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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
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Mon Sep 30 2024
Journal Name
The Scientific World Journal
Relationship Between the Level of Vitamin D3 Deficiency and Successful Osseointegration: A Prospective Clinical Study
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Purpose: This study aimed to evaluate the influence of vitamin D3 levels on bone density, primary dental implant stability, and successful osseointegration.

Materials and Methods: Clinical and radiological examination with a standardized cone‐beam computed tomography (CBCT) machine and laboratory investigation for serum levels of vitamin D3 were performed for all patients. Only patients in need of single or multiple straightforward dental implant surgery in either jaw with no history of systemic disease or condition that may interfere with bone healing were included in this study to receive the dental implant by the same oral and maxillofacial surgeon, which re‐opened

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of Engineering
Pharmaceutical Wastewater Treatment Associated with Renewable Energy Generation in Microbial Fuel Cell Based on Mobilized Electroactive Biofilm on Zeolite Bearer
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In this study, a novel application of lab-scale dual chambered air-cathode microbial fuel cell (MFC) has been developed for simultaneous bio-treatment of real pharmaceutical wastewater and renewable electricity generation. The microbial fuel cell (MFC) was provided with zeolite-packed anodic compartment and a cation exchange membrane (CEM) to separate the anode and cathode. The performance of the proposed MFC was evaluated in terms of COD removal and power generation based on the activity of the bacterial consortium in the biofilm mobilized on zeolite bearer. The MFC was fueled with real pharmaceutical wastewater having an initial COD concentration equal to 800 mg/L and inoculated with anaerobic aged sludge. Results demo

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Publication Date
Mon Jun 01 2015
Journal Name
The European Physical Journal Applied Physics
A carbon nanotubes photoconductive detector for middle and far infrared regions based on porous silicon and a polyamide nylon polymer
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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF COSTING TECHNIQUES IN REDUCTION OF COST AND ACHIEVING COMPETITIVE ADVANTAGE IN IRAQI FINANCIAL INSTITUTIONS
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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Technology manufacturing Ghazi oven and sessile cost of production of ceramic
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The ceramic work of the business that was stationed with the history of its evolution of man on earth, and this gives him a linking formula and the reality of life, including asking as inherited civilized . Operation creativity over several stages and developments have helped in the formation of human hands, including a reflection on productions are large and diverse.

To search for new horizons in ceramic art began to form new technologies outside the traditional frameworks ,devoted  technical and scientific expertise and access to an advanced stage in porcelain from technical and aesthetic point of view the field, shall be deemed to contemporary ceramic civilized idea of ​​Modernism from the ceramic work can in no way b

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Publication Date
Fri Aug 01 2025
Journal Name
Al-academy
The effectiveness of media in Iraqi theatre performances, the play (The Pawns) as a model
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أن الثورة الرقمية أصبحت اليوم واقع حتمي نعيشه من حيث القت بظلالها على مختلف جوانب الحياة، ولم يخل المسرح من هذا التأثير وخاصة في ظهور ملامح ما بعد الحداثة بكل ما تحملهُ من رؤى فكرية وفلسفية وجمالية، مع ذلك التطور التكنولوجي في هذا السياق يسعى المسرحيون والمخرجون والممثلون الى تأسيس علاقات فاعلة مع شبكات الانترنيت والوسائط الرقمية مما ظهر العديد من المواقع المهتمة بالمسرح. من هنا ظهرت اهمية الربط بين الث

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Publication Date
Wed Dec 28 2022
Journal Name
Al–bahith Al–a'alami
Effectiveness of Digital journalism in developing political awareness among Iraqi feminist activists "A survey study"
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The paper aims to reveal the effectiveness of digital journalism in developing political awareness among Iraqi feminist activists. This paper is descriptive, and it adopted the analytical descriptive survey method. A snowball sample composed of (102) respondents of Iraqi feminist activists was adopted and questionnaire was used to collect data. The research has reached the following conclusions: The rate of Iraqi Feminist Activists dependence on digital Journalism have increased; to develop their political awareness, and their preference - in this regard - (the pages of journalistic institutions to social media) in a way that exceeds other types of digital journalism. (Variety of languages) has topped the priorities of Iraqi feminist act

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Publication Date
Fri Jun 12 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Augmentation of the localized bony defects with synthetic bone substitute in simultaneous dental implant surgery(Clinical study)
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Background: Simultaneous and staged guided bone regeneration (GBR) is one of the several surgical techniques that have been developed in the past two decades to regenerate bone and thus to allow implant placement in compromised sites (fenestration and dehiscence). It is a surgical procedure that consists of the placement of a cell-occlusive physical barrier between the connective tissue and the alveolar bone defect. The treatment concept advocates that regeneration of osseous defects is predictably attainable via the application of occlusive membranes, which mechanically exclude non-osteogenic cell populations from the surrounding soft tissues, thereby allowing osteogenic cell populations originating from the parent bone to inhabi

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Publication Date
Fri May 21 2021
Journal Name
International Journal Of Pavement Research And Technology
Developing Resilient Modulus Prediction Models Based on Experimental Results of Crushed Hornfels Mixes with Different Gradations and Plasticity
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