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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 Jun 01 2023
Journal Name
Journal Of Engineering
Proposing a General Formula for Evaluating the Parametric Cost Using MLR Method
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This research takes up address the practical side by taking case studies for construction projects that include the various Iraqi governorates, as it includes conducting a field survey to identify the impact of parametric costs on construction projects and compare them with what was reached during the analysis and the extent of their validity and accuracy, as well as adopting the approach of personal interviews to know the reality of the state of construction projects. The results showed, after comparing field data and its measurement in construction projects for the sectors (public and private), the correlation between the expected and actual cost change was (97.8%), and this means that the data can be adopted in the re

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Publication Date
Thu Oct 30 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Penetrating Cardiac Injury in a Child Following Nail Gun Accident: Clinical Implications and Public Health Concerns
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Penetrating cardiac injuries caused by nail guns are exceedingly rare but often life-threatening, with reports showing an increasing trend. We described the case of an adolescent male who sustained accidental cardiac penetration by an iron nail while performing carpentry work. Rapid referral to a specialized cardiac center enabled timely surgical intervention, illustrating the pivotal role of early recognition, expedited transfer, and expert management in optimizing outcomes. This case also highlights the grave risks associated with the employment of minors in hazardous occupational settings, where exposure to unsafe environments may lead to catastrophic consequences.

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Publication Date
Sun Dec 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Comparison between the effects of Aloe vera and chlorhexidine on clinical periodontal parameters
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Background: Periodontal diseases are one of the major dental pathologies that affect human populations worldwide at high prevalence rates The term periodontal disease usually refers only to plaque related inflammatory disease of the dental supporting tissues. Mouth rinses which act as an anti-plaque agents mostly used as adjuncts to oral hygiene. Aims of the study: To Estimate and compare the effects of Aloe vera relative to chlorhexidine on the clinical periodontal parameters (plaque index, gingival index, bleeding on probing). Material and method: A total of 44 subjects with plaque-induced gingivitis, baseline of data were collected for (PLI, GI, and BOP) and underwent oral hygiene instruction, scaling and polishing, then divided into:

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Publication Date
Fri Jun 01 2018
Journal Name
J. Pharm. Sci. & Res
Periodontal health status for post-menopausal women with and without osteoporosis (Clinical and radiographical study)
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Publication Date
Tue Sep 27 2022
Journal Name
Al–bahith Al–a'alami
CREATIVITY IN THE TELEVISION ADVERTISING MESSAGE AND ITS EFFECTIVENESS IN ATTRACTING THE ATTENTION OF THE RECIPIENT: (A research drawn from a Degree thesis)
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Declaration has become today has an important and active and influential role in the recipient public life، and are concentrated advertising on the creativity component manufacture to attract his attention toward what to be announced from a variety products، and is dominated by television commercials tempo and imagination، and display them a variety of ways catches the attention and an impressive simulates the their senses of hearing and sight، to influence in the receiver and the public paid for purchase.

Through it crystallization the subject of our research on the importance of creativity in television advertising and effective for attracting the attention of the publi

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Publication Date
Mon Sep 10 2018
Journal Name
Iraqi Journal Of Physics
The influence of magnetic field and cathode dimensions on plasma characteristics in hollow cathode system
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Experimental study on the effect of cylindrical hollow cathode, working pressure and magnetic field on spatial glow distribution and the characteristics of plasma produced by dc discharge in Argon gas, were investigated by image analyses for the plume within the plasma. It was found that the emission intensity appears as a periodic structure with many peaks appeared between the electrodes. Increasing the pressure leads to increase the number of intensity peaks finally converted to continuous form at high pressure, especially with applied of magnetic field, i.e. the plasma is more stable with the presence of magnetic field. The emission intensity study of plasma showed that the intensity has a maximum value at 1.07 mbar pressure and decre

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
Preparing a New Type of Concrete Based on Sulfur-melamine Modifier
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In this research work, a new type of concrete based on sulfur-melamine modification was introduced, and its various properties were studied. This new type of concrete was prepared based on the sulfur-melamine modification and various ingredients. The new sulfur-melamine modifier was fabricated, and its fabrication was confirmed by IR spectroscopy and TG analysis. The surface morphology resulted from this modifier was studied by SEM and EDS analysis. The components ratios in concrete, chemical and physical characteristics resulted from sulfur-melamine modifier, chemical and corrosion resistance of concrete, stability of concrete against water adsorption, stability of concrete against freezing, physical and mechanical properties and durabi

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Publication Date
Tue Jul 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Domestic Violence and Extremism among the Young: A Field Study in the Madain Region
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Young people represent the power and cornerstone of societies and their superiority is linked to their well-being. Their empowerment is as essential as the heart to the body, if it is corrupt, then the whole body is corrupt, and vice versa. The exposure to extremism and pressure from their families leads to violent acts and crimes for obtaining money through unknown organized bodies. This will drive them to fail in their life in an attempt to fulfill their most basic needs, which they have been deprived of by their families, the government, and other institutions. Therefore, governments should provide job opportunities for young people and provide entertainment centers, sports clubs, and family education centers that raise awareness of s

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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
Mon May 29 2023
Journal Name
Rawal Medical Journal
Comparison of functional and radiological outcomes of lower third closed tibia fractures treated by nail VS plate osteosynthesis
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Objective: To determine the functional and radiological outcomes of lower third tibia closed fractures fixed by nail or plate osteosynthesis. Methodology: This randomized controlled trial included 20 patients presenting with closed fracture lower third tibia in Al-Kindy teaching hospital, Baghdad, Iraq. The patients were divided as every other one into two equal groups; group I had fractures fixed by 3.5 mm locked plate and group II by intramedullary locking nail. We followed all patients for 24 weeks to assess surgical complications, fracture union, alignment and functional outcome based on Knee society score (KSS). Results: The mean union time in both groups was 10.2 ± 1.48 and 9.3 ± 1.77 weeks, respectively (p = 0.003). Mean KSS in bot

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