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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 Mar 10 2025
Journal Name
Proceedings On Engineering Sciences
WAREHOUSE IN INDUSTRY 4.0 BASED DRONE, COMPUTER VISION, AND ARTIFICIAL INTELLIGENCE TECHNOLOGIES: A LITERATURE REVIEW
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Publication Date
Fri Apr 01 2016
Journal Name
Journal Of Engineering
Satellite Images Classification in Rural Areas Based on Fractal Dimension
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Fractal geometry is receiving increase attention as a quantitative and qualitative model for natural phenomena description, which can establish an active classification technique when applied on satellite images. In this paper, a satellite image is used which was taken by Quick Bird that contains different visible classes. After pre-processing, this image passes through two stages: segmentation and classification. The segmentation carried out by hybrid two methods used to produce effective results; the two methods are Quadtree method that operated inside Horizontal-Vertical method. The hybrid method is segmented the image into two rectangular blocks, either horizontally or vertically depending on spectral uniformity crit

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical significance of Osteoprotegerin, Vitamin D, Obestatin and some biochemical variables in Kidney failure Patients
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Chronic kidney disease (CKD) is described as an abnormalities of renal function, existing for a long period of time. By reason of the early grades of Chronic kidney disease can be experiences no symptoms, its premature identification is strenuous. initial stage CRD can cause various complications, such as anemia, matabolyic disorders of bone mineral. The study was done to assess the effect the chronic renal disease stage on the Osteoprotegerin, 1,25 dihydroxyvitamin D, Obestatin levels and some biochemical parameters in patients not undertaken dialysis therapy. In this case-control study fifty-five patients with Kidney failure and fourty healthy people were examined. Circulating concentrations of Osteoprotegerin, 1,25 dihydroxyvitamin D

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Publication Date
Thu Nov 08 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of osteoporosis prevention instruction program on nursing college students’ knowledge at Baghdad University
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Objective(s): Assess the effectiveness of osteoporosis prevention instruction program on nursing college students’
knowledge at Baghdad University.
Methodology: A quasi-experimental design was used to assess the effectiveness of osteoporosis prevention
instruction program on nursing college students at University of Baghdad from April 2011 to September 2011. A
random sample consisted of (40) females students from first year of Nursing College \ Baghdad University. The data
was collected by using constructed questionnaire, which consists of three parts. Part one: consists of demographic
information and health characteristics .Part two: consists of students’ daily life behaviors which include, dietary
behaviors, an

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Publication Date
Mon Jul 01 2019
Journal Name
Iop Conference Series: Materials Science And Engineering
Wells location effect on the underground gas storage in UM ERadhuma Formation-Ratawie oil field
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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Economics And Finance Studies
RELATIONSHIP BETWEEN COST REDUCTION AND REEVALUATING CUSTOMERS' DESIRES: THE MEDIATING ROLE OF SUSTAINABLE DEVELOPMENT
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Publication Date
Thu Oct 14 2021
Journal Name
Kufa Medical Journal
The Relationship between Knowledge and Practice in Clinical Breast Examination among Women in Baghdad, Iraq
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Aim: This study aims to determine both the level  of knowledge, attitude, and practice  in clinical breast examination in women and the relationship between knowledge and practice.Data collection was performed within a three-month period starting from February 2019 on.  Subjects and Method: A cross-sectional analytical study included 657 non-randomly selected women visiting primary health care centers in Baghdad city with an average of age between (20-59) years old.  Results: Only 51.8% ever heard of clinical breast examination. The mean knowledge score for clinical breast examination was (51.2±44). Only 5.5% of women performed regular clinical breast examinations. Participants who adequately practice clinical breast examinatio

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Investigate the effectiveness of investment in the electricity sector And its role in achieving sustainable development
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The provision of electric power is necessary for the advancement of the country's economy. It is the main engine of the economy and its various activities. It is an indicator of social welfare and it is considered as the basic pillars for achieving sustainable development (economic, social, environmental and institutional) by raising the levels of performance and meeting local needs. The problem of research was the absence of a program to audit the performance of the electricity sector contributes to ensure the application of sustainable development. The research was based on the hypothesis that the preparation of a proposed program to audit the performance of the electricity sector contributes to the achievement of The researchers sough

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Publication Date
Tue May 01 2018
Journal Name
2018 2nd Ieee Advanced Information Management,communicates,electronic And Automation Control Conference (imcec)
Hybrid Regressor and Approximation-Based Adaptive Control of Robotic Manipulators with Contact-Free Motion
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Publication Date
Wed Oct 08 2025
Journal Name
Key Engineering Materials
Improved Performance of Hydrogen Sulfide Gas Sensor Based on Zinc Oxide Nanostructures Thermally Synthesized Doped with Silver Nanoparticles and Multi-Walled Carbon Nanotubes
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The present work reports an approach of hydrothermal growth of ZnO nanorods, which simplifies the production of low cost films with controlled morphology for H2S gas sensor application. The prepared ZnO nanorods exhibit a hexagonal wurtzite phase analyzed by the X-ray diffraction analysis. The FTIR spectra provide information that the band located between 465-570 cm-1 corresponds to the stretching bond of Zn-O, which confirms the creation of ZnO. PL spectroscopic studies showed that the doping of Ag NPs and f-MWCNT in the ZnO matrix leads to the tuning of the bandgap. The SEM analysis showed the morphology of ZnO was the nanorods. The nanocomposites Ag/ZnO and F-MWCNT/ZnO which prepared, sep

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