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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
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Tue May 31 2022
Journal Name
Journal Of Positive School Psychology
A GENRE-BASED ANALYSIS OF POLITICAL SPEECHES IN THE UN GENERAL ASSEMBLY
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Publication Date
Thu Mar 24 2022
Journal Name
Arab World English Journal
Collocation Networks of Selected Words in Academic Writing: A Corpus-Based Study
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This study aims at shedding light on the linguistic significance of collocation networks in the academic writing context. Following Firth’s principle “You shall know a word by the company it keeps.” The study intends to examine three selected nodes (i.e. research, study, and paper) shared collocations in an academic context. This is achieved by using the corpus linguistic tool; GraphColl in #LancsBox software version 5 which was announced in June 2020 in analyzing selected nodes. The study focuses on academic writing of two corpora which were designed and collected especially to serve the purpose of the study. The corpora consist of a collection of abstracts extracted from two different academic journals that publish for writ

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Publication Date
Fri Jun 30 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Instruction Program on Teachers’ Performance of Counseling for Primary School Pupils regarding Attention Deficit and Hyperactivity Disorder
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Objective(s): To evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, to identify the relationship between Teachers’ Performance of Counselling for Pupils with Attention Deficit and Hyperactivity Disorder and their demographic.

Methodology: A quasi-experimental (pre-posttest) design was carried out to evaluate teachers’ performance of counseling for pupils with Attention Deficit and Hyperactivity Disorder, at Al-Firdous mixed primary School and to find out the association between teachers' performance about Attention Deficit and Hyperactivity Disorder and their socio-demographic characteristic. The study was started from 18th September 2

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Publication Date
Sun Nov 26 2017
Journal Name
Journal Of Engineering
Reservoir Characterizations and Reservoir Performance of Mishrif Formation in Amara Oil Field
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Mishrif Formation is the main reservoir in Amara Oil Field. It is divided into three units (MA, TZ1, and MB12). Geological model is important to build reservoir model that was built by Petrel -2009. FZI method was used to determine relationship between porosity and permeability for core data and permeability values for the uncored interval for Mishrif formation. A reservoir simulation model was adopted in this study using Eclipse 100. In this model, production history matching executed by production data for (AM1, AM4) wells since 2001 to 2015. Four different prediction cases have been suggested in the future performance of Mishrif reservoir for ten years extending from June 2015 to June 2025. The comparison has been mad

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Publication Date
Wed Nov 01 2017
Journal Name
Journal Of Engineering
Stator Faults Diagnosis and Protection in 3-Phase Induction Motor Based on Wavelet Theory
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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Engineering
Petrophysical Analysis of an Iraqi Gas Field (Mansuriya Gas Field)
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Mansuriya Gas field is an elongated anticlinal structure aligned from NW to SE, about 25 km long and 5-6 km wide. Jeribe formation is considered the main reservoir where it contains condensate fluid and has a uniform thickness of about 60 m. The reservoir is significantly over-pressured, (TPOC, 2014).

This research is about well logs analysis, which involves the determination of Archie petrophysical parameters, water saturation, porosity, permeability and lithology. The interpretations and cross plots are done using Interactive Petrophysics (IP) V3.5 software.

The rock parameters (a, m and n) values are important in determining the water saturation where (m) can be calcul

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Publication Date
Mon Jun 01 2015
Journal Name
Iraqi Journal Of Science
Simulation of Solar Coronal Magnetic Field Using Potential Field Model
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In this paper, 3D simulation of the global coronal magnetic field, which use observed line of sight component of the photosphere magnetic field from (MDI/SOHO) was carried out using potential field model. The obtained results, improved the theoretical models of the coronal magnetic field, which represent a suitable lower boundary conditions (Bx, By, Bz) at the base of the linear force-free and nonlinear force free models, provides a less computationally expensive method than other models. Generally, very high speed computer and special configuration is needed to solve such problem as well as the problem of viewing the streamline of the magnetic field. For high accuracy special mathematical treatment was adopted to solve the computation comp

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Publication Date
Thu Jun 24 2021
Journal Name
Frontiers In Medicine
The Characterisation of the Craniofacial Morphology of Infants Born With Zika Virus; Innovative Approach for Public Health Surveillance and Broad Clinical Applications
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Background: This study was carried out in response to the Zika virus epidemic, which constituted a public health emergency, and to the 2019 WHO calling for strengthened surveillance for the early detection of related microcephaly. The main aim of the study was to phenotype the craniofacial morphology of microcephaly using a novel approach and new measurements, and relate the characteristics to brain abnormalities in Zika-infected infants in Brazil to improve clinical surveillance.

Methods: 3D images of the face and the cranial vault of 44 Zika-infected infants and matched healthy controls were captured using a 3D stereophotogrammetry system. The CT scans of the brain of t

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Publication Date
Wed Jun 11 2025
Journal Name
Academic Science Journal
Review Article: Tumor Markers, Types and Clinical Applications
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Over the past ten years, tumor markers have played an increasingly important role in clinicaloncology. This trend is expected to continue as technology advances and our knowledge of thehuman body and disease processes grows. In the treatment of cancer, tumor markers are widelyused for a variety of purposes, including screening, selecting a management strategy,determining the prognosis, and post-therapy follow-up. A comprehensive of the fundamentalsof pathophysiology and identification strategies for each specific malignancy is necessary fortheir prudent application in clinical practice. Oncology's use of cancer biomarkers hastransformed the way that cancer is treated, and led to notable improvements in patient outcomesand cancer tre

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