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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 Apr 01 2016
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Communications In Nonlinear Science And Numerical Simulation
Simultaneous determination of time and space-dependent coefficients in a parabolic equation
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Publication Date
Mon Jan 01 2018
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Journal Of Pharmacy Research
Design and in vitro characterization of bisacodyl as a hollow-type suppositories
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Publication Date
Thu Dec 01 2016
Journal Name
Journal Of Engineering
A Laboratory Study Attempt of Flow and Energy Dissipation in Stepped Spillways
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A new laboratory study conducted on stepped spillways in order to investigate their efficiency of dissipating flow energy. All previous study on stepped spillway indicated that the flow energy dissipation decreased as increasing in discharge. Increasing in the step numbers and the spillway slope led to energy dissipation decrease. In this study, an experimental attempt to increase energy dissipation at variable discharges was performed on stepped spillway and that leads to decreasing the cost of initiating the stilling basin or may be ignoring it. Five spillways were constructed from concrete and tested to investigate and compare among them. Three were roughed by gravel with different size for each one, one of them was s

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Publication Date
Tue Aug 26 2025
Journal Name
Microbial Science Archives
Listeria monocytogens: A review of its characteristics, pathogenicity and prevalence in Iraq
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Listeria monocytogenes represents a critical foodborne pathogen causing listeriosis, a severe infection with mortality rates of 20- 30%. This comprehensive review integrates cutting-edge research from 2015-2024 with Iraqi epidemiological data to address significant knowledge gaps in regional surveillance and global comparative analysis. Recent discoveries include five novel Listeria species in 2021, revolutionary whole genome sequencing (WGS) surveillance systems, and advanced understanding of RNA-mediated regulation. Iraqi prevalence data reveals concerning patterns with rates ranging from 3.5% to 93.8% across different sample types, substantially higher than global averages. Critically, Iraqi isolates demonstrate alarming antibiotic resis

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Publication Date
Thu Aug 01 2024
Journal Name
Journal Of Engineering Research
Design, analysis and development of a proton exchange membrane in fuel cell
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Publication Date
Thu Jan 31 2019
Journal Name
Journal Of The College Of Education For Women
A New Vision in the Locality and the Factors of Forming Meander
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The research addressed an analytical field investigation of the locality of meander, the factors responsible of the locality of the meander at certain points of the stream other than others, and the role sequence of these factors in the formation process.
The research revealed that the location of forming the meander was associated closely with the scale structural composition of the bank materials from which the first stage of forming the curved stream, for the inhomogeneous or non-identical opposite banks in their scale structural composition saw an activity of differential corrosion, while the homogeneous and identical opposite banks in their scale structural composition saw an identical corrosion activity in its intensity at both

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Publication Date
Wed Dec 30 2015
Journal Name
College Of Islamic Sciences
Medical evidence in matters of proof between Sharia and law: A model
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Praise be to God, prayer, and peace be upon the Messenger of Allah and his God and his companions. The field of the judiciary to prove or invalidate some cases in the field of proof of descent and attachment to the plaintiff or exile, and other legal and judicial issues, especially in this era where the spread of previously unknown evidence, such as DNA, which was discovered in 1953, and the genetic fingerprint discovered 1984, blood analysis and a Saliva, sweat, poetry, etc. in the field of forensic evidence, in forensic medicine or medical expertise, it can be used to identify the killer, or verify his identity, using all the evidence in the scene, such as a point of blood or sweat, and the like So, as well as to prove the lineage is u

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Publication Date
Fri Sep 15 2017
Journal Name
كلية الاداب جامعة بغداد
A Contrastive study of ‘Inversion ‘ in Modern English and Modern Arabic Poetry
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The present paper respects 'inversion' as a habit of arranging the language of modern English and Arabic poetry . Inversion is a significant phenomenon generally in modern literature and particularly in poetry that it treats poetic text as it is a violator to the ordinary text. The paper displays the common patterns and functions of inversion which are spotted in modern English and Arabic poetry in order to show aspects of similarities and differences in both languages. It concludes that inversion is most commonly used in English and Arabic poetry in which it may both satisfy the demands of sound correspondence and emphasis. English and Arabic poetic languages vary in extant to their manipulation of inverted styles as they show changeable f

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Publication Date
Thu Oct 06 2022
Journal Name
Advances In Systems Science And Applications
Stability and Bifurcation of a Delay Cancer Model in the Polluted Environment
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It is well known that the spread of cancer or tumor growth increases in polluted environments. In this paper, the dynamic behavior of the cancer model in the polluted environment is studied taking into consideration the delay in clearance of the environment from their contamination. The set of differential equations that simulates this epidemic model is formulated. The existence, uniqueness, and the bound of the solution are discussed. The local and global stability conditions of disease-free and endemic equilibrium points are investigated. The occurrence of the Hopf bifurcation around the endemic equilibrium point is proved. The stability and direction of the periodic dynamics are studied. Finally, the paper is ended with a numerical simul

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Publication Date
Sat Oct 28 2023
Journal Name
Baghdad Science Journal
A Comparative Study on Association Rule Mining Algorithms on the Hospital Infection Control Dataset
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Administrative procedures in various organizations produce numerous crucial records and data. These
records and data are also used in other processes like customer relationship management and accounting
operations.It is incredibly challenging to use and extract valuable and meaningful information from these data
and records because they are frequently enormous and continuously growing in size and complexity.Data
mining is the act of sorting through large data sets to find patterns and relationships that might aid in the data
analysis process of resolving business issues. Using data mining techniques, enterprises can forecast future
trends and make better business decisions.The Apriori algorithm has bee

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