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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 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 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
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
Wed Jun 01 2016
Journal Name
Journal Of Engineering
The Effects of Inclination and Compounds Angles of Round Holes in Staggered Rows on Adiabatic Film Cooling Effectiveness of Vane Suction side
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The aim of this work is oriented to increase film cooling effectiveness value through numerical investigations for flow of Mach number not more than 0.3 around vane surface, to find the effects of inclination and compounds angles of round holes in staggered rows on adiabatic film cooling effectiveness of vane suction side. Multi cylindrical film cooling hole cases were studied with pitch ratio P/d =2 and 3, local blowing ratios M=0.382, 0.77 and 1.14,  inclination angles a=30° and 45°, compound angles β= 0°, 15°, 30° and 45° and local momentum ratios I= 0.084, 0.34 and 0.756  for better cooling process.

            A numerica

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Publication Date
Thu Mar 30 2017
Journal Name
Journal Of Biotechnology Research Center
Study the Effects of Methotrexate with and without Vitamin A on Some Biochemical and Histological Parameters in Male Rabbits
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The present study aims to evaluate the effects of methotrexate (MTX) with and without vitamin A (Vit. A) on some biochemical parameters and histological structure in male rabbits liver. Twenty male rabbits weighing 1250-1480 gm were divided into four equal number groups. The first group was given 2 ml distilled water as control group. The second group was given MTX (20 mg/kg), the third group was given Vit. A (5000 IU), while the fourth group was given MTX (20 mg/kg) +Vit. A (5000 IU) in alternative days. Following four weeks of treatment, lipid profile total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), [low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL)]; in addition to thyroid hormones tr

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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
Wed Sep 30 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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Publication Date
Wed Jun 01 2022
Journal Name
Res Militaris
The Effect of Internal Control in Supporting the Implementation of Cost Techniques in Iraqi Companies
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In the last few years, there have been a lot of changes in the economy, society, and the environment. This has led to much competition between companies, directly and indirectly affecting production and marketing processes. Most companies are trying to cut production and manufacturing costs by using modern cost techniques such as product life cycle costing and Continuous Improvement (Kaizen) technology, in the method of measuring production costs or service costs, and the need for internal control to keep an eye on how these technologies are being used and how well they work. And to find out the effect of internal control on the implementation of costing techniques in Iraqi companies, 64 questionnaires were given to people who work in the i

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