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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 Jun 15 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Occlusal features, perception of occlusion and orthodontic treatment need and demand among 13 years aged Baghdadi students Part II: (Cross sectional epidemiological study)
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Background: The present study aimed to assess the distribution, prevalence, severity of malocclusion in Baghdad governorate in relation to gender and residency Materials and Methods: A multi-stage stratified sampling technique was used in this investigation to make the sample a representative of target population. The sample consisted of 2700 (1349 males and 1351 females) intermediate school students aged 13 years representing 3% of the total target population. A questionnaire was used to determine the perception of occlusion and orthodontic treatment demand of the students and the assessment procedures for occlusal features by direct intraoral measurement using veriner and an instrument to measure the rotated and displaced teeth. Results a

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
Towards a proposed conception of the role of the professional practice specialist for social work In the field of social care for corona patients (A field study at the Iraqi Ministry of Social Affairs)
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This study aimed to identidy the role of a professional social worker practice specialist in the field of social care for Corona patients, in light of some demographic variables such as (gender, marital status, economic status,), through a field study at the Iraqi Ministry of Social Affairs. A random sample of (50) social workers in the Iraqi Ministry of Social Affairs in various places affiliated with the ministry was chosen. a questionnaire developed by the researcher about the role of the social worker in the field of social care for Corona patients was administered to the study sample to collect the needed data. The results showed that there is a positive statistically significant correlation relationship at the level (0.01) between

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Publication Date
Sat Jul 01 2017
Journal Name
2017 Computing Conference
Protecting a sensitive dataset using a time based password in big data
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Publication Date
Mon Jun 15 2026
Journal Name
Al–bahith Al–a'alami
Foreign Series in the Kurdish Satellite Channels and Their Role in the Development of Awareness among Young People in the Kurdistan Region (Korean Series as a Model) (A Field Study on a Sample of Students of the Institute of Fine Arts in the City of Sulay
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The dubbing process for the Foreign Dramas by the Kurdish language became a serious phenomenon in the Kurdish satellite TV, especially in the past few years. It attracted a wide audience, especially young adolescents. And prepared by some breakthrough hostile to Kurdish culture and value coordinated by others remedy for the structural gaps and lapses have, as a result of climate which is brought into existence globalization and secretions variety dimensional, saturated value and cognitive effects bearing a strong identity of its elements. From here, the problem of this research is the ambiguity of their role in a series of developmental processes Kurdish awareness of young people and the extent of the impact that caused it.

This

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Publication Date
Mon Jan 01 2018
Journal Name
Ournal Of Advanced Research In Dynamical And Control System
Effect of magnetic field on peristaltic transport of bingham plastic fluid
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Publication Date
Fri Aug 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
The impact of strategic approach in the effectiveness of small and medium Enterprises in Iraq
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The purpose of this research highlight the achievement of the effectiveness of small and medium enterprises dimensions and conformable to analyze the relationship between business strategies and human resources management strategies , and launched search of a dilemma thought provoking fundamental questions revolve around the search is the lack of appropriate strategies in these enterprises to help them continuity and permanence in business and markets , as these enterprises lack the human resources management strategies appropriate , as well as business strategies that make them withstand the changes in the market environment is changing and volatile . It was to

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Female displacement phenomenon between dispersion and incorporation A field study in Female Training House - Baghdad Wasan mohsin hasan
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Vagrancy is global problem, but its geographical distribution differs from one society
to another and from one place to another inside the same society.Till now there isn't a real factor that can explain the phenomenon, spite that economy plays aconstituent and distinguishing part, and spite the fact that Vagrancy is considered a realdeviation that can be compared with criminality level, and cannot be separated from its effecton family, local society and school. In addition to unprecedented work under heavily pressurethat attack to a minimum protection and safety. Vagrant may be a child, a teen, a young, or
even an old man. Vagrancy thus means different people with different ages and not onlyprecisely children. Vagrant is not neces

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Publication Date
Sat Dec 31 2016
Journal Name
Al-kindy College Medical Journal
CLINICAL PRESENTATIONS AND COMPLICATIONS OF GUILLAIN BARRE SYNDROME IN CHILDREN WELFARE TEACHING HOSPITAL
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Background: Guillain Barré syndrome is an acute inflammatory demyelinating disease of the peripheral nerves. Its synonyms are: acute inflammatory demyelinating polyradiculoneuropathy, idiopathic polyneuritis, acute infective polyneuropathy and post infections polyneuritis. Objectives: We attempt to study the clinical presentations and complications in patients with GBS who were admitted to children welfare Teaching Hospital and to compare the results with the other studies.Type of the study: A retrospective study.Methods: A study done on seventy patients with GBS who were admitted to children Welfare Teaching Hospital in Medical City-Baghdad from different parts of Iraq between January 2002-December 2006.Results: Forty (57.14%) of them

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical Assessment and Cytomorphometric Analysis of Buccal Mucosal Cells in Behçet’s Disease Patients
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Background: Behçet’s disease (BD) is a disorder of systemic inflammatory condition. Its important features are represented by recurrent oral, genital ulcerations and eye lesions. Aims. The purpose of the current study was to evaluate and compare cytological changes using morphometric analysis of the exfoliated buccal mucosal cells in Behçet’s disease patients and healthy controls, and to evaluate the clinical characteristics of Behçet’s disease. Methods. Twenty five Behçet’s disease patients have been compared to 25 healthy volunteers as a control group. Papanicolaou stain was used for staining the smears taken from buccal epithelial cells to be analyzed cytomorphometrically. The image analysis software has been used to

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Publication Date
Tue Dec 01 2020
Journal Name
International Journal Of Electrical And Computer Engineering (ijece)
A Haptic feedback system based on leap motion controller for prosthetic hand application
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Leap Motion Controller (LMC) is a gesture sensor consists of three infrared light emitters and two infrared stereo cameras as tracking sensors. LMC translates hand movements into graphical data that are used in a variety of applications such as virtual/augmented reality and object movements control. In this work, we intend to control the movements of a prosthetic hand via (LMC) in which fingers are flexed or extended in response to hand movements. This will be carried out by passing in the data from the Leap Motion to a processing unit that processes the raw data by an open-source package (Processing i3) in order to control five servo motors using a micro-controller board. In addition, haptic setup is proposed using force sensors (F

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