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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 Jan 01 2023
Journal Name
8th Engineering And 2nd International Conference For College Of Engineering – University Of Baghdad: Coec8-2021 Proceedings
Effect of permeation grouting with nano-materials on shear strength of sandy soil: An experimental study
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Publication Date
Fri Jan 10 2020
Journal Name
Polymers
Influence of Polyphosphates on the Physicochemical Properties of Poly (Vinyl Chloride) after Irradiation with Ultraviolet Light
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Three new polyphosphates were synthesized in good yields by reacting diethylenetriamine with the appropriate phosphate ester in ethanol under acidic conditions. The polyphosphate structures were determined using FT-IR and 1H-NMR spectroscopies, and their elemental compositions were confirmed by EDX spectroscopy. Polyphosphates were added to poly(vinyl chloride) (PVC) at low concentrations to fabricate thin films. The PVC films were irradiated with ultraviolet light for long periods, and the effect of polyphosphates as the photostabilizer was investigated by determining changes in the infrared spectra (intensity of specific functional group peaks), reduction in molecular weight, weight loss, and surface morphology. Minimal changes we

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Publication Date
Sun Oct 01 2023
Journal Name
History Of Medicine
Correlation of Afamin with oxidative stress in GDM
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It is becoming a public health issue to predict which expectant women will develop gestational diabetes mellitus (GDM). The goal of this case control research is to investigate the role of maternal oxidative stress levels in the first, second, and third trimesters, as well as other factors, in the development of gestational diabetes mellitus (GDM). Methods Between October and December 2021, 142 women participated in this research. The 101 GDM patients were split into three groups based on their gestation (T1, T2, and T3), and 41 healthy pregnant women were chosen as the comparison group. TAS and TOS levels of oxidative stress and XO were calculated using a Spectrophotometer for colorimetric techniques; fasting and random sugar levels, as

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Publication Date
Sun Jun 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Characteristic of Absorption with Reaction in Packed Column
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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Surface enhanced Raman spectroscopy based sensitive and specific detection of vitamin D3, glycated hemoglobin, and serum lipid profile of breast cancer patients
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Considering the expanding frequency of breast cancer and high incidence of vitamin D3 [25(OH)D3] insufficiently, this investigate pointed to explain a relation between serum [25(OH)D3] (the sunshine vitamin) level and breast cancer hazard. The current study aimed to see how serum levels of each [25(OH)D3], HbA1c%, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglyceride (TG) were affected a woman’s risk of getting breast cancer. In 40 healthy volunteers and 69 untreated breast cancer patients with clinical and histological evidence which include outpatients and hospitalized admissions patients at the Oncology Center, Medical City / Baghdad - Iraq. Venous blood samp

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Publication Date
Thu Jul 21 2022
Journal Name
Journal Of Advanced Biotechnology And Experimental Therapeutics,
Effect of gentamicin and doxycycline on expression of relB and relE genes in Klebsiella pneumonia
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Publication Date
Mon Nov 01 2010
Journal Name
Iraqi Journal Of Physics
Characterization of Quartz and Calcite Particle size Presents in Local Dust Fell on Baghdad on June 2009
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Dust samples have been collected from three areas in Baghdad during dust storm occurred in 18th of June 2009 to characterize elemental particle size and composition by different techniques. The x-ray diffraction detected six minerals those are calcite, and quartz, present as a major components, dolomite, kaolinite, gypsum and plagioclase present as miner components .EDX detected some normal elements presented in local soil except traces of lead , nickel, and chromium. The particle size analysis by a set of sieves have revealed that the majority particle distribution was between (32 and 45)μm . To isolate the aerosol size, PM10 buoyancy method of powder in water showed a signifying amounts of particulate size .Scheerer’s method was app

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Publication Date
Wed Sep 02 2020
Journal Name
International Journal Of Drug Delivery Technology
Synthesis of Levofloxacin Derivatives with some Amines and their Complexes with Copper(II) Salts and Evaluation of their Biological Activity
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Levofloxacin belongs to the fluoroquinolone family; it is a potent broad-spectrum bactericidal agent. The pharmacophore required for significant antibacterial activity is the C-3 carboxylic acid group and the 4-pyridine ring with the C-4 carbonyl group, into which binding to the DNA bases occur. In this work, we tried to show that by masking the carboxyl group through amide formation using certain amines to form levofloxacin carboxamides, an interesting activity is kept. Levofloxacin carboxamides on the C-3 group were prepared, followed by the formation of their copper complexes. The target compounds were characterized by FT-IR, elemental analysis. The antimicrobial activity of the target compounds was evaluated and showed satisfactory resu

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Publication Date
Wed Aug 05 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Aging effect of different types of composite resin restoration on shear bond strength to different orthodontic adhesives with sapphire bracket (In vitro comparative study)
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Background: This study was performed to determine the effect of aging of different types of composite material restorations on: Shear bond strength (SBS) to light cure and no mix chemical cure orthodontic adhesives with sapphire bracket and the debonding failure sites. Materials and methods: One hundred forty four composite disks were made from three different composite resin materials which are: 3M Filtek Z250, 3M filtek Z350 and 3M Valux plus, each group with (48) disks each, then according to the duration of storage each group was subdivided into two equal groups one of them stored for one day and the other was stored for one month, then each group was further subdivided into two equal subgroups with (12) disks each one bonded with ligh

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Publication Date
Tue Feb 01 2022
Journal Name
Baghdad Science Journal
Ghrelin and Leptin and Their Relations with Insulin Resistance in Diabetes Mellitus Type 2 Patients
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Ghrelin and leptin are hunger hormones related to type 2 diabetes mellitus (T2DM), and the pathogenesis of T2DM is the abnormality in insulin secretion and insulin resistance (IR). The aim of this study is to evaluate ghrelin and leptin concentrations in blood and to specify the relationship of these hormones as dependent variables with some biochemical and clinical measurements in T2DM patients. In this study, forty one T2DM and forty three non-diabetes mellitus (non-DM) subjects, aged between 40-60 years and with normal weight, were enrolled. Fasting serum ghrelin and leptin were estimated by enzyme-linked immunosorbent assay (ELISA). In our results ghrelin was significantly increased, and leptin was significantly decreased, in T2DM pa

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