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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
Fri Jun 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Periodontal health status of patients with Maxillary Chronic Rhinosinusitis (Part 1: Clinical study)
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Background: Periodontal diseases (PD) are inflammatory conditions of the tissues supporting the teeth, most often gingivitis and periodontitis. Maxillary chronic rhinosinusitis (MCRS) is the inflammation of the maxillary sinuses which is last for at least 12 consecutive weeks duration. Aims of study: Distribution of periodontal diseases among patients with Maxillary chronic rhinosinusitis according to gender and age. Materials and methods: Males and females subjects (25-45 years), divided into two groups; 150 patients suffer from MCRS and 130 subjects without MCRS. Clinical periodontal parameters; Plaque Index (PL.I), Gingival Index (G.I), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and Bleeding On Probing (BOP) recorded f

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Publication Date
Thu Jul 31 2025
Journal Name
Indonesian Journal Of Chemistry
Evaluation of the Antioxidant and Anticancer Effectiveness of Some New Metal Ions Complexes with Azo Dye: Synthesis and Characterization
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This paper presents a new azo dye 3-[2-(1H-indol-2-yl)ethyldiazenyl]quinolin-2-ol] from the reaction of the diazonium salt derived from tryptamine and 2-hydroxyquinoline. Azo dye was used to prepare a series of complexes with the chlorides of Ni(II), Pt(IV), Pd(II), Cd(II), and Zn(II). Compounds were analyzed and characterized using elemental analysis, magnetic measurement, UV-vis, IR, MS, NMR, and conductivity. The findings demonstrated that the ligand acts as ionic in complex form, O-bidentate, supporting the proposed formula. The complexes generally exhibited tetrahedral and octahedral geometries, except the palladium complex, which adopted a square planar geometry. TGA was used to investigate the thermal characteristics of compo

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
Symbolic significance and its effectiveness in industrial product design
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The current research dealt with the symbolic significance and its effectiveness in the design of the industrial product, the aesthetic communicative discourse that embodies the imagination and human conscience. Whether according to what has been termed custom or what has been approved by traditions long ago, symbolism may be the main actor in linking the identifying components of the product. In addition, symbolism provides the user with the key to accessing a direct awareness of the product’s shape and function, as an identification of the product by stimulating the symbolic form of the consumer’s imagination and inviting him to To meditate in order to realize the implicit meaning behind these forms and thus achieve the symbolism of

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Publication Date
Tue Dec 30 2025
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Optimum design and performance analysis of a gas lift system in the carbonate reservoir of Ahdab oil field
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   Gas lift is one of the most important artificial lift methods for increasing oil production, as wells often require this method after the reservoir's energy has decreased. In this research, an optimal gas lift system is designed for five horizontal wells in the Ahdab oil field, which suffers from low production. At the same time, water cut in some of these wells reaches 66%, while the productivity index is low in others, which makes the challenges clear, and a deep analysis is needed to find an optimal system. The Pipesim program is used to design the optimal gas lift system, which contains features that facilitate the implementation of the appropriate design and provide the ability to analyze and determine the optimal design v

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Publication Date
Tue Nov 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Reflection Leader-Member Exchange In Organizational Commitment A Field research in Ministry of Iraqi Defense
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Abstract

The researcher seeks, through different aspects of the search, to reach a set of objective concerning in content creation a clear vision about conceptual and practical dimension of relation and effects between (Leader-Member Exchange, and Organizational Commitment) to construct a framework of a pragmatic model as a solution to research problem and it questions. The theoretical problem is derived basically from the scarcity of Arab studies and researches that deal by study and analyses for such important of The two variables blend. The practical problem depends in deriving from reality of every day work in the Iraqi ministry of defense.

On this basis, a formula of research problem for pur

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Publication Date
Fri Dec 22 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Clinical Characteristics and Therapeutic Management of Osteogenesis Imperfecta in Iraqi Children
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Background: Osteogenesis imperfecta (OI) is a rare congenital condition that results in bone fragility, recurrent fractures, and various extra-skeletal manifestations. Currently, intravenous bisphosphonate is the mainstay of medical treatment in OI. Objective: To identify the effect of current management strategies on Iraqi children diagnosed with OI. Methods: A retrospective study enrolled OI patients who were registered in Central Child Teaching Hospital, Baghdad, Iraq, from January 2015 to December 2022. We enrolled confirmed OI cases (either clinically and/or radiologically) who received cyclic pamidronate therapy for at least 3 cycles. They neither received other types of bisphosphonates nor underwent surgical intervention. Res

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Publication Date
Sat Feb 12 2022
Journal Name
Engineering, Technology &amp; Applied Science Research
Investigating the Causes of Poor Cost Control in Iraqi Construction Projects
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Controlling cost in construction projects is an essential issue. This study investigates the most critical problems that cause weakness in cost control in Iraqi construction projects. The quantitative technique was used by conducting a survey directed to professionals who work on construction projects. One hundred and sixty-four questionnaire forms were distributed to private sector companies, government companies, and government institutions, and the responses were subjected to the required statistical analysis. The results indicate that the most influential factors are the weakness in keeping up with the use of modern concepts, methods, and technologies, the delay in receiving the amounts due for work done from the owner, fluctuat

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Publication Date
Sun Jun 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
Designing system cost for water pollution plants in mayoralty of Baghdad
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          There is an increase in the need for cost accounting in all organizations and from different sectors to provide detailed information to the totals of financial accounting, first and help solve problems associated with inventory and analysis, tabulation and allocation of cost elements II and do the planning process and provide the necessary oversight and help to take the right decisions such as pricing decisions that need to Information cost accounting.
And suffer most of the non-governmental organizations from the lack of a cost accounting system provides information on the cost of service in these organizations and the department research sample circle v

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Publication Date
Wed Oct 01 2025
Journal Name
Journal Of Economics And Administrative Sciences
A Modified Fama-MacBeth Model based on the Single-Index Model
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The aim of this essay is to use a single-index model in developing and adjusting Fama-MacBeth.  Penalized smoothing spline regression technique (SIMPLS) foresaw this adjustment.  Two generalized cross-validation techniques, Generalized Cross Validation Grid (GGCV) and Generalized Cross Validation Fast (FGCV), anticipated the regular value of smoothing covered under this technique. Due to the two-steps nature of the Fama-MacBeth model, this estimation generated four estimates: SIMPLS(FGCV) - SIMPLS(FGCV), SIMPLS(FGCV) - SIM PLS(GGCV), SIMPLS(GGCV) - SIMPLS(FGCV), SIM PLS(GGCV) - SIM PLS(GGCV). Three-factor Fama-French model—market risk premium, size factor, value factor, and their implication for excess stock returns and portfolio return

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Applying A* Path Planning Algorithm Based on Modified C-Space Analysis
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In this paper, a modified derivation has been introduced to analyze the construction of C-space. The profit from using C-space is to make the process of path planning more safety and easer. After getting the C-space construction and map for two-link planar robot arm, which include all the possible situations of collision between robot parts and obstacle(s), the A* algorithm, which is usually used to find a heuristic path on Cartesian W-space, has been used to find a heuristic path on C-space map. Several modifications are needed to apply the methodology for a manipulator with degrees of freedom more than two. The results of C-space map, which are derived by the modified analysis, prove the accuracy of the overall C-space mapping and cons

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