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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 01 2025
Journal Name
Nigerian Postgraduate Medical Journal
The Effectiveness of Deep Breathing Exercise Training Program in Reducing Discomfort Symptoms amongst Undergoing Haemodialysis: A Randomised Controlled Trial
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Background:

Chronic kidney disease is one of the leading public health problems that affect millions of women and men worldwide.

Aims:

This study aims to examine the effect of deep breathing to reduce discomfort amongst patient undergoing haemodialysis (HD).

Materials and Methods:

This randomised controlled experimental study was conducted consisted of 108 patients (54 in each group) who undergoing HD in hospitalised adults’ patients between November 2024 an

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Publication Date
Tue May 01 2012
Journal Name
First Eage Workshop On Iraq - Hydrocarbon Exploration And Field Development
Microfacies and Petrographic study for Yamama formation in Ratawi field
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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Assessing Asphalt and Concrete Pavement Surface Texture in the Field
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The incorporation of safety characteristics into the traditional pavement structural design or in the functional evaluation of pavement condition has not been established yet. The design has focused on the structural capacity of the roadway so that the pavement can withstand specific level of repetitive loading over the design life. On the other hand, the surface texture condition was neither included in the AASHTO design procedure nor in the present serviceability index measurements.

The pavement surface course should provide adequate levels of friction and ride quality and maintain low levels of noise and roughness. Many transportation departments perform routine skid resistant testing, the type of equipment us

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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Science
Detection of Zn Water Pollution by a Biosensor Based on Alkaloids Derived from Iraqi Catharanthus Roseus
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     In this work, the detection of zinc (Zn) ions that cause water pollution is studied using the CSNPs- Linker-alkaloids compound that was prepared by linking extracted alkaloids from Iraqi Catharanthus roseus plant with Chitosan nanoparticles (CSNPs) using maleic anhydride. This compound is characterized by an X-ray diffractometer (XRD) which shows that it has an orthorhombic structure with crystallite size in the nano dimension. Zeta Potential results show that the CSNPs-Linker-alkaloids carried a positive charge of 54.4 mV, which means it possesses high stability.  The Fourier transform infrared spectroscopy (FTIR) shows a new distinct band at 1708.93 cm-1 due to C=O esterification. Scanning electron microscope (SEM) image

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Publication Date
Mon Jul 04 2022
Journal Name
Journal Of Petroleum Exploration And Production Technology
Effect of acid treatment on the geomechanical properties of rocks: an experimental investigation in Ahdeb oil field
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Acidizing is one of the most used stimulation techniques in the petroleum industry. Several reports have been issued on the difficulties encountered during the stimulation operation of the Ahdeb oil field, particularly in the development of the Mishrif reservoir, including the following: (1) high injection pressures make it difficult to inject acid into the reservoir formation, and (2) only a few acid jobs have been effective in Ahdeb oil wells, while the bulk of the others has been unsuccessful. The significant failure rate of oil well stimulation in this deposit necessitates more investigations. Thus, we carried out this experimental study to systematically investigate the influence of acid treatment on the geomechanical properties of Mi4

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Publication Date
Wed Jan 01 2025
Journal Name
Academic Science Journal
Role of efflux pump genes in the antibiotic resistance of Klebsiella pneumoniae bacteria isolated from clinical cases: A Review Paper
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Publication Date
Sun Dec 07 2014
Journal Name
Baghdad Science Journal
The Effect of Sodium Selenite and Vitamin A on FSH and LH Level in Albino Male Mice treated with Hexavalent Chromium
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The present expermint was designed to determine the effect of Sodium Selenite (0.5 mg/kg) and Vitamin A (10 mg/kg) in FSH and LH level in Albino Male Mice treated with Hexavalent Chromium (1000 ppm). `This study included 48 mice divided into six groups (1st group treated with distilled water and the 2nd group treated with Sesame Oil were considered as control group, 3th group exposed to Hexavalent chromium , 4th group treated with Sodium Selenite and exposed to Hexavalent Chromium , 5th group treated with Vitamin A and exposed to Hexavalent Chromium and 6th group treated with Sodium Selenite and Vitamin A and exposed to Hexavalent Chromium ) . The treatment lasted for 35 days. The results showed a significant (P ? 0.05) decrease in FSH an

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Publication Date
Sun May 01 2016
Journal Name
Journal Of Engineering
Field Observation of Soil Displacements Resulting Due Unsupported Excavation and Its Effects on Proposed Adjacent Piles
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Soil movement resulting due unsupported excavation nearby axially loaded piles imposes significant structural troubles on geotechnical engineers especially for piles that are not designed to account for loss of lateral confinement. In this study the field excavation works of 7.0 m deep open tunnel was continuously followed up by the authors. The work is related to the project of developing the Army canal in the east of Baghdad city in Iraq. A number of selected points around the field excavation are installed on the ground surface at different horizontal distance. The elevation and coordinates of points are recorded during 23 days with excavation progress period. The field excavation process was numerically simulated by using the finite

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Publication Date
Thu Feb 09 2023
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of A cognitive Behavioral Counseling Program in Enhancing Self-Management in Reducing the Academic Procrastination of Tenth grade male Students
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This study aims to find out the effectiveness of a cognitive-behavioral counseling program in enhancing self-management in reducing the academic procrastination of tenth-grade male students. The sample consisted of (26) male students divided into an experimental group of (13) students and a control group of (13) students. Two scales of self-management and academic procrastination were used, prepared by the researcher. The counseling program was prepared by the researcher. The results showed the program's effectiveness in enhancing self-management and reducing academic procrastination in the posttest, as it showed the continuation of this enhancement in self-management and the increase in the reduction of procrastination in the follow-up

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Publication Date
Wed Oct 11 2023
Journal Name
Journal Of Educational And Psychological Researches
Motivations of Volunteers in Jordan: An Exploratory Study Based on a Sample of University Students within the Context of their Social Relations
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Volunteerism is an element included in many human cultures. It represents a positive cooperative act between individuals and groups. It expresses the social value systems. As a social phenomenon, it develops in societies according to innumerous circumstances and conditions. This study uses a functional approach that assumes that volunteering performs six functions for volunteers. Namely, we assume that volunteering (1) creates a sense of protection (2) meets significant cultural values (3) improves professional status of volunteers, (4) strengthens their social relationships, (5) helps them achieve a better understanding of life, and finally, (6) enhances their outlook and self-esteem. The central aim of the study is to discuss these fun

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