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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
Sat Dec 21 2019
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Clinical Complications of Beta-Thalassemia Major
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Beata thalassemia

Beta thalassemia syndrome by reduction or absence of B-globin chain synthesis. Without iron chelation therapy (ICT) the regular blood transfusion would increase the iron stores to several times. Endocrine glands are vulnerable to iron overload causing endocrine dysfunction.  Iron deposition within the parathyroid gland causes hypoparathyroidism particularly after ten years of age. Pancreatic islets are very susceptible to oxidative damage due to iron overload; their high divalent metal expression makes them highly susceptible to iron-catalyzing oxidative stress. The pathogenicity of osteopathy in  is multifactorial comprising environmental (diet and lifestyle), iatrogenic (medicines), genetic and acqui

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Economics And Administrative Sciences
Effect of Job Burnout on Employee Performance: Field Research in the General Company for Vegetable Oil Industry
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Abstract

      This research aims to know the effect of job burnout in the worker’s performance. The researcher presented a theoretical basis for job burnout and the worker's performance. In order to achieve the objectives of the research, a hypothesis was drawn up that determines the nature of the relationship between the independent variable of job burnout and its dimensions (reduced personal accomplishment, depersonalization, Emotional Exhaustion) and variable dependent performance of workers dimensions (productivity, job satisfaction, organizational commitment, creativity), And to represent the volume of this community according to (de Morgan, D. Morgan) glo

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Publication Date
Thu Sep 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
The impact of corporate governance on narrowing the expectations gap in the audit work environment (field study)
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The different crises and financial collapses place in many companies, particularly in developed countries as a result of administrative and financial corruption return aspects of the task to the role of the company and the external auditor, both in their emphasis on honesty and fairness of financial statements and the Provisions of accounting information and on the contrary to the truth, you may have to the loss of the rights of stakeholders, particularly existing investors, and the loss of confidence of prospective investors in the accounting information contained in the financial statements of these companies, which led to a crisis of confidence and credibility in the profession of accounting and auditing where the wonder of ma

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Publication Date
Sun Dec 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Analysis of Stuck Pipe Incidents in Khabaz Field
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There are many events which causes nonproductive time (NPT) in the drilling industry. The mostly effective in this NPT is pipe sticking event. A considerable amount of time and resources can be spent in efforts to free a stuck pipe. In addition, Unsuccessful fishing operations results in costly alternatives including side-tracking. The drilling in Khabaz oil field poses many operational challenges among of them stuck pipe , lost circulation, flow of salt water during drilling, and hole caving. Stuck pipe can be considered the quite difficult problem in Khabaz oil field due to associated incidents which lead to NPT activities.Well Khabaz -34 was selected to study the problem of stuck pipe in this field. An analysis of stuck pipe even

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Obstacles to development in the field of education
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Education is the most powerful and important weapon in fighting poverty and unemployment because it provides students with new skills that appropriate the new market requirements and fair distribution of natural resources. It also transfers knowledge, skills, and ethics over generations. Education aims to create effective leaders who go under training and rehabilitation process, create a new human and instill faith, generate the creativity and innovation, and keep abreast with scientific process, updating curriculum, and finally, applying the technical education

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Publication Date
Sun Dec 30 2018
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Analysis of Stuck Pipe Incidents in Khabaz Field
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There are many events which causes nonproductive time (NPT) in the drilling industry. The mostly effective in this NPT is pipe sticking event. A considerable amount of time and resources can be spent in efforts to free a stuck pipe. In addition, Unsuccessful fishing operations results in costly alternatives including side-tracking. The drilling in Khabaz oil field poses many operational challenges among of them stuck pipe , lost circulation, flow of salt water during drilling, and hole caving. Stuck pipe can be considered the quite difficult problem in Khabaz oil field due to associated incidents which lead to NPT activities.
Well Khabaz -34 was selected to study the problem of stuck pipe in this field. An analysis of stuck pipe event

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Publication Date
Wed Sep 20 2023
Journal Name
Scientific Culture
THE REALITY OF THE PARTICIPATION OF FEMALE ENTREPRENEURS IN ACHIEVING THE GOALS OF SUSTAINABLE DEVELOPMENT/ A FIELD STUDY IN BAGHDAD GOVERNORATE
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Abstract In light of the changing conditions that prevail in society, and the intense competition that institutions and countries are forced to face, especially after the opening of markets, and the transformation of the world into what is called a small village, entrepreneurship has emerged as an important tool for dealing with the developments of societies, whether it is related to individual business projects or Economics for national business, leadership was the key to any driving force towards achieving growth. Today, women are no longer captive to a specific orientation, but rather all horizons and fields of work have been opened to them, and they have been able to occupy the most important economic, voluntary, service, and

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Economics And Administrative Sciences
application of business managment in the field of football with studuy of the case of spanish club (Real Madrid) و (Barcelona
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Football has progressed from being a ritual and a celebration to become an amateur sport, a professional sport, and now, increasingly, a commercial sport. In the analysis of football business model, the systemic approach should be adopted. If sport is regarded as one of the business sectors, then the application of business system methodology can be fully justified. The interest to create strong football business system calls for the search of the ways of popularizing football business model and boosting the economic potential of its participants. In the research literature tend to ignore the business processes within the sports business. Besides, the systemic approach in football business is usually limited to p

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Publication Date
Fri Feb 08 2019
Journal Name
Iraqi Journal Of Laser
Laser Field Effect on Chemisorption Energy and Its Contributions for the System Na2 / W(100)
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In this study, a mathematical model is presented to study the chemisorption of two interacting atoms on solid surface in the presence of laser field. Our mathematical model is based on the occupation numbers formula that depends on the laser field which we derived according to Anderson model for single atom adsorbed on solid surface. Occupation numbers formula and chemisorption energy formula are derived for two interacting atoms (as a diatomic molecule) as they approach to the surface taking into account the correlation effects on each atom and between atoms. This model is characterized by obvious dependence of all relations on the system variables and the laser field characteristics which gives precise description for the molecule –

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Publication Date
Mon Feb 01 2021
Journal Name
Journal Of Physics: Conference Series
Influence of grid-orientation effect on modeling of Iraqi oil field: case studies
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Abstract<p>Reservoir simulation models are utilized by oil and gas companies with a purpose to develop fields. Expansions and improvements in simulation software have lessened the time to develop a model. Simulating the reservoir aims to realize fluid flow, physical, and chemical procedures happening in a hydrocarbon reservoir adequately well for the reason of improving hydrocarbon recovery under various working stipulations. Grid-orientation effects are complicated problem in numerical reservoir simulation. These influences were coming when utilized of numerical utilization mechanism to conditions characterizing physically inconstant displacement procedure. These impacts happen in an assortment</p> ... Show More
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