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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
Mon May 05 2025
Journal Name
Assistive Technology
Evaluation the findings of WHO rapid assistive technology assessment (rATA) in Iraq: A field-based survey
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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The role of prophylactic antibiotics in compound facial fractures treated by closed and open reduction
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Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as co

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Publication Date
Fri Apr 23 2021
Journal Name
Al-nahrain Journal Of Science
A Clinical-Statistical Study on COVID-19 Cases in Iraq: A Case Study
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Background: COVID-19 is a disease that started in Wuhan/China in late 2019 and continued through 2020 worldwide. Scientists worldwide continue to research to find vaccines, treatments, and medication for this disease. Studies also conenue to find the pathogenicity and epidemiology mechanisms. Materials and Methods: In this work, we analyzed cases obtained from Alshifaa center in Baghdad/Iraq for 23/2/2020-31/5/2020 with total instances of 797, positive cases of 393, and death cases of 30. Results: Results showed that the highest infection cases were among people aged between 41-45. Also, it was found that males' number of cases was more than females. In contrast, death cases were significantly higher in males than females. It was not

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Publication Date
Wed Aug 30 2023
Journal Name
مجلة نسق
The Effectiveness of a Program Based on the Theory of the Five Minds in Developing Focused Reading and Extensive Reading Skills among Second-Year Middle School Students
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Publication Date
Sun Apr 01 2018
Journal Name
Al–bahith Al–a'alami
Effectiveness of sports television programs in the development of sports culture among youth: field study
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The aim of the research is to determine the extent to which young people watch television sports programs and the impact of viewing on the level of sports culture among young people and the impact of demographic variables on youth over the viewing of sports programs, The study was conducted on a sample of (200) male and female students from the faculties of the University of Baghdad, where a questionnaire form composed of several axes and questions was prepared to measure the effectiveness of sports programs in youth culture, The statistical program used spss to empty data and extract results by frequency, percentages, correlations, The research reached several results, the most important of which is that there is a strong influence of s

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Publication Date
Wed Jan 01 2025
Journal Name
Eastern Ukrainian Medical Journal
IMPACT OF HIGHLY SELECTIVE VERSUS RELATIVELY SELECTIVE COX2 INHIBITORS ON INSULIN SENSITIVITY IN IRAQI PATIENTS DIAGNOSED WITH TYPE 2 DIABETES
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Background: A worldwide health epidemic, type 2 diabetes mellitus was significantly influenced by chronic inflammation, which led to increased insulin resistance (IR). The most widely practiced form of therapy used to control musculoskeletal pain in people with diabetes is non-steroidal anti-inflammatory drugs (NSAIDs), which provide their action by inhibiting cyclooxygenase enzyme (COX). COX1, COX2, and COX3 are distinct isoforms of the cyclooxygenase enzyme. The potential anti-inflammatory benefits of cyclooxygenase-2 (COX-2) inhibitors, both selective and non-selective, have been investigated concerning the management of type 2 diabetes patients. Objective: the purpose of this research is to explore the impact of highly selective

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Publication Date
Sun Jun 23 2024
Journal Name
Asee Annual Conference And Exposition
Undergraduate Research Impact on Students' Retention and Academic Development Based on Their Study Field and the Mentoring Approach
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The impact of undergraduate research experiences on students' academic development and retention in STEM fields is significant. Students' success in STEM fields is based on developing strong research and critical thinking skills that make it essential for students to engage in research activities throughout their academic programs. This work evaluates the effectiveness of undergraduate research experiences with respect to its influence on student retention and academic development. The cases presented are based on years of experience implementing undergraduate research programs in various STEM fields at Colorado State University Pueblo (CSU Pueblo) funded by HSI STEM Grants. The study seeks to establish a correlation between students' reten

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Publication Date
Thu Apr 21 2016
Journal Name
Iraqi Dental Journal
Amoxicillin vs Levofloxacin in Treatment of Chronic Periodontitis: Review
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Thu Apr 21 2016
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Iraqi Dental Journal
Amoxicillin vs Levofloxacin in Treatment of Chronic Periodontitis: Review
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Publication Date
Mon Mar 01 2021
Journal Name
World Heart Journal
Change in Left Ventricular Size and Ejection Fraction in Patients at Rest vs. Stress with Different Degrees of Ischemic Heart Failure
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Background and Aim. Coronary artery disease (CAD) is a major risk factor for the progression to heart failure (HF), which is associated with an increase in left ventricular volume (LVV). This study aims to measure ventricular function and myocardial perfusion imaging markers of the left side of the heart, which can be performed with injection of a 99mTc at stress and rest by using single-photonemission-computed-tomography (SPECT). Subject and methods. The study included 121 patients with CAD, comprising 53 females and 68 males with ages between 25 to 88 years and 265 healthy subjects comprising 84 males and 181 females. All patients and healthy subjects volunteered to participate in this study. They were classified according to

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