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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 Jan 30 2020
Journal Name
Journal Of Engineering
Comparison of Single and Group Bored Piles Settlement Based on Field Test and Theoretical Methods
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 Bored piles settlement behavior under vertical loaded is the main factor that affects the design requirements of single or group of piles in soft soils. The estimation of bored pile settlement is a complicated problem because it depends upon many factors which may include ground conditions, validation of bored pile design method through testing and validation of theoretical or numerical prediction of the settlement value. In this study, a prototype single and bored pile group model of arrangement (1*1, 1*2 and 2*2) for total length to diameter ratios (L/D) is 13.33 and clear spacing three times of diameter, subjected to vertical axial loads. The bored piles model used for the test was 2000

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Publication Date
Fri Nov 21 2025
Journal Name
Plos Global Public Health
Association of socioeconomic and demographic determinants with clinical outcomes in Iraqi patients with diabetes: A cross-sectional study
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Social determinants of health (SDH) profoundly influence diabetes outcomes; nevertheless, their impact on the Iraqi diabetic population remains under researched. The objectives of this study were To investigate the relationship between particular social determinants of health (SDH) variables namely food and housing insecurity, social support, income, and education and clinical outcomes, including HbA1c levels, medication adherence, and patient satisfaction among Iraqi diabetic patients. A cross-sectional study involving 212 diabetic patients in Iraq was conducted. Participants attending a healthcare facility in Iraq filled out validated questionnaires regarding social determinants of health, medication adherence, and satisfaction. HbA1c rea

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Publication Date
Tue Jan 02 2024
Journal Name
Medical Oncology
COX 2-inhibitors; a thorough and updated survey into combinational therapies in cancers
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Publication Date
Thu Sep 12 2019
Journal Name
Al-kindy College Medical Journal
The role of prophylactic antibiotics in nasal packing for epistaxis
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Background: This study is to evaluate the necessity of prescribing prophylactic antibiotics for nasal packing in spontaneous epistaxis. There are few published papers of infective complications in such patients.

Methods: This prospective study analysed 149 consecutive patients admitted to AL-Kindy teaching hospital with spontaneous, epistaxis, who underwent nasal packing  over 2 years period . in the first  year, 78 patients received prophylactic antibiotics , In the second  year 71 patients were not given prophylatic antibiotics.  Exclusion criteria included antibiotics prescribed for unrelated  pathology and post-operative epistaxis. Signs and symptoms of acute otitis m

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Publication Date
Tue Aug 30 2022
Journal Name
Research Journal Of Pharmacy And Technology
Correlation of Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with serum GDF-15 in a group of hypertensive Iraqi patients
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The Growth Differentiation Factor -15 (GDF-15) is a member of the transforming growth factor β superfamily. İt represents an example of the stress response cytokines. It's mostly found in cardiac myocytes, adipocytes, macrophages, endothelial cells, and vascular endothelial cells, whether they're generated normally or not. GDF-15 levels have increased and are associated with cardiovascular risk. Aim of the study: To investigate the correlation between angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) with the level of plasma GDF-15 in a group of hypertensive patients. Materials and methods: A case-control study involved 90 individuals, 60 hypertensive patients (36 on ACE inhibitors and 24 on ARBs)

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Publication Date
Thu Jun 30 2022
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
DESIGN AND VALIDATION OF A LOW−COST WIRELESS ELECTROMYOGRAPHY SYSTEM : DESIGN AND VALIDATION OF A LOW−COST WIRELESS ELECTROMYOGRAPHY SYSTEM
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Electromyography (EMG) is being explored for evaluating muscle activity. For gait analysis, EMG needs to be small, lightweight, portable device, and with low power consumption. The proposed superficial EMG (sEMG) system is aimed to be used in rehabilitation centers and biomechanics laboratories for gait analysis in Iraq.

The system is built using MyoWare, which is controlled by using STM32F100 microcontroller. The sEMG signal is transferred via Bluetooth to the computer (about 30m range) for further processing. MATLAB is used for sEMG signal conditioning. The overall system cost (without computer) is about $80. The proposed system is validated using wired NORAXON EMG using the mean root mean squared metho

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Publication Date
Thu Nov 02 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Appraising the Role of Pharmacists in Medication Reconciliation at Hospital Discharge: A Field-Based Study
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Objective: To measure the effect of the pharmacist-led medication reconciliation service before hospital discharge on preventing potential medication errors. Methods: This behavioral interventional study took place in a public teaching hospital in Iraq between December 2022 and January 2023. It included inpatients who were taking four or more medications upon discharge from the internal medicine ward and the cardiac care unit. The researcher provided the patients with a medication reconciliation form and reconciliation form (including medication regimen and pharmacist instructions) before discharging them home. Any discrepancies between the patients’ understanding and the actual medication recommendations prescribed by the physici

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Publication Date
Fri Jun 18 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Effectiveness of Educational Pillars Based on Vygotsky's Theory in Achievement and Information Processing Among First Intermediate Class Students
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The aim of the research is to identify the effectiveness of the educational pillars strategy based on Vygotsky's theory in mathematical achievement and information processing of first-grade intermediate students. In pursuit of the research objectives, the experimental method was used, and the quasi-experimental design was used for two equivalent groups, one control group taught traditionally and the other experi-mental taught according to the educational pillars strategy. The research sample consisted of (66) female students from the first intermediate grade, who were inten-tionally chosen after ensuring their equivalence, taking into account several factors, most notably chronological age and their level of mathematics, and they we

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
CD49d and CD26 in chronic lymphocytic leukemia: their correlation with clinical Binet staging and clinical parameters
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The study aimed to assess the expression of CD49d and CD26 in newly diagnosed CLL patients and find their correlation with clinical Binet stage, and other clinical parameters. This study was conducted on 51 newly diagnosed CLL patients based on lymphocyte count > 5×109/L and immunophenotyping. The expression of CD49d, and CD26 were investigated using eight-color flow cytometer. The expression of CD49d and CD26 were detected in 56.9 %, 68.8 % of CLL patients, respectively. The correlation between CD49d expression and CD26 expression was statistically significant (p < 0.001) with high concordance rate between them. The positive expression of both CD49d and CD26 had statistically significant association with clinical Binet staging (p < 0.001,

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Publication Date
Sun Mar 01 2026
Journal Name
Interdisciplinary Neurosurgery
Surgical outcomes and challenges in spinal cord tumor resection: a comparative study of elderly vs. young patients
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