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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 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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Thu Jan 01 2026
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Global Heart
Awareness, Willingness, and Concerns about Clinical Trial Participation among Iraqi Patients: A Cross-Sectional Study
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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
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Understanding the Experience of Hospital Pharmacists with the Effectiveness, Safety, Adverse Drug Reaction Reporting and Interchangeability of Biopharmaceutical Medicines
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The study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.

The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c

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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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Publication Date
Wed Nov 16 2016
Journal Name
Eurasip Journal On Wireless Communications And Networking
Evaluation of efficient vehicular ad hoc networks based on a maximum distance routing algorithm
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Traffic management at road intersections is a complex requirement that has been an important topic of research and discussion. Solutions have been primarily focused on using vehicular ad hoc networks (VANETs). Key issues in VANETs are high mobility, restriction of road setup, frequent topology variations, failed network links, and timely communication of data, which make the routing of packets to a particular destination problematic. To address these issues, a new dependable routing algorithm is proposed, which utilizes a wireless communication system between vehicles in urban vehicular networks. This routing is position-based, known as the maximum distance on-demand routing algorithm (MDORA). It aims to find an optimal route on a hop-by-ho

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Publication Date
Sat Dec 01 2012
Journal Name
Journal Of Engineering
Effect Of Technology Based Learning As A Supplement To Traditional Technology On Student's Achievement
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This paper describes a practical study on the impact of learning's partners, Bluetooth Broadcasting system, interactive board, Real – time response system, notepad, free internet access, computer based examination, and interaction classroom, etc, had on undergraduate student performance, achievement and involving with lectures. The goal of this study is to test the hypothesis that the use of such learning techniques, tools, and strategies to improve student learning especially among the poorest performing students. Also, it gives some kind of practical comparison between the traditional way and interactive way of learning in terms of lectures time, number of tests, types of tests, student's scores, and student's involving with lectures

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Publication Date
Sat May 01 2021
Journal Name
Journal Of Physics: Conference Series
The Classification of Fetus Gender Based on Fuzzy C-Mean Using a Hybrid Filter
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Abstract<p>This paper proposes a new approach, of Clustering Ultrasound images using the Hybrid Filter (CUHF) to determine the gender of the fetus in the early stages. The possible advantage of CUHF, a better result can be achieved when fuzzy c-mean FCM returns incorrect clusters. The proposed approach is conducted in two steps. Firstly, a preprocessing step to decrease the noise presented in ultrasound images by applying the filters: Local Binary Pattern (LBP), median, median and discrete wavelet (DWT), (median, DWT & LBP) and (median & Laplacian) ML. Secondly, implementing Fuzzy C-Mean (FCM) for clustering the resulted images from the first step. Amongst those filters, Median & Lap</p> ... Show More
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