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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 Jan 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Osteocalcin and Some Biochemical Marker in Diabetes Mellitus Iraqi Women's patients with Osteoporosis
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Diabetes mellitus is a set of metabolic diseases, the most prevalent of which is chronic hyperglycemia. The culprits include insulin synthesis, insulin action, or both. Osteoporosis is a progressive systemic skeletal disorder defined by decreased bone mass and micro architectural degeneration of bone tissue, resulting in increased bone fragility and fracture risk, according to the World Health Organization (WHO). The degree of Nervosa damage determines how much a diabetic patient's body has been compromised. The current study's goal is an estimation: Age, BMI, FBS, HbA1C, D3, ALP, Ca, P, and Osteocalcin in Iraqi T2DM Women's patients with and without Osteoporosis. Three vitamins are required for Osteocalcin biosynthesis: vitamin K for Gla f

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Publication Date
Thu Jun 29 2023
Journal Name
Journal Of University Of Babylon For Pure And Applied Sciences
Genetic Detection of IMP-1 Gene and its Relationship with Biofilm Formation in Klebsiella pneumonia
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Background: Klebsiella pneumoniae were considered as normal flora of skin, and intestine. It can cause damage to human lungs; the danger of this bacterium is related to exposure to the hospital surroundings. materials and methods: the detection of Klebsiella pneumoniae on morphological and biochemical tests and then assured with VITEK 2 system. Resistance to antibiotics was determined by Kirby-Baeur method. And genotyping of IMP-1 in isolates was done by PCR technique, then biofilm formation was identified by Micro titer plate method. Results: The present study included a collecting of 50 specimens from different clinical specimens, (blood 40%, urine 30%, sputum 20%, wound infection 10%); 10 isolates were identified as K

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Publication Date
Fri Dec 01 2023
Journal Name
Baghdad Science Journal
Gene Expression and Methylation Levels of PCSK9 Gene in Iraqi Patients with Coronary Artery Disease
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The expression of the Proprotein Convertase Subtilisin/Kexin Type 9 gene (PCSK9) is inextricably related to lipid levels and a risk of atherosclerotic coronary artery disease (ASCAD). The present study aims to measure the quantity of PCSK9 gene expression and the effect of methylation on its expression level taking part in the pathogenesis of acute coronary artery disorder.

A current study included 150 subjects from the Iraqi population, 100 ASCAD patients and 50 healthy controls. The concentration of PCSK9 in each serum sample was determined by the ELISA technique, the expression levels of the PCSK9 gene in whole blood were estimated by RT-qPCR – Quantitative Reverse Transcription PCR method, and DNA

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Southwest Jiaotong University
The Dynamics of an Eco-Epidemiological Model with Allee Effect and Harvesting in the Predator
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The aim of this study was to propose and evaluate an eco-epidemiological model with Allee effect and nonlinear harvesting in predators. It was assumed that there is an SI-type of disease in prey, and only portion of the prey would be attacked by the predator due to the fleeing of the remainder of the prey to a safe area. It was also assumed that the predator consumed the prey according to modified Holling type-II functional response. All possible equilibrium points were determined, and the local and global stabilities were investigated. The possibility of occurrence of local bifurcation was also studied. Numerical simulation was used to further evaluate the global dynamics and the effects of varying parameters on the asymptotic behavior of

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Publication Date
Thu Dec 10 2009
Journal Name
Iraqi Journal Of Laser
Diagnosis and Treatment of Cervical Intraepithelial Neoplasia with Carbon Dioxide Laser Therapy in Selected Patients
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Female infection with HPV (human papilla virus) has been established as an essential cause of CIN (cervical intraepithelial neoplasia). The danger of transformation from CIN to frank malignancy should be considered. Objective: The goal of this study is to evaluate the effectiveness of CO2 laser vaporization of ectocervical lesion high grade squamous intraepithelial lesion (HGSIL). Patients and Methods: Four Female out of 150 affected with HGSIL lesions were submitted to CO2 laser vaporization and followed up in 4 months later, and 10 women with HGSIL lesion submitted to electrocautery diathermy for the comparison. Results: Among women treated by CO2 laser vaporization, 3 women had negative results (clear cervix), at 4 months follow up; o

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
Gene frequency and haplotype analysis of HLA class I in patients with simple renal cysts
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Background: The study of human leukocytes (HLA) alleles, and haplotype frequencies within populations provide an important source of information for anthropological investigation, organ and hematopoietic stem cell transplantation as well as disease association, certain diseases showed association with specific alleles specially those of known or suspected hereditary origin or immunological basis, whether simple renal cyst is congenital or acquired is still unclear and need to be investigated.Objectives: To study the genetic aspect of simple renal cysts by detecting the gene frequency and the haplotype of HLA class I of patients with simple renal cysts, and to find the presence of these cysts in other family members.Method: Thirty patient

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Publication Date
Sun Apr 30 2017
Journal Name
Journal Of Engineering
Biotreatment of Slaughterhouse Wastewater Accompanied with Electrcity Generation and Nutrients Recovery in Microbial Fuel Cell
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In recent years and decades, there is a great need for developing new alternative energy sources or renewable sustainable energy. On the other hand, new technology approaches are growing . towards benefits from the valuable nutrients in wastewater which are unrecoverable by traditional wastewater treatment processes.  In the current study, a novel integrated system of microbial fuel cell and anoxic bioreactor (MFC-ANB) was designed and constructed to investigate its potential for slaughterhouses wastewater treatment, nitrogen recovery, and power generation. The system consisted of a double-chamber tubular type MFC with biocathode inoculated with freshly collected activated sludge. The MFC-ANB system was continuously fed with real-fi

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Publication Date
Sun Oct 31 2021
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn: 2789-3219 )
Evaluation of EOS Gene Expression and IL-6 Serum Levels in Iraqi Patients with Psoriasis
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Background: EOS (encoded by the IKZF4 gene) is a member of the zinc finger transcription factor IKaros family, and plays a critical role in Treg suppressor functions, and maintaining Treg stability. IL-6 is a soluble mediator with a pleiotropic effect on inflammation, immune response, and hematopoiesis. Aim: To estimate serum IL-6 level and EOS gene expression in Iraqi patients with psoriasis. Method: Twenty-two patients with psoriasis (8 females, 14 males) with age ranged 18-72 years, were recruited from Baghdad Teaching Hospital, Dermatology Clinic, Baghdad, and 24 healthy donors. The serum levels of IL-6 by ELISA and the gene expression of IKZF4 (EOS gene) by RT-qPCR technique. Results: The results showed a non-significant diffe

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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
Evaluation of obesity, smoking, and sedentary lifestyle associations with low back pain in young adults
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Background: low back pain is one of the most common public health problems and of the most common musculoskeletal complaint. Many risk factors have been considered for developing low back pain include smoking, obesity and sedentary lifestyle.

Aim of study: To evaluate smoking, obesity, and sedentary lifestyle associations with low back pain in young adults aged (18 – 39 years).

Methods: a comparative cross sectional study for young adults aged 18 – 39 years, participants with low back pain as a symptom constitutes the first group, others free of this symptom considered as the control group. Age and gender matched in both groups. Smoking, obesity and sedentary life sty

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Publication Date
Tue Jun 30 2015
Journal Name
Al-kindy College Medical Journal
The prevalence and antimicrobial resistance of Pseudomonas species in patients with chronic suppurative otitis media
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Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were mal

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