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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 Jan 01 2023
Journal Name
Springer Nature
Clinical and Surgical Aspects of Congenital Heart Diseases
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This text and guide discusses the surgical and medical management of congenital heart diseases in both adult and children. It describes the disease, pathology, treatment, complications and follow-up with extensive use of didactic material to educate the reader to the practicalities of the subject. It details the novel research via an extensive literature review, while covering all aspects of the surgical and medical treatment of congenital heart disease. It includes review of the laparoscopic techniques and epidemiology of each disease involved and their prevalence to provide the reader with the full clinical picture. Clinical and Surgical Aspects of Congenital Heart Diseases: Text and Study Guide provides a thorough practical reference fo

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Clinical and biochemical evaluation of facial acanthosis nigricans
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KE Sharquie, AA Noaimi, HG Mahmood, SM Al-Ogaily, Journal of Cosmetics, Dermatological Sciences and Applications, 2015 - Cited by 6

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Publication Date
Mon Aug 31 2020
Journal Name
Bmc Oral Health
The success of using 2% lidocaine in pain removal during extraction of mandibular premolars: a prospective clinical study
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Abstract<sec><title>Background

The purpose of this study was to evaluate the anesthetic effectiveness of a buccal infiltration technique combined with local massage (using 2% lidocaine) in the extraction of mandibular premolars to be utilized as an alternative to the conventional inferior alveolar nerve block.

Methods

Patients eligible included any subject with a clinical indication for tooth extraction of the mandibular 1st or 2nd premolars. All patients were anesthetized buccally by local infiltration technique followed by an external pressure applied for 1 min directly over the injection area. In each case, another local

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Publication Date
Tue Jun 15 2021
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Genetic Structure, Transmission, Clinical Characteristics, Diagnosis, Treatment and Prevention of Coronavirus Disease 2019 (COVID-19): A Review
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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a pandemic of coronavirus disease 2019 (COVID-19) which represents a global public health crisis. Based on recent published studies, this review discusses current evidence related to the transmission, clinical characteristics, diagnosis, management and prevention of COVID-19. It is hoped that this review article will provide a benefit for the public to well understand and deal with this new virus, and give a reference for future researches.

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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
Fri Aug 14 2026
Journal Name
Computers, Materials &amp; Continua
SHA-512 Based Key Generation and Two-Dimensional Logistic Permutation with a Median Filter for Enhanced Grayscale Image Encryption
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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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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
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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