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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 Feb 01 2022
Journal Name
Academy Of Accounting And Financial Studies Journal
THE ROLE OF THE TARGET COST SYSTEM IN ACTIVATING ENVIRONMENTAL COST MANAGEMENT AN APPLIED STUDY AT ASHOUR GENERAL CONSTRUCTIVE CONTRACT CO
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The problem of the study was to identify the possibility of benefiting from the application of the target cost system as a modern cost system to activate the environmental cost management instead of the traditional systems used in the company due to the great transformations witnessed by the business environment in all fields, which have resulted in the search for modern systems to provide more accurate and more appropriate information to reduce Costs, because accurate information makes the company have a complete vision to achieve the company’s goals. To solve this problem, the research was based on the following hypothesis (that the role of the target cost system leads to the activation of environmental cost management). Target c

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Publication Date
Wed Apr 07 2021
Journal Name
Indian Journal Of Forensic Medicine & Toxicology,
The Clinical Effect of Super Oxidized Water Mouthwash on The Periodontal Parameters (Plaque Index, Gingival Index And Bleeding on Probing) for Patients with Dental Biofilm Induced Gingivitis
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Publication Date
Mon Jun 05 2023
Journal Name
Journal Of Economics And Administrative Sciences
The Effect of Knowledge Upgrading on Business Continuity:A Field Research in Private Colleges and Universities in Baghdad
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The research aims to study the effect of knowledge upgrade on business continuity in private colleges and universities in Baghdad. The research problem is summarized in the main question (were the academic leaders able to employ knowledge upgrading to enhance business continuity). The most important of this sector were the universities and the private college in the city of Baghdad as a field for this research, the researchers conducted a field visit to (10) universities or private colleges, the research sample consisted of (177) individuals from the deans of colleges and their assistants, as well as heads of scientific and administrative departments. The data was analyzed and the hypotheses were tested using the appropriate statistical

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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)
Efficacy, safety and Cardiovascular Disease Risk Lowering Ability of ACE Inhibitors, B-Blockers and Combination Antihypertensive Drug Regimes in Iraq
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Hypertension is a major health problem throughout the world because of its high prevalence and its association with increased risk of cardiovascular diseases. It is defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. The aim of this study was to compare the efficacy, safety and cardiovascular disease risk lowering ability, of three antihypertensive drug regimens.

A retrospective study was carried out on 66 hypertensive patients, divided in to three groups based on their antihypertensive drug regimens (ACE inhibitors, β-blockers treated and combination antihypertensive therapy, the combination therapy consist of two or more of the following antihypertensive drugs ACE inhibitor di

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Publication Date
Mon Aug 01 2022
Journal Name
Bulletin Of Electrical Engineering And Informatics
Solid waste recycling and management cost optimization algorithm
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Solid waste is a major issue in today's world. Which can be a contributing factor to pollution and the spread of vector-borne diseases. Because of its complicated nonlinear processes, this problem is difficult to model and optimize using traditional methods. In this study, a mathematical model was developed to optimize the cost of solid waste recycling and management. In the optimization phase, the salp swarm algorithm (SSA) is utilized to determine the level of discarded solid waste and reclaimed solid waste. An optimization technique SSA is a new method of finding the ideal solution for a mathematical relationship based on leaders and followers. It takes a lot of random solutions, as well as their outward or inward fluctuations, t

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Publication Date
Fri Apr 02 2010
Journal Name
Journal Of The University Of Karbala
Spectrophotometric determination of Cisapride Based on ion-pair complex formation with Bromophenol blue
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A new simple, sensitive and inexpensive method has been developed for the spectrophotometric determination of cisapride in pharmaceutical formulation. The turbidimetric method is based on the formation of the ion-pair complex between the drug and bromophenol blue (BPB) in presence of potassium chloride at pH= 2.6, with a maximum absorbance at 520 nm. The calibration graph is linear in the concentration range 5-50µg.ml-1 , with good correlation coefficient (r = 0.9989).The limit of detection was found to be 1.14 µg.ml-1 and no interference was observed from common excipients in the pharmaceutical preparation that contain cisapride with good accuracy and precision.

Publication Date
Tue Jul 05 2022
Journal Name
Journal Of Pharmaceutical Care
Epidemiological and Clinical Factors Affecting the Response to Etanercept Among Patients with Rheumatoid Arthritis
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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The impact of wages and benefits systems on the performance of employees A field study in the General Company for Food Industries in the city of Baghdad
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The research aims to find out the impact of wages and benefits systems on the performance of employees, which included the research community on a sample of employees in the company, and the sample consisted of (50) employees and an employee, A questionnaire composed as prepared (23) paragraph, use the promised statistically methods in data collected by the questionnaire analysis. The research reached a number of results, the most prominent of which were: There is a correlation between wage systems, benefits and performance of employees, and the presence of the impact of the systems of wages and benefits to the performance of employees. The research was presented a set of recommendations including: increasing the effectiveness of

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Publication Date
Sun Mar 28 2021
Journal Name
Journal Of The College Of Education For Women
The Effectiveness of a Structural Theory- based Training Program in Enhancing Arabic Language Teachers’ Teaching Practices and their Tendencies towards Structural Teaching: مريم بنت حسن البلوشي، ريا بنت سالم المنذري، علي مهدي كاظم
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The study aims to identify the effectiveness of a structural theory-based training program in enhancing the teaching practices of Arabic language teachers teaching grade ten in South Al Batinah in Sultanate of Oman. The study used the quasi-experimental design, and the sample consisted of 40 male and female teachers. To achieve the objectives of the study, a training program, an observation form and a measurement tool of teachers’ tendencies towards a structural teaching were made. The program was implemented with an experimental group of 20 female and male teachers in the first semester of the academic year 2018/2019. The study has found that there is a statistically significant difference between the average grades before and after i

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Publication Date
Sat Dec 05 2020
Journal Name
International Journal Of Clinical Practice
Assessment of COVID‐19 Treatment containing both Hydroxychloroquine and Azithromycin: A natural clinical trial
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