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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
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of projects during the trial operation period in accordance with the cost, quality and time - applied research in the Directorate-General for the distribution
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Research includes evaluation of projects implemented and which entered into trial operation period in accordance with the evaluation criteria and of (cost, quality and time) to determine the size deviations gap for the sample of projects during the years of assessment (2011-2012-2013-2014) of each of the three evaluation criteria, and then followed by a calculation the size of the overall gap to the problem based on the research problem to determine deviations from the specific implementation of each project by answering several questions to answer turns out the reasons for these deviations occur.

The importance of research Focus on the evaluation of received projects from contractors executing the projec

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Publication Date
Wed Nov 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Responding to Environmental Changes through Resilient Urban Design: Insights from Iraq
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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Application Artificial Forecasting Techniques in Cost Management (review)
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For the duration of the last few many years many improvement in computer technology, software program programming and application production had been followed with the aid of diverse engineering disciplines. Those trends are on the whole focusing on synthetic intelligence strategies. Therefore, a number of definitions are supplied, which recognition at the concept of artificial intelligence from exclusive viewpoints. This paper shows current applications of artificial intelligence (AI) that facilitate cost management in civil engineering tasks. An evaluation of the artificial intelligence in its precise partial branches is supplied. These branches or strategies contributed to the creation of a sizable group of fashions s

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Publication Date
Fri Mar 19 2021
Journal Name
Periodicals Of Engineering And Natural Sciences (pen)
New cost control techniques in mega construction projects
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Publication Date
Fri Jan 01 2021
Journal Name
Wiadomości Lekarskie
EVALUATION THE EFFECT OF PRODIGIOSIN ON ALGD EXPRESSION IN CLINICAL ISOLATES OF PSEUDOMONAS AERUGINOSA
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The aim of this study is to investigate the role of prodigiosin on P. aeruginosa' s biofilm genes involved in the pathogenicity and persistency of the bacteria; Materials and methods: Gram negative bacterial isolates were taken from burn and wounds specimen obtained from some of Baghdad hospitals. Forty six isolates were identified as Pseudomonas aeruginosa and four isolates as Serratia marcescens by using biochemical tests and VITEK 2 compact system. Susceptibility test was performed for all P. aeruginosa isolates, the results showed that 100% were resistant to Amikacin and 98% were sensitive to Meropenem. Resistant isolates were tested for biofilm formation; the strong and moderate isolates (17) were detected by PCR for AlgD gene

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Publication Date
Mon Jun 30 2014
Journal Name
Al-kindy College Medical Journal
The effect of cigarette smoking on the clinical outcome of pulmonary tuberculosis in Iraq
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Background: Tobacco smoking and tuberculosis (TB) are two major public health problems; Associations between smoking and tuberculosis including death from tuberculosis have been reported , A reduction in smoking could be expected to have a significant impact on TB incidence and prevalence .
Objectives: to assess the effect of smoking on tuberculosis.
Methods: This study was conducted from June 2011 to June 2012 in 200 patients, adult ( aged 17 years and more), newly diagnosed patients of pulmonary tuberculosis, at the chest and Respiratory Disease Specialized Center in Baghdad. Demographic data, presenting symptoms, data on smoking, and recurrence of disease were compared. Information on smoking status, tobacco smoking was collecte

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Publication Date
Thu Oct 01 2009
Journal Name
Ipmj
Perniosis: Clinical and epidemiological study in Iraqi patient
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A Al-Nuaimy, B Fadheel…, IPMJ, 2009 - Cited by 1

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Publication Date
Thu Oct 01 2009
Journal Name
Journal
Perniosis: clinical and epidemiological study in Iraqi patients
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AN Adil A, F Basman M, 2009

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Publication Date
Wed Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
((Human Resource Staffing Strategy and and its impact in the high performance A Field research in Ministry of Agriculture))
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Abstract

were determine the problem of current research to answer the  question on the consciousness of the Ministry of Agriculture to adopt Staffing  strategy and identify the shortcomings  as the independent variable, represented by the three dimensions (recruitment , selection, placement) and its impact on high performance, as  dependent   variable is described  in  four dimensions (leadership, strategy, structure and processes, culture), in this research were  Used  analytical descriptive  style . This research aims to identify the correlation and impact  of Staffing strategy at high-performance in Ministry of Agriculture , To clarify the relationship between

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Oral And Maxillofacial Surgery
Pain Reduction in Extensive Apical Surgery of the Anterior Maxilla: A Comparative Clinical Study
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Purpose: The purpose of this study was to compare the outcomes of 2 different anesthetic techniques (local infiltration vs infraorbital nerve block) for eliminating pain during apical surgeries that are associated with extensive periapical pathology in the anterior maxilla. Materials and Methods: Patients were randomly divided into 2 groups: patients in group I were anesthetized labially by local infiltration injections, whereas those in group II received a single infraorbital nerve block. Palatal injections were given for the 2 groups. Once the pain was initiated during surgery, the procedure was discontinued until profound anesthesia was secured. The studied variables were age, gender, onset of anesthesia, operative time, and intraoperati

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