its dimensions (outsourcing of staffing, outsourcing of training and development, outsourcing of wages and compensation, outsourcing of human resources information systems) on organizational winning (dependent variable) with its dimensions (the culture of winning, successful organizational change, continuous improvement, and adoption of risk). The research problem was the questions posed by the researcher, the most important of which is the extent to which the research sample realizes the importance of applying outsourcing to human resources activities and its role in organizational vi

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