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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 Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Education Program on Youth's Awareness towards Household Waste Control
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Objective: determine the effectiveness of an education program on youth's level of awareness towards
household waste control.
Methodology: A Quazi-experimental study was conducted. Non-probability (quota sample) of (80) young
persons is selected from Baghdad Governorate. They are divided into two equal groups of (40) subjects for the
study group which is exposed to the household waste control educational program. The remaining is the
control group which is not exposed to the educational program.
Results: The findings of the study indicated that youth of the study group have got benefits from the
implementation of the educational program towards household waste control and change has occurred to
their awareness tow

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Education Program on High School Males Students' Knowledge about Smoking
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Abstract

Objective(s): To evaluate high school male students' knowledge about substance use, to determine the effectiveness of the education program on high school mal students' knowledge about substance use.

 

 Methodology: A quasi-experimental (pre-posttest) design was carried out to determine the effectiveness of an educational program on knowledge of high school students about substance use in AL-Kut city. The study was started from 20th h September 2022 to 24th November 2022. The sample was non-probability (purposive sample) sample of (60) student were selected according to the study that are working in Al Kut Education Directo

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Publication Date
Thu Jan 04 2024
Journal Name
World Academy Of Sciences Journal
Antibacterial and antibiofilm activity of klebicin crude extract on clinical isolates of <i>Salmonella</i> and <i>Enterobacter</i>
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Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
Bifurcation and Stability Analysis of Stagnation Point for Fluid Flow in an Inclined Channel with Inclined Magnetic Field for Peristaltic Transport
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Streamlined peristaltic transport patterns, bifurcations of equilibrium points, and effects of an inclined magnetic field and channel are shown in this study. The incompressible fluid has been the subject of the model's investigation. The Reynolds values for evanescence and an infinite wavelength are used to constrain the flow while it is being studied in a slanted channel with a slanted magnetic field. The topologies over their domestic and cosmopolitan bifurcations are investigated for the outcomes, and notion of the dynamical system are employed. The Mathematica software is used to solve the nonlinear autonomous system. The flow is found to have three different flow distributions namely augmented, trapping and backward flow. Outc

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Publication Date
Mon Jan 01 2024
Journal Name
International Journal Of Neutrosophic Science
A New Paradigm for Decision Making under Uncertainty in Signature Forensics Applications based on Neutrosophic Rule Engine
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One of the most popular and legally recognized behavioral biometrics is the individual's signature, which is used for verification and identification in many different industries, including business, law, and finance. The purpose of the signature verification method is to distinguish genuine from forged signatures, a task complicated by cultural and personal variances. Analysis, comparison, and evaluation of handwriting features are performed in forensic handwriting analysis to establish whether or not the writing was produced by a known writer. In contrast to other languages, Arabic makes use of diacritics, ligatures, and overlaps that are unique to it. Due to the absence of dynamic information in the writing of Arabic signatures,

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Publication Date
Tue Dec 29 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Medication Safety in Patients under 18 Years Old; a Retrospective Study based on Iraqi Pharmacovigilance Center Database
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Medication safety is an important part of the comprehensive patient safety term. Medication safety is gaining more attention as the World Health Organization set the goal of decreasing medication harm by (50%) for the next 5 years when launching the third global challenge. Studying medication safety in the risk groups such as young ages, children are crucial to learn more about the effect of medicines in this risk group since they are not included in the clinical trials. Adverse drug reaction is defined as any harm resulted from the drug itself during medical process journey, while medication errors are any harm resulted from the treatment process rather than the drug or it is the result of the failure in a step of the treatment process

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Publication Date
Mon Jun 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of the Effectiveness of Coenzyme Q10 Gel in Management of Patients with Chronic Periodontitis (II inter group comparison)
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Background: Anti-oxidants are used as supplements to counteract the over production of free radicals in periodontal disease.Co-Q10 functions as an intercellular antioxidant by acting as a primary scavenger of free radicals (FRs) and reactive oxygen species (ROS), this study aimed to evaluate the effect of intra pocket application of perio Q gel (coenzyme Q10) alone and as adjunct to scaling and root planing on the periodontal clinical parameters in the treatment of patients with chronic periodontitis and compare the better improvement on the clinical periodontal parameters among different treatment modalities at 3 and 6 weeks. Materials and methods: A total of 323 sites with pocket depth (5-8) mm in patients with chronic periodontitis were

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Publication Date
Fri Mar 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
A clinicopathological analysis of 151 odontogenic tumors based on new WHO classification 2022: A retrospective cross-sectional study
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Background: Odontogenic tumors are a diverse group of lesions with a variety of clinical behavior and histopathologic subtypes, from hamartomatous and benign to malignant. The study aimed to examine the clinical and pathological features of odontogenic tumors in Baghdad over the last 11 years (2011–2021). Materials and Methods: The present retrospective study analyzed all formalin-fixed, paraffin-embedded tissue blocks of patients diagnosed with an odontogenic tumor that were retrieved from archives at a teaching hospital/College of Dentistry in Baghdad University, Iraq, between 2011 and 2021. The diagnosis of each case was confirmed by examining the hematoxylin and eosin stained sections by two expert pathologists. Data from pati

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Publication Date
Tue Sep 18 2018
Journal Name
Water
A Systematic Operation Program of a Hydropower Plant Based on Minimizing the Principal Stress: Haditha Dam Case Study
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Dam operation and management have become more complex recently because of the need for considering hydraulic structure sustainability and environmental protect on. An Earthfill dam that includes a powerhouse system is considered as a significant multipurpose hydraulic structure. Understanding the effects of running hydropower plant turbines on the dam body is one of the major safety concerns for earthfill dams. In this research, dynamic analysis of earthfill dam, integrated with a hydropower plant system containing six vertical Kaplan turbines (i.e., Haditha dam), is investigated. In the first stage of the study, ANSYS-CFX was used to represent one vertical Kaplan turbine unit by designing a three-dimensional (3-D) finite element (F

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Publication Date
Mon Jun 15 2026
Journal Name
Iraqi Journal Of Science
Synthesis, Characterization and Quantum Mechanical Study of Some New 2-benzylidenehydrazinecarbothioamide Derivatives as Corrosion Inhibitors for Carbon/mild Steel in Acidic Medium.
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In this work, some of new 2-benzylidenehydrazinecarbothioamide derivatives have been prepared by condensation of thiosemicarbazide and different substituted aromatic benzaldehydes in presence of glacial acetic acid to give compounds (1-6), these compounds have characterized by its physical properties and spectroscopic methods. This work also included theoretical study to prove the ability of these compounds as corrosion inhibitors; The program package of Gaussian 09W with its graphical user interface GaussView 5.0 had used for this purpose; the methods of Density Functional Theory (DFT) with basis set of 6-311G (d,p) / hybrid function of B3LYP and semiempirical method of PM3 have been used, the study included theoretical simulation

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