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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
Thu Feb 07 2019
Journal Name
Journal Of The College Of Education For Women
Nominal Ellipsis in English & Arabic and its Influence on the Translation of the Meanings of Some Selected Qurànic Verses ( A Contrastive study ): هدى فالح حسن & جمانة شكيب محمد
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Nominal ellipsis is a linguistic phenomenon found in English and Arabic .It is
based on leaving out a part of a nominal construction or more for the sake of good
style , compactness and connectedness .This phenomenon is found in the language of
the Glorious Qur’an .The study in hand is concerned with how translators handle
translating Qur’anic verses which contain ellipted nouns , i ,e. , to what extent the
translated Qur’anic verses are close to the original ones , and to what extent their
translations serve understanding the meanings of the glorious verses while at the
same time maintaining their beauty in style. The study aims at shedding light on
nominal ellipsis in English and Arabic .The study undertak

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Publication Date
Mon Jul 27 2026
Journal Name
Journal Of Physical Education
Body Image and Its Relationship With Self – Confidence In Female College of Physical Education and Sport Sciences Students
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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Detection of Helicobacter Pylori IgG and IgA , Serum Biomarkers CA19-9 and CEA in Patients with Gastrointestinal Diseases
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Gastrointestinal diseases and especially chronic gastritis are mainly induced by Helicobacter pylori infection, and provides the basis for gastric carcinogenesis and colorectal cancer. The study involved the detection of serum anti-H. pylori IgG and IgA antibody of  and some serum biomarkers ;CEA and CA19-9 in patients with gastrointestinal diseases. Fifty eight serum samples were collected from 25 males and 33 females .Peripheral venous blood was collected from each patient and sera obtained  by centrifugation. Serum anti-H. pylori IgG and IgA ,serum CEA and  CA19-9 were evaluated by enzyme-linked immunoadsorbent assays (ELISA).Forty eight serum samples were positive for IgG (82.7% ) divided int

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Publication Date
Wed Feb 01 2023
Journal Name
Eurasian Chemical Communications
Assessment of systemic oxidative stress and antioxidants in Iraqi women with newly diagnosed and tamoxifen-treated breast cancer
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Breast cancer (BC) is one of the most frequently observed malignancy in females worldwide. Today, tamoxifen (TAM) is considered as the highly effective therapy for treatment of breast tumors. Oxidative stress has implicated strongly in the pathophysiology of malignancies. This study aimed to investigate the changes in the levels of oxidants and antioxidants in patients with newly diagnosed and TAM-treated BC. Sixty newly diagnosed and 60 TAM-treated women with BC and 50 healthy volunteers were included in this study. Parameters including total oxidant capacity (TOC), total antioxidant capacity (TAC), and catalase (CAT) activity were determined before and after treatment with TAM. The serum levels of TOC and oxidative stress index (OSI) were

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Publication Date
Sat May 01 2021
Journal Name
European Journal Of General Dentistry
Assessment of Serum Interleukin-1β and Interleukin-6 Levels in Patients with Chronic Periodontitis and Coronary Heart Disease
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Abstract<p> Objective The aim of this study was to assess whether serum cytokine levels correlate with clinical periodontal parameters in health or disease.</p><p> Materials and Methods Male subjects (40–60 years) with CP (n = 30), CP + CHD (n = 30), and healthy controls (n = 20) had plaque index (PLI), gingival index (GI), bleeding on probing, probing pocket depth (PPD), and clinical attachment level (CAL) evaluated. Serum IL-1β and IL-6 levels were quantified using enzyme-linked immunosorbent assay.</p><p> Results PLI, GI, PPD, and CAL were significantly higher in patients with CP + CHD compared to those with CP. Serum levels of IL-1β and IL-6 were also si</p> ... Show More
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Publication Date
Mon Jul 27 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Oro-facial manifestations, oxidative stress marker and antioxidant in serum and saliva of patients with Beta thalassemia major
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Background: Beta thalassemia is a typically autosomal recessive form of severe anemia which is caused by an imbalance of two types of protein (alpha and beta) subunits of hemoglobin. Oxidative stress imbalance is the equilibrium between pro-oxidant\antioxidant statuses in cellular system, which results in damaging the cells. Antioxidant is a chemical that delays the start or slows the rate of lipid oxidation reaction and it play a very important role in the body defense system against reactive oxygen species. The aims of this study were to recorded the oro-facial manifestations in beta thalassemic patients and assess the oxidative stress marker malondialdehyde in serum and salivs and their role in the pathogenesis of beta thalassemia and ev

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Publication Date
Sat Jul 01 2017
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
EFFECT OF HONEY ON SPERM CHARACTERISTICS AND PREGNANCY RATE IN MICE
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    The aim of the current study is to demonstrate the effect of honey on the sperms characteristics (sperm concentration, sperm motility, grade of activity and sperm normal morphology) as well as pregnancy rate in mice. Sperms were obtained from caudal epididymis of male mice and prepared by adding10% of honey to the IVF medium using direct sperms activation technique for 30 minute incubation period before artificial insemination.

 

    The study revealed a significant (P > 0.05) increase in active sperm motility (grade A and grade B) 49% and pregnancy rate 53.3% in female mice artificially inseminated with sperms. On the other hand, there were no significant differences in sperm con

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Publication Date
Wed Nov 03 2021
Journal Name
European Journal Of Humanities And Educational Advancements (
Impact of ASSURE Model on Mathematical Correlation and Achievement in Mathematics
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Publication Date
Wed Mar 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
The Extent of the Practice of Iraqi Banks to Manage Profits Using the (LLp it) Model and Its Reflection on the Tax Base, A Case Study of A Sample of Iraqi Private Banks Listed in The Iraqi Stock Exchange
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The research aims to identify the extent to which Iraqi private banks practice profit management motivated by reducing the taxable base by increasing the provision for loan losses by relying on the LLP it model, which consists of a main independent variable (net profit before tax) and independent sub-variables (bank size, total debts to total equity, loans granted to total obligations) under the name of the variables governing the banking business. (Colmgrove-Smirnov) was used to test the normal distribution of data for all banks during the period 2017-2020, and then find the correlation between the main independent variable sub and the dependent variable by means of the correlation coefficient person, and then using the multiple

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Publication Date
Wed Apr 15 2026
Journal Name
Experimental And Theoretical Nanotechnology
Antibacterial and antioxidant activity of gamma star-like MnO2 nanostructure with and without coating with iron oxide nanoparticles
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Bacterial resistance caused by antibiotic misuse has garnered substantial attention, prompting numerous researchers to develop materials that can combat these resistant pathogens. The hydrothermal method is employed to produce γ-MnO2 nanostars and to coat them with Fe2O3 nanoparticles. The materials are characterized using XRD, FE-SEM, EDX, and UV-vis spectrophotometry, as well as antioxidant and antibacterial activities. The nano γ-MnO2 star shapes are coated with tiny spherical Fe2O3 nanoparticles with diameters of 35-47 nm. The peaks located at the crystal planes (120), (031), (131), (230), (300), (160), (421), and (003) are represented by the values of 2θ = 22.36º, 34.36º, 37.22º, 38.78º, 42.56º, 56.14º, 65.48º and 68.

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