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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 Sep 01 2013
Journal Name
Baghdad Science Journal
Spectrophotometric Determination of Bismuth(III) with Arsenazo(III) Reagent in Water samples and Veterinary Preparation
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A simple , sensitive and accurate spectrophotometric method for the trace determination of bismuth (III) has been developed .This method is based on the reaction of bismuth (III) with arsenazo(III) in acid solution (pH=1.9) to form a blue water soluble complex which exhibits maximum absorption at 612nm .Beer's law is obeyed over the concentration range of 2-85 ?g bismuth (III) in a final volume of 20 mL( i.e. 0.1 – 4.25?g.mL-1) with a correlation coefficient of (0.9981) and molar absorptivity 1.9×104 L.mol-1.cm-1 . The limit of detection (LOD) and the limit of quantification (LOQ) are 0.0633 and 0.0847 ?g.mL-1 , respectively . Under optimum conditions,the stoichiometry of the reaction between bismuth (III) and arsenazo(III) r

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Publication Date
Thu Jan 01 2015
Journal Name
Health
Evaluation of Myocardial Performance in Hypertensive Patients with Type 2 Diabetes and Normal Ejection Fraction
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Publication Date
Fri Jan 01 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
Role of CoQ10 and IGFBP-1 in Obese Male Patients with Diabetic Mellitus Type II
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Study the role of CoQ10 and IGFBP-1 in obese male patients with diabetic mellitus type 2. ELISA method was used to assay Serum CoQ10 and IGFBP-1. Blood was taken with drawn sample from 30 obese normal patients with age range (40-60) years, 30 diabetic patients with age range (40-60) years at duration of disease (1-5) years and 30 normal healthy patients. The mean difference between T2DM according to CoQ10 (12.5±1.1) was decreased than the mean of IFG (21.8±3.2) (P 0.002) and the mean difference between T2DM according to IGFBPs (0.65±0.06) was decreased than the mean of IFG (3.2±0.3) (P 0.000). While no significant difference between mean age of DM2 patients (55.5±1.06), and IFG (55.6±0.9) (p 0.90), no significant difference bet

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Publication Date
Fri Nov 01 2013
Journal Name
The Iraqi Postgraduate Medical Journal
Efficacy and safety of topical podophyllin 5% ointment in patients with mild plaque-type psoriasis
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KE Sharquie, AA Noaimi, WK Al-Janabi, The Iraqi Postgraduate Medical Journal, 2013 - Cited by 3

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Publication Date
Wed Mar 01 2023
Journal Name
International Journal Of Nonlinear Analysis And Applications
The use of ARIMA, ANN and SVR models in time series hybridization with practical application
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Forecasting is one of the important topics in the analysis of time series, as the importance of forecasting in the economic field has emerged in order to achieve economic growth. Therefore, accurate forecasting of time series is one of the most important challenges that we seek to make the best decision, the aim of the research is to suggest employing hybrid models to predict daily crude oil prices. The hybrid model consists of integrating the linear component, which represents Box Jenkins models, and the non-linear component, which represents one of the methods of artificial intelligence, which is the artificial neural network (ANN), support vector regression (SVR) algorithm and it was shown that the proposed hybrid models in the predicti

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
The susceptibility test of vaginal yeasts and their relationship with the age in Iraqi women
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This study aims to isolate the pathogenic yeasts from genital tract and investigate their relationship with the age .The results clarified that the most pathogenic yeast isolated from genital tract was Candida albicans , also the results of C.albicanas isolates susceptibility test, to different antifungal revealed that they were sensitive to Miconazole, Ketoconazole and Clotrimazol and were resistant to Nystatin and Grisofulvin. The study of relationship of vaginal infection with the age showed that the incidence of infection with Candida was high among females age group (19-39 years).

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Publication Date
Mon Mar 31 2014
Journal Name
Al-khwarizmi Engineering Journal
Corrosion Behavior of V2AlC and Cr2AlC Compared with SS 316L in NaOH at Four Temperatures
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Abstract

      This work involves the manufacturing of MAX phase materials include V2AlC and Cr2AlC using powder metallurgy as a new class of materials which characterized by regular crystals in lattice. Corrosion behavior of these materials was investigated by Potentiostat to estimate corrosion resistance and compared with the most resistant material represented by SS 316L. The experiments were carried out in 0.01N of NaOH solution at four temperatures in the range of 30–60oC. Polarization resistance values which calculated by Stern-Geary equation indicated that the MAX phase materials more resistant than SS 316L. Also cyclic polarization tests confirme

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Publication Date
Sun Jul 30 2023
Journal Name
Al-rafidain Journal Of Medical Sciences
Correlation of Kidney Injury Molecule-1 and Nephrin Levels in Iraqi Patients with Diabetic Nephropathy
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Diabetic nephropathy is characterized by persistent microalbuminuria and metabolic changes that decline renal functions. Researchers have been prompted to explore new biomarkers such as KIM-1 and nephrin that may enhance the identification of disease. Objective: To Evaluate biomarker levels of kidney injury molculre-1 (KIM-1) concentration and nephrin as early and sensitive markers of nephropathy in type 2 diabetic patients. Method: One hundred T2DM patients were included in a cross-sectional study at the specialized center for endocrinology and diabetes, Baghdad. The first group includes 50 diabetic nephropathy (DN) patients, and the second group includes 50 T2DM patients without DN. Biochemical and clinical parameters were reported for pa

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Publication Date
Fri Dec 15 2017
Journal Name
Journal Of Baghdad College Of Dentistry
Measurement of serum Superoxide dismutase levels in women with polycystic ovarian syndrome and chronic periodontitis
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ABSTRACT Background: Polycystic ovarian syndrome (PCOS) is one of the most important reproductive and endocrine disorders in women at reproductive age. It's associated with metabolic disorder, obesity, insulin resistance and oxidative stress chronic periodontitis and PCOS both of them associated with low chronic grade of inflammation. The prevalence of periodontal disease seems to be higher in women with PCOS. Superoxide dismutase enzyme (SOD) is an important circulating marker and protecting enzyme helping the body tissues to get rid of reactive oxygen species (ROS) that damage the tissue. Aim of the study: The aim of this study was to measure and compare the levels of (SOD) among group of chronic periodontitis patients with PCOS, group

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Publication Date
Sun Sep 05 2010
Journal Name
Baghdad Science Journal
Detection of interleukin-6 and interleukin-8 in serum from women with recurrent spontaneous abortion
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To investigate the role of IL-6 and IL-8 in the immune-regulatory mechanisms involved in the recurrent spontaneous abortion of the first trimester of pregnancy. Serum level of IL-6 and IL-8 were determined in 25 women of age (20-35) years who had a spontaneous abortion of unknown aetiology during the first trimester of pregnancy .They were compared with the corresponding levels of 20 pregnant and non-pregnant women as control groups .cytokine levels were measured by (ELISA) technique .The women with spontaneous abortion had highly significant (P < 0.01) increased serum level of IL-8 and highly significant (P < 0.01 ) decreased level of IL-6 compared to those with normal pregnant and non-pregnant women. The results of this study ma

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