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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 Aug 11 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The effect of the maximum physical effort on some physiological variables, body components and achievement level in the effectiveness of air rifle shooting
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The job that confronts players with the effectiveness of shooting with an air rifle is high, so it requires necessary functional adaptations that differ in their degrees from other sports. Regular training in air rifle shooting leads to physiological changes in most of the body's internal systems, and changes and responses can be identified. The functional accompanying physical activity through the presence of body components that reflect these physiological changes in the form of changes in some components, and the importance of research lies in studying the physiological changes accompanying the maximum physical effort and the consequent development of the level of achievement in the effectiveness of shooting with air rifle and body

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Publication Date
Mon Oct 15 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
STUDY OF THE EFFECT OF MAGNETIC FIELD POLES ON THE GROWTH OF Staphylococcus AND Streptococcus ISOLATED FROM TOOTH DECAY: STUDY OF THE EFFECT OF MAGNETIC FIELD POLES ON THE GROWTH OF Staphylococcus AND Streptococcus ISOLATED FROM TOOTH DECAY
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The study aimed to determine the impact of energy for the north and south magnetic poles on the the growth of bacteria isolated from cases of tooth decay, 68 swabs were collected from surfaces of faulty tooth, the detected of Staphylococcus aureus

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Southwest Jiaotong University
Inclined Magnetic Field of Non-uniform and Porous Medium Channel on Couple Stress Peristaltic Flow and application in medical treatment (Knee Arthritis)
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The present study analyzes the effect of couple stress fluid (CSF) with the activity of connected inclined magnetic field (IMF) of a non-uniform channel (NUC) through a porous medium (PM), taking into account the sliding speed effect on channel walls and the effect of nonlinear particle size, applying long wavelength and low Reynolds count estimates. The mathematical expressions of axial velocity, stream function, mechanical effect and increase in pressure have been analytically determined. The effect of the physical parameter is included in the present model in the computational results. The results of this algorithm have been presented in chart form by applying the mathematical program.

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Publication Date
Sun Oct 21 2018
Journal Name
Al-kindy College Medical Journal
Evaluation of the clinical examination in thediagnosis of acute medial collateral ligament injury of the knee joint in comparism with examination under general anesthesia
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Background: Tear of MCL of the knee is a frequent problem among knee ligaments injuries.Injuries to the MCL are usually caused by contact on the outside of the knee and are accompanied by sharp pain on the inside of the knee. Contrary to most other knee ligaments the medial collateral ligament (MCL) has an excellent ability to heal, being fairly large and well vascularised structure. The vast majority of isolated medial ligament injuries heal without significant long-term problems

Objectives: is to compare between the early clinical examination, and assessment under general anesthesia (GA), and to find out the best methods to assess the MCL tear especially in suspected cases.

Type

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Publication Date
Sun Dec 02 2018
Journal Name
Journal Of The College Of Education For Women
The Role of Local Satellite Channels in the formation of knowledge and trends of the Iraqi Public Towards Terrorism: A Field Study
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Terrorism is a global phenomenon that engulfs most regions of the world to varying degrees. Media outlets are aware of the many incidents of violence and terrorism that have increased in recent times. The differences between the size of the phenomenon in different societies are the causes and severity of the phenomenon. On the role of local satellite channels in shaping the knowledge and trends of the Iraqi public towards the events of terrorism, in light of the assumptions of reliance on the media. The importance of this study is that it assesses the role of local satellite channels in the formation of knowledge and trends The study seeks to know the extent of exposure of the Iraqi public to local satellite channels, and to reveal the e

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Publication Date
Tue Feb 05 2019
Journal Name
Journal Of The College Of Education For Women
Social Safety Nets and its role in the protection of widows (Problems and advancement options) A field study in the Social Welfare Department for Women
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Current search problem manifested and widows who community harsh to bear hardships and pains، The goals of continuing the sustainability of life and take responsibility, and especially in light of the difficult circumstances in which Iraq is going through, and the displacement of murder and terrorism, which generated huge numbers of widows and orphans Because of the loss of a breadwinner and which became women and children are the most harm to the victim and as a result of wars and armed tendencies So this research is an important and vital topic opens our horizons important for overlapping roles of women widows and their impact on the achievement and status of Iraqi women and that as long as aptly characterized and their ability to end

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Publication Date
Mon Feb 01 2021
Journal Name
Iop Conference Series: Materials Science And Engineering
On modelling and adaptive control of a linear smart beam model interacting with fluid
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Abstract<p>This paper deals with modelling and control of Euler-Bernoulli smart beam interacting with a fluid medium. Several distributed piezo-patches (actuators and/or sensors) are bonded on the surface of the target beam. To model the vibrating beam properly, the effect of the piezo-patches and the hydrodynamic loads should be taken into account carefully. The partial differential equation PDE for the target oscillating beam is derived considering the piezo-actuators as input controls. Fluid forces are decomposed into two components: 1) hydrodynamic forces due to the beam oscillations, and 2) external (disturbance) hydrodynamic loads independent of beam motion. Then the PDE is discretized usi</p> ... Show More
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Publication Date
Sun Apr 01 2007
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Observations on the ultrastructure of a rat mammary gland treated with harmal and borage
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Background : It had been indentified by histological, histochemical and morphometrical studies that peganum harmala is a mammogenic herb and borage officinalis is a lactogenic one . To complete our investigation about these two herbs , we performed electron microscopical study . Materials and methods : Rats were grouped according to their physiological status into three groups . Each group was subdivided in to three subgroups : one control and two experimental . The two experimental group were treated daily; the 1st one with an aqueous extract of peganum harmala seeds and the 2nd with an aqueous extract of borage officinalis flowers . After two weeks of treatment , mammary glands were employed for electron microscopical study . Resu

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program on Nurses- midwives' Knowledge about Pain Management during Labor in Baghdad Maternity Hospitals
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Objectives: To assess nurses-midwives' knowledge about pain management during labor before and after implementation of educational program and to determine the effectiveness of educational program on nurses-midwives' knowledge about pain management during labor in Baghdad Maternity Hospitals.

Methodology: A quasi-experimental design has been conducted during the period of (February 27th 2019 through 2nd June 2019) on non-probability sample (purposive) consists of (44 Nurses/midwives') who are work in delivery room, the sample was exposed to pretest, educational program, posttest. The study was conducted in three Directories, (Baghdad Teaching Hospital) at medical city health

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instruction Program on Pregnant Women’s Knowledge regarding Anemia at Primary Health Care Centers in Baquba City
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Objective: to identify the effect of the Instruction program on the knowledge of pregnant women who suffering anemia.

Methodology: A quasi-experimental design was carried out with the application of pre- post test for the study and the control group. Purposive sample, consists of (60) pregnant women diagnosed with anemia attending four health care centers in Baquba city.

Result: The findings indicate that the level of hemoglobin is increasing post instructional program among women in the study group, in which (46.7%) of women are reveal a level of (8.1-9) g/dl that is less than normal pre instructional program and the level is increased to normal level post instructional

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