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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
Thu Dec 12 2013
Journal Name
Iraqi Journal Of Science
Determination of Optimum Mechanical Drilling Parameters for an Iraqi Field with Regression Model
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Publication Date
Wed Jan 28 2015
Journal Name
Al-khwarizmi Engineering Journal
Thermal Field Analysis of Oblique Machining Process with Infrared Image for AA6063-T6
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Abstract

 Metal cutting processes still represent the largest class of manufacturing operations. Turning is the most commonly employed material removal process. This research focuses on analysis of the thermal field of the oblique machining process. Finite element method (FEM) software DEFORM 3D V10.2 was used together with experimental work carried out using infrared image equipment, which include both hardware and software simulations. The thermal experiments are conducted with AA6063-T6, using different tool obliquity, cutting speeds and feed rates. The results show that the temperature relatively decreased when tool obliquity increases at different cutting speeds and feed rates, also it

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Publication Date
Sun Nov 01 2015
Journal Name
Journal Of Engineering
Enhancement Solution to Improve Remediation of Soil Contaminated with Lead by Electrical Field
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A laboratory investigation of six different tests were conducted on silty clay soil spiked with lead in concentrations of 1500 mg/kg. A constant DC voltage gradient of 1 V/cm was applied for all these tests with duration of 7 days remediation process for each test. Different purging solutions and addition configurations, i.e. injection wells, were investigated experimentally to enhance the removal of lead from Iraqi soil during electro-kinetic remediation process. The experimental results showed that the overall removal efficiency of lead for tests conducted with distilled water, 0.1 M acetic acid, 0.2 M EDTA and 1 M  ammonium citrate as the purging solutions were equal to 18 %, 37 %, 42 %, and 29 %, respectively. H

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Publication Date
Sun Jun 26 2022
Journal Name
International Journal Of Corrosion And Scale Inhibition
Theoretical and experimental studies of copper(II) and nickel(II) complexes derived from the ligand N-benzyl benzimidazole as corrosion inhibitors in ionic and bacterial media
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Publication Date
Thu Sep 01 2016
Journal Name
Indonesian Journal Of Electrical Engineering And Computer Science
Performance evaluation of heterogeneous network based on RED and WRED
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Publication Date
Wed Aug 10 2011
Journal Name
Ibn Al- Haitham J. For Pure & Appl. S Ci.
A Complete (k,r)-Cap in PG(3,p) Over Galois Field GF(4)
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The aim of t his p aper is t o const ruct t he (k,r)-caps in t he p rojective 3-sp ace PG(3,p ) over Galois field GF(4). We found t hat t he maximum comp let e (k,2)-cap which is called an ovaloid, exist s in PG(3,4) when k = 13. Moreover t he maximum (k,3)-cap s, (k,4)-cap s and (k,5)-caps.

Publication Date
Thu Feb 29 2024
Journal Name
Iraqi Journal Of Science
Monitoring the Expansion of Unplanned Urbanization and its Impact on Climate Change based on Google Earth Engine Service, a Case Study of Baghdad / Iraq
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     The earth's surface comprises different kinds of land cover, water resources, and soil, which create environmental factors for varied animals, plants, and humans. Knowing the significant effects of land cover is crucial for long-term development, climate change modeling, and preserving ecosystems. In this research, the Google Earth Engine platform and freely available Landsat imagery were used to investigate the impact of the expansion and degradation in urbanized areas, watersheds, and vegetative cover on the land surface temperature in Baghdad from 2004 to 2021. Land cover indices such as the Normalized Difference Vegetation Index, Normalized Difference Water Index, and Normalized Difference Built-up Index (NDVI, NDWI, an

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Publication Date
Fri Nov 01 2013
Journal Name
The Iraqi Postgraduate Medical Journal
Clinical and sequential histopathological study of scabietic and postscabietic nodules
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KE Sharquie, SA Al-Mashhadani, AA Noaimi, WM Katof, THE IRAQI POSTGRADUATE MEDICAL JOURNAL, 2013 - Cited by 6

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Publication Date
Wed Jul 08 2020
Journal Name
Plant Archives
ISOLATION AND DIAGNOSIS OF SOME CANDIDA SPECIES FROM SOME BAGHDAD CITY HOSPITALS WITH PCR TECHNIQUE AND EVALUATION OFTHE EFFECTIVENESS OF SOME ANTIFUNGALS
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The current study aimed to isolate and diagnose Candida spp yeasts that cause candidiasis with a PCR device from patients reviewed for some hospitals in Baghdad city and by 190 samples, the study recorded 123 isolates and the total percentage of infection was 64.7% .Samples were taken from different clinical cases of the vagina, blood and mouth and the Candida spp were (70.37%, 41.26%, 86.95%) respectively. Five types of yeasts were isolated and diagnosed, namely C. albicans, C. tropicalis, C. parapsilosis, C. krusei and C.glabarta. They were confirmed by PCR device and the most notable were yeast C. albicans, where 91 isolates were found, 73.98%, while the lowest infection was recorded. C.glabartawith 3 isolates, at 2.43%, significant diff

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Publication Date
Thu Dec 15 2022
Journal Name
Al Kut Journal Of Economics And Administrative Sciences
The relationship of demographic diversity to institutional effectiveness An analytical study of a sample of workers in public organizations in Iraq
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Diversity has become one of the required phenomena to be available within public organizations, in light of the changes taking place in the global and international environment and in various fields. Therefore, it was imperative to study the impact of this phenomenon in various institutions, especially public ones, in most developing countries, including Iraq. The current research aims to analyze the relationship between The demographic diversity and institutional effectiveness of a sample of workers in public institutions included (500) respondents. The questionnaires were distributed to them randomly. Diversity is considered an independent variable and institutional effectiveness a dependent variable. The researcher used interview tools a

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