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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
Sun Jun 30 2019
Journal Name
Journal Of The College Of Education For Women
Ready-made clothes for students of the University of Baghdad between reality and ambition ( A field study )
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     تعد الملابس وسيلة هامة لكل مايقوم به الانسان في حياته العامة ، فهي الانطباع والكلمة الخارجية عن ذاته الداخلية فهي تعكس فكرة الفرد عن ذاته وعن شخصيته , كما تعد وسيلة تعبير جمالية وفنية , فهي تساعد على اخفاء عيوب الجسد وابراز محاسنه . ويتوقف اختيار الفرد لملابسه على مجموعة  عوامل منها احتياجه , قدراته المالية , سنه , مركزه الاجتماعي , طبيعة عمله ,الظروف الجوية التي يعيش فيها وعلى مايُؤمن به من قيم و

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Publication Date
Fri Dec 01 2023
Journal Name
Food Bioscience
Green synthesis of silver nanomaterials and evaluation of their antibacterial and antioxidant effectiveness in chicken meat
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Publication Date
Sun Sep 15 2024
Journal Name
Journal Of Baghdad College Of Dentistry
The reliability of insertion torque as an indicator for primary stability in immediate dental implant: A prospective clinical study
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Background: The primary stability of the dental implant is a crucial factor determining the ability to initiate temporary implant-supported prosthesis and for subsequent successful osseointegration, especially in the maxillary non-molar sites. This study assessed the reliability of the insertion torque of dental implants by relating it to the implant stability quotient values measured by the Osstell device. Material and methods: This study included healthy, non-smoker patients with no history of diabetes or other metabolic, or debilitating diseases that may affect bone healing, having non-restorable fractured teeth and retained roots in the maxillary non-molar sites. Primary dental implant stability was evaluated using a torque ratc

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Publication Date
Wed Feb 01 2023
Journal Name
South Asian Journal Of Social Sciences And Humanities
The Impact of the Sustainable Strategy on Strategic Performance: Field Study in the Iraqi Tourism Sector
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The tourism industry, with its two sides (recreational and religious), is one of the important investment fields in Iraq, it is represented Iraq as the second economic source after the oil sector. So a need for serious efforts to develop the tourism sector and maintain its sustainability. This paper will be one of the important contributions in this field; the paper aims to explore the extent of the impact of the sustainable strategy on the level of overall performance in the Iraqi tourism sector. The field of research was some Iraqi tourist institutions at Iraqi tourism, Which covers the field of study on the one side, and can be studied on the other side, for the developing study methodology and organizing its main parts, the research pap

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Publication Date
Mon Sep 01 2003
Journal Name
Iraqi Journal Of Tropical Disease Researches
The isolation and identification of some pathogenic bacteria from clinical cutaneous infection in human
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Publication Date
Thu Feb 19 2026
Journal Name
International Journal Of Surgery Open
Secondary trigeminal neuralgia: an in-depth review of etiopathology, clinical manifestations, and management approaches
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Secondary trigeminal neuralgia (STN) results from an identifiable underlying pathology, including tumor compression, multiple sclerosis, arteriovenous malformations, hypertension, structural lesions, inflammation, trauma, or familial genetic conditions. This study, through a comprehensive review of the literature in PubMed, Google Scholar, Web of Science, and the Cochrane Library, explores the multifaceted aspects of STN. This study delves into the diverse etiological factors, focusing on the pathophysiological mechanisms that lead to trigeminal nerve dysfunction. The clinical manifestations of STN often overlap with those of primary trigeminal neuralgia, creating diagnostic challenges and necessitating a thorough evaluation that in

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Prevalence and Characterization of Some Colibactin Genes in Clinical Enterobacteriaceae isolates from Iraqi Patients
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The members of the family of Eentrobacteriaceae harbour a gene cluster called polyketide synthase (pks) island. This cluster is responsible for the synthesis of the genotoxin colibactin that might have an important role in the induction of double-strand DNA breaks, leading to promote human colorectal cancer (CRC). Eleven out of the eighty eight isolates (12.5%) were pks+, distributed as 7 (8%) isolates of E. coli, 2 (2.25%) of K. pneumoniae and 2 (2.25%) of E. aerogenes. The cytotoxic effects of selected pks+ isolates (E. coli and E. aerogenes) on HeLa cells were represented by decreasing cell numbers and enlarged cell nuclei in comparison to the untreated cells. Cytological changes were observed when the infected HeLa cells culture

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Publication Date
Tue Sep 08 2020
Journal Name
Baghdad Science Journal
Prevalence and Characterization of Some Colibactin Genes in Clinical Enterobacteriaceae isolates from Iraqi Patients
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The members of the family of Eentrobacteriaceae harbour a gene cluster called polyketide synthase (pks) island. This cluster is responsible for the synthesis of the genotoxin colibactin that might have an important role in the induction of double-strand DNA breaks, leading to promote human colorectal cancer (CRC). Eleven out of the eighty eight isolates (12.5%) were pks+, distributed as 7 (8%) isolates of E. coli, 2 (2.25%) of K. pneumoniae and 2 (2.25%) of E. aerogenes. The cytotoxic effects of selected pks+ isolates (E. coli and E. aerogenes) on HeLa cells were represented by decreasing cell numbers and enlarged cell nuclei in comparison to the untreated cells. Cyt

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Publication Date
Sun Dec 09 2018
Journal Name
Baghdad Science Journal
Detection of Pseudomonas aeruginosa in Clinical Samples Using PCR Targeting ETA and gyrB Genes
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Pseudomonas aeruginosa has variety of virulence factors that contribute to its pathogenicity. Therefore, rapid detection with high accuracy and specificity is very important in the control of this pathogenic bacterium. To evaluate the accuracy and specificity of Polymerase Chain Reaction (PCR) assay, ETA and gyrB genes were targeted to detect pathogenic strains of P. aeruginosa. Seventy swab samples were taken from patients with infected wounds and burns in two hospitals in Erbil and Koya cities in Iraq. The isolates were traditionally identified using phenotypic methods, and DNA was extracted from the positive samples, to apply PCR using the species specific primers targeting ETA, the gene encoding for exotoxin A, and gyrB gene. The res

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Publication Date
Mon May 25 2020
Journal Name
Journal Of Xi'an University Of Architecture & Technology
Iraqi Virtual Science Library (IVSL)): A field study of Iraqi researcher’s viewpoint
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The aim of the research is to shed light on the stages of developing the Iraqi virtual science Library(IVSL) project, and to define its distinctive role in providing all kinds of electronic resources to researchers from professors and graduate students, to identify its contents , the entry interfaces and applications of use, and provide them through electronic portals to publishing houses, research institutions and international universities, The research sample included the teaching staff and researchers participating in educational qualification courses at the Continuing Education Center at the University of Baghdad, The research population and its sample consisted of the category of (IVSL) users, and its sample (387) users. Analysis meth

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