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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
Sat Jun 13 2026
Journal Name
Journal Of Baghdad College Of Economic Sciences University
The impact of competitive pressures and strategic renewal of business organization Field research in a sample of premium class hotels- in Iraq
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هدف البحث الى بيان طبيعة ارتباط والتأثير بين الضغوط التنافسية (المتغير المستقل) والتجديد الاستراتيجي (المتغير التابع) ، تم تطبيق البحث في فنادق الدرجة الممتازة في بغداد. وبلغت عدد افراد عينة البحث (99) مديراً يعملون في (6) فنادق من الدرجة (الممتازة) ببغداد، وهي (فندق الرشيد، فندق عشتار، فندق ميريديان، فندق المنصور، فندق بابل، وفندق بغداد) وتم اجراء التحليل الاحصائي باستخدام البرنامج الاحصائي AMOS وظهرت وجود تنافسي

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Publication Date
Thu Jan 01 2026
Journal Name
Global Heart
Awareness, Willingness, and Concerns about Clinical Trial Participation among Iraqi Patients: A Cross-Sectional Study
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Publication Date
Thu Jan 01 2026
Journal Name
Global Heart
Awareness, Willingness, and Concerns about Clinical Trial Participation among Iraqi Patients: A Cross-Sectional Study
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Publication Date
Sun Feb 10 2019
Journal Name
Journal Of The College Of Education For Women
Social Medical Care for the Deformed Children: A Field Study in Baghdad City
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The Child is the first sedum for the human society performing, and we deal in our
research to explain the nature of the mutual relations in between the form and the medicine
social caring foundation. So the motherhood and the childhood nowadays become the most
dedicated in the researchers works, whom interesting in the social affairs, and that whom
work in the medicine field as scientists.
So the child is the future man and must be in wright body construction that need to great
care and interest to make him wright mind through capability of performing anything support
to him.
In our research we deal with the main factors in which lead to infect the child by the
creative malfunction, like the environmental and m

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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The Efficiency Of Physics Forceps In Comparison To The Conventional Dental Extraction Forceps: A randomized Clinical Trial
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Background: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic process often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. The physics forceps is one of those innovations in dental extraction technologies that claim to provide an efficient means for atraumatic dental extractions. Materials and method: A randomized clinical trial was conducted to compare the physics forceps with the conventional forceps for the removal of 28 mandibular single rooted teeth under the following parameters: incidence of crown, root, b

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Publication Date
Wed May 10 2023
Journal Name
Journal Of Engineering
SDPLL-Based Frequency Estimation of a Sinusoid in Colored Noise
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The problem of frequency estimation of a single sinusoid observed in colored noise is addressed. Our estimator is based on the operation of the sinusoidal digital phase-locked loop (SDPLL) which carries the frequency information in its phase error after the noisy sinusoid has been acquired by the SDPLL. We show by computer simulations that this frequency estimator beats the Cramer-Rao bound (CRB) on the frequency error variance for moderate and high SNRs when the colored noise has a general low-pass filtered (LPF) characteristic, thereby outperforming, in terms of frequency error variance, several existing techniques some of which are, in addition, computationally demanding. Moreover, the present approach generalizes on existing work tha

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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
The Effect of Ferric Citrate in Controlling Iron Deficiency Anemia and its Tolerability in a Sample of Iraqi Hemodialysis Patients: Randomized Controlled Clinical Trial
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Background: The iron deficiency anemia along with hyperphosphatemia are the main complications of dialysis patients. Traditional iron supplement has been failed to correct iron deficiency anemia, therefore, the current study aimed to investigate the efficacy and tolerability of new phosphate binder, ferric citrate, in a sample of Iraqi patients with end stage renal disease on maintenance hemodialysis. Method: Prospective, randomized, open label, active controlled trial was conducted in one center for dialysis in Babylon governance. Patients were randomized to receive ferric citrate with dose of 6 g/d and calcium carbonate with dose of 3 g/d for eight weeks. Hemoglobin concentration, mean corpuscular hemoglobin concentration and count o

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Publication Date
Fri Nov 04 2022
Journal Name
Journal Of Optics
Coreless optical fiber for hemoglobin (HB) sensing with bilayer based on surface plasmon resonance
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In this work, an optical fiber biomedical sensor for detecting the ratio of the hemoglobin in the blood is presented. A surface plasmon resonance (SPR)-based coreless optical fiber was developed and implemented using single- and multi-mode optical fibers. The sensor is also utilized to evaluate refractive indices and concentrations of hemoglobin in blood samples, with 40 nm thickness of (20 nm Au and 20 nm Ag) to increase the sensitivity. It is found in practice that when the sensitive refractive index increases, the resonant wavelength increases due to the decrease in energy.

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Publication Date
Mon Jan 04 2021
Journal Name
Multimedia Tools And Applications
Attention enhancement system for college students with brain biofeedback signals based on virtual reality
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Publication Date
Tue Jun 01 2021
Journal Name
Baghdad Science Journal
A New Methodology to Find Private Key of RSA Based on Euler Totient Function
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          The aim of this paper is to present a new methodology to find the private key of RSA. A new initial value which is generated from a new equation is selected to speed up the process. In fact, after this value is found, brute force attack is chosen to discover the private key. In addition, for a proposed equation, the multiplier of Euler totient function to find both of the public key and the private key is assigned as 1. Then, it implies that an equation that estimates a new initial value is suitable for the small multiplier. The experimental results show that if all prime factors of the modulus are assigned larger than 3 and the multiplier is 1, the distance between an initial value and the private key

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