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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
Mon Sep 08 2025
Journal Name
Expert Review Of Pharmacoeconomics &amp; Outcomes Research
A comprehensive measurement of hemophilia economic burden in Iraq: a field-based study
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Publication Date
Fri Apr 04 2025
Journal Name
European Journal Of Dentistry
The Effectiveness of Conventional and Advanced Aligning Archwires: The Insights of Two Randomized Clinical Trials
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Abstract<p> Objectives This study aimed to compare the clinical effectiveness of four aligning archwires: Superelastic Nickel-Titanium (Superelastic-NiTi), SmartArch, Copper-Nickel-Titanium (Cu-NiTi), and Speed Tubular coaxial-Nickel-Titanium (Tubular coaxial-NiTi), regarding the alignment efficiency, associated perception of pain, and possibility of inducing root resorption.</p><p> Materials and Methods This study includes two randomized clinical trials run in parallel. Patients with 5 to 9 mm of mandibular anterior teeth crowding according to Little's irregularity index (LII) who needed fixed orthodontic appliances without extraction were randomly assigned to four groups of</p> ... Show More
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Publication Date
Sun Feb 22 2026
Journal Name
Clinical Drug Investigation
A Field-Based Cost-Effectiveness Study of Aflibercept and Bevacizumab in Treat-and-Extend Versus Pro Re Nata Protocols for Diabetic Macular Edema in Iraq
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Publication Date
Mon Aug 12 2024
Journal Name
Al-rafidain J Med Sci
Identifying Clinical and Biochemical Predictors of Seizures in Children with Acute Bacterial Meningitis: Insights from a Cross-Sectional Study
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Background: The occurrence of seizures in bacterial meningitis is important, as it has been reported to increase the risk of complications; however, its frequency and predictors are not well studied yet. Objective: To assess the frequency, clinical, and biochemical predictors of seizures in children with acute bacterial meningitis. Method: A cross-sectional study recruited confirmed acute bacterial meningitis cases based on positive CSF culture and sensitivity among children aged 2 months to 15 years admitted to the Central Child Teaching Hospital emergency department in Iraq. Patients were divided into two groups based on seizure at presentation time. Demographic characteristics [age, gender, residence, duration of fever and disease, prese

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Entry cost based on activity-based cost specifications and comparative study
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Several recent approaches focused on the developing of traditional systems to measure the costs to meet the new environmental requirements, including Attributes Based Costing (ABCII). It is method of accounting is based on measuring the costs according to the Attributes that the product is designed on this basis and according to achievement levels of all the Attribute of the product attributes. This research provides the knowledge foundations of this approach and its role in the market-oriented compared to the Activity based costing as shown in steps to be followed to apply for this Approach. The research problem in the attempt to reach the most accurate Approach in the measurement of the cost of products from th

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Publication Date
Tue Mar 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effectiveness of prophylactic agents in prevention of oral mucositis in patients with head and neck cancer receiving radiotherapy
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Background: Oral mucositis is regarded as one of the major complications of radiation therapy especially in patients with head and neck cancer. The aim of this study was to evaluate the efficacy of glutamine in preventing or minimizing the development of mucositis of the oral cavity. Subjects and methods: Forty-six participants were randomly selected amongst those who were planned to receive radiation therapy for head and neck region cancers. They were randomly divided into two groups of 23 subjects, one group received glutamine and the second group received a placebo. Results: Glutamine had a statistically significant effect in reducing the occurrence and/or severity of oral mucositis in the treated patients compared to patients in the con

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Publication Date
Tue Oct 29 2019
Journal Name
Journal Of Engineering
Demand Priority in a Power System With Wind Power Contribution Load Shedding Scheme Based
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The load shedding  scheme has been extensively implemented as a fast solution for unbalance conditions. Therefore, it's crucial to investigate supply-demand balancing in order to protect the network from collapsing and to sustain stability as possible, however its implementation is mostly undesirable. One of the solutions to minimize the amount of load shedding is the integration renewable energy  resources, such as wind power, in the electric power generation could contribute significantly to minimizing power cuts as it is ability to positively improving the stability of the electric grid. In this paper propose a method for shedding the load base on the priority demands with incorporating the wind po

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Publication Date
Tue Nov 19 2024
Journal Name
Review Of Clinical Pharmacology And Pharmacokinetics - International Edition
Clinical use of tumor necrosis factor-alpha inhibitors in Iraq: a review of their documented efficacy, safety, and associated genetics
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This comprehensive review examines the efficacy and safety of tumor necrosis factor-alpha (TNF-α) inhibitors in treating various autoimmune diseases, and focuses on their application in Iraqi patients. Elevated TNF-α levels are linked to autoimmune disorders, leading to the development of anti-TNF-α therapies such as infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab, which have gained FDA approval for conditions like psoriasis, in¬flammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis. While these therapies demonstrate sig¬nificant therapeutic benefits, including improved quality of life and disease management, they also carry risks, such as increased susceptibility to infections and pote

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Publication Date
Sun Dec 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Prediction of penetration Rate and cost with Artificial Neural Network for Alhafaya Oil Field
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Prediction of penetration rate (ROP) is important process in optimization of drilling due to its crucial role in lowering drilling operation costs. This process has complex nature due to too many interrelated factors that affected the rate of penetration, which make difficult predicting process. This paper shows a new technique of rate of penetration prediction by using artificial neural network technique. A three layers model composed of two hidden layers and output layer has built by using drilling parameters data extracted from mud logging and wire line log for Alhalfaya oil field. These drilling parameters includes mechanical (WOB, RPM), hydraulic (HIS), and travel transit time (DT). Five data set represented five formations gathered

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Publication Date
Fri Oct 01 2010
Journal Name
2010 Ieee Symposium On Industrial Electronics And Applications (isiea)
Effectiveness of the cumulative vs. normal mode of operation for combinatorial testing
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