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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
Sun Sep 01 2024
Journal Name
Heliyon
Synthesis and characterization of some Metal ions complexes with mixed ligand of azo dye and Metformin and evaluation of its effectiveness on the growth of some pathogenic bacteria clinically isolated and study of its Toxicity on normal and cancerous Hepatocytes
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Publication Date
Sun Sep 01 2024
Journal Name
Heliyon
Synthesis and characterization of some Metal ions complexes with mixed ligand of azo dye and Metformin and evaluation of its effectiveness on the growth of some pathogenic bacteria clinically isolated and study of its Toxicity on normal and cancerous Hepatocytes
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Four metal compounds mixed ligand of azo dye ligand (L) and metformin.(Met) were produced at aquatic ethanol for (1:1:1) (M:L:Met). The prepared compounds were identified by utilizing atomic absorption flame, FT.IR and UV–Vis spectrum manners as well as conductivity mensuration. These compounds was assayed of the gained datum the octahedral geometry was proposed into whole prepared complexes.Also in this research was studied represented examining the antibacterial and antifungal impact of the azo dye ligand (L), metformin.(Met) and (Co,Ni, Cu and Cd complexes) on four types of pathogenic, clinically isolated bacteria that are resistant to antibiotic, like Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Klebsiella pneu

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Publication Date
Mon Jan 01 2024
Journal Name
Heliyon
Synthesis and Characterization of Some Metal Ions Complexes with Mixed Ligand of Azo Dye and Metformin and Evaluation of its Effectiveness on the Growth of Some Pathogenic Bacteria Clinically Isolated and Study of its Toxicity on Normal and Cancerous Hepatocytes
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Publication Date
Sun Dec 01 2002
Journal Name
Iraqi Journal Of Physics
Effect of the electric field on drilling Brass by Laser
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The research include a pulsed Nd: YAG Laser with (300µs) pulse duration in the TEM00 mode at (1.06µm) wavelength for energies between (0.5-3) J was employed to drill Brass material which is use in industrial applications. The process of drill was assisted by an electric field. This resulted in an increase in the hole aspect ratio by the value (45%) and decrease in the hole taper by the value (25%) of its value under ordinary drilling conditions using the same input energy.

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Detection, purification and characterization of a bacteriocin produced by Bacillus subtilis NK16 exhibits a significant antimicrobial activity against clinical Staphylococcus spp.
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Bacteriocin is an important antimicrobial peptide that can be used in industrial and medical fields due to its characteristics of antibacterial, food preservation and anticancer activities. Fifty isolates of Bacillus sp were collected from different soil samples which were already recognized via morphological and biochemical identification process. The isolates were screened for bacteriocin production effective against Staphylococcus spp in order to select the highest producing isolate. The isolate NK16 showed the maximum bacteriocin production (80 AU/ml) which was further characterized as Bacillus subtilis NK 16 through using API identification system (API 20E and API 50CHB). Then, next step was to detect the optimal conditions for maximum

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Publication Date
Thu Oct 01 2020
Journal Name
Palarch's Journal Of Archaeology Of Egypt / Egyptology
The effect of the legislative omission on effectiveness of administration in confronting the corona virus Study in Iraqi law
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The effectiveness and quality of legislation depend on the extent to which it relates to political , economic ,social ,geographical , health and moral realities , so the unrealistic legislation and its failure to address all the problems facing society make these legislation out of reality , this requires this legislation be able to regulate all aspects related to public health in society in exceptional circumstances such as cases of wars ,diseases and pandemics as outbreaks of corona virus in the word ,this study focuses on the effects of legislative omission on the effectiveness of the administration when performing its tasked in health administrative control in exceptional circumstances in light of spread of corona virus pandemic in Iraq

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A proposed audit program for a comprehensive electronic banking system based on business risks : applied research
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The research seeks to identify the comprehensive electronic banking system and the role of the auditor in light of the customer's application of electronic systems that depend on the Internet in providing its services, as a proposed audit program has been prepared in accordance with international auditing controls and standards based on the study of the customer's environment and the analysis of external and internal risks in the light of financial and non-financial indicators, the research reached a set of conclusions, most notably, increasing the dependence of banks on the comprehensive banking system for its ability to provide new and diverse banking services, The researcher suggested several recommendations, the most important of whi

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Publication Date
Sat Mar 30 2019
Journal Name
Journal Of Pure And Applied Microbiology
Antibiotic Resistance of Isolated Gram Negative Bacilli from Different Clinical Sample in a Central Teaching Hospital of Pediatric in Baghdad
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The number of infections caused by microorganisms is increasing significantly over the last few years. A total of 140 patients admitted to the central teaching hospital of pediatrics from the 1st of Jun 2017 to 31 October 2017. The Clinical samples was processed from culture and sensitivity testing. Antibiotic discs used for gram negative isolates. The most prevalent gram negative isolates included Escherichia coli 63 (45.0 %), Pseudomonas spp. 21 (15.0 %), Klebsiella spp. 19 (13.6 %) predominantly. Escherichia coli were the most prevalent isolates from urine 45 (71.4 %), Klebsiella spp. 11 (57.9 %) and Enterobacter spp. 11 (68.8 %) followed by Escherichia coli 10 (15.9 %) predominant from blood. 68 (48.6 %) of specimens were urine, 47 (33.

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Publication Date
Mon Dec 30 2002
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Thermal Conductivity Characteristics of Polymer composites Based on Polyethylene Wastes Filled with Post-Industry Wood Wastes
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Publication Date
Wed Sep 01 2021
Journal Name
Iraqi Journal Of Physics
Enhancement of Photoconductive Detector Based on Carbon Nanotubes Decorated with Silver Nanoparticles by Adding Conductive Polymer
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In this work, wide band range photo detector operating in UV, Visible and IR was fabricated using carbon nanotubes (MWCNTs, SWCNTs) decorated with silver nanoparticles (Ag NPs). Silicon was used as a substrate to deposited CNTs/Ag NPs by the drop casting technique. Polyamide nylon polymer was used to coat CNTs/Ag NPs to enhance the photo-response of the detector. The electro-exploding wire technology was used to synthesize Ag NPs. Good dispersion of silver NPs achieved by a simple chemistry process on the surface of CNTs. The optical, structure and electrical characteristic of CNTs decorated with Ag NPs were characterized by X-Ray diffraction and Field Emission Scanning Electron Microscopy.  X-ray diffra

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