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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
Tue Jul 31 2018
Journal Name
Online Journal Of Veterinary Research
Clinical pathology and immuno-histochemistry of mammary tumors from military and pet dogs in Iraq.
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Mammary tumors (CMT) in dogs in Iraq may be induced by carcinogenic war ordnance. In our study, 10 virgin un- spayed military/pet bitches aged 5-15 years presented with abnormal masses in the abdomen with painful oedema, swelling, anorexia, weight loss, weakness and mild fever. Examination of regional lymph nodes and thoracic radiography confirmed metastasis. Tumors were excised and determined to be mostly adenocarcinomas involving multiple glands, solid in texture, 5-15 cm in size, mostly in the inguinal mammary glands at stage T3: >5 cm. Microscopy confirmed presence of adenocarcinoma in 8 dogs and solid carcinoma in 2 with half of tumors being grade III. Tumors had pleomorphic hyperchromatic cell nuclei in stroma, epithelial cells of duc

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Publication Date
Mon Jan 16 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Intervention Program on Nurses’ Performance toward Neonatal Endotracheal Suctioning Procedure
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Objective(s): To evaluate nurses’ Practice toward neonatal endotracheal suctioning procedure, and to determine the effectiveness of the interventional program on nurses’ practices, as well as to find out the relationship between nurses’ practice and their demographic characteristics.

Methodology: A Pre-experimental, one group design, was carried out to achieve the objectives of the current study using the evaluation approach and the implementation of the education program for the period from January 17 to June 31, 2022. A non- probability, purposive sample of (24) nurses were selected from the Neonatal Intensive Care Unit at Pediatric Teaching Hospital/ Medical City Department. A checklist w

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Publication Date
Sat Apr 01 2017
Journal Name
Journal Of Economics And Administrative Sciences
Tacit knowledge of auditors and their reflection on the effectiveness of the performance to some inspectors general offices
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This research aims to find out the extent the reflection of tacit knowledge dimensions (experience, skill, intuition, the ability to think) on Organizational performance of the offices of inspectors general dimensions (internal processes, growth and learning the focus, the focus on the customer) and the measurement and analysis of the type of impact the tacit knowledge of auditors on performance Organizational in inspectors general offices, the research seeks to diagnose the extent of awareness of Office Management knowledge implicit and the attention span of the administration in determining levels and performance levels, and the resolution means the main information-gathering adopted by the researcher, which, as well as his exp

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Publication Date
Wed Jan 01 2025
Journal Name
Aip Conference Proceedings
Predicting biochemical oxygen demand at Al-Rustumiya wastewater treatment plant inlet using the artificial neural network
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Publication Date
Sat Mar 01 2014
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Effectiveness of the organization and its role in achieving the requirements of Strategic success: A survey study of the opinions of a sample of workers at the Asia Telecom Company in Baghdad
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The research aims present to highlight the importance of creating construction Organizational appropriate to achieve strategic success and reduce many of the negative effects experienced by organizations has been developing his questionnaire especially so was distributed to a sample of workers in the Asia-cellular as sample included (60) responsive 0 and can embody intellectual dilemma following questions (What are the dimensions of the organizational infrastructure, and what are the justifications for carrying out the reform and development cleared the organizational structure to make it more flexible) to contribute to the achievement of the strategic requirements for success of the organization surveyed.
Find recommended a number o

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Publication Date
Mon Mar 25 2019
Journal Name
Al-academy
Effectiveness of Interpretation in Graphic Design: سحر علي سرحان
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The interpretation is one of the means used to by the designer to construct his perceptions of the world in which he lives, either to better understand or rediscover or reproduce the new thing and the creative thing which is characterized by novelty and originality. The design innovations in the political posters, achieved by the designer, result from his perceptions for the response towards a certain subject through what he has of practical experience to interpret his ideas and his desire to achieve harmony with the reality and compatibility with his aims in visible visual effects that will be established in the recipient's memory and stimulate his senses in the realization of the content of the media message. The political poster has a

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Publication Date
Tue Jun 14 2022
Journal Name
Al-academy
The effectiveness of the deconstructive pattern in theatrical performance
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Theatrical art, from (Plato) to (Heidegger), passing through (Husserl) and (Husserl) has propagated the parallel relations between the overlapping formal patterns in the world of hypotheses crowded with diaspora and scattering, leading to the manifestations of implicit meaning in the intellectual and aesthetic discourse, through the deconstructive pattern that restructures The aesthetic image according to the aesthetic data to be employed, so the effectiveness of the deconstructive system had an important role in authorizing the Ghanaian logic and continuity on which the Western meta meaning was based, and the artistic scene was subjected to it in line with literature and art to be able to pay attention to the achievement and clarify it

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Publication Date
Fri Jun 30 2023
Journal Name
Ingénierie Des Systèmes D Information
Performance Evaluation of a Multi Organizations Secure Internet of Vehicles Based on Hyperledger Fabric Blockchain Platform
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Publication Date
Sun Jun 13 2021
Journal Name
Molecular Crystals And Liquid Crystals
Liquid crystal behavior of Ag(I) complexes based on a series of mesogenic 1,3,4-thiadiazole ligands
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Publication Date
Tue Nov 01 2016
Journal Name
International Journal Of Pharmaceutical Sciences Review And Research
A study on some variables affecting the preparation of ethyl cellulose based floating microspheres of lafutidine
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Lafutidine (LAF) a newly developed histamine H2-receptor antagonist with absorption window makes it a good candidate to be prepared as floating drug delivery system. The current study involves formulation and in- Vitro evaluation of lafutidine as floating microspheres. Different formulation variables that affect the physicochemical properties of the prepared microspheres besides to the drug release behavior were investigated. Fourteen formulas were prepared by emulsion (o/w) solvent evaporation method using Ethyl cellulose (EC) as the polymeric matrix and tween 80 (TW80) as an emulsifying agent. The prepared formulas were evaluated for their percentage buoyancy (%), Percentage yield (%) and Entrapment efficiency (EE %). The results obt

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