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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 Feb 15 2021
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Educational Program on Nurses' Practices toward Chemotherapy-Induced Peripheral Neuropathy for Children at Hematology Center in Baghdad City
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Objectives: the study aims to assess nurses' practices toward chemotherapy-induced peripheral neuropathy (CIPN) for children at the hematology center, and to determine the effectiveness of the health education program on nurses' practices toward CIPN, and to find out the relationships between the effectiveness of Health education program and demographic characteristics of nurses.

Methodology: Use quasi-experimental design in the study (a design that divides the sample into two groups, a study group and a control group, with data collection in three stages). This study was conducted at a hematology center in Baghdad city for the period (from December 16th, 2019 to 8th May 202

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Publication Date
Fri May 22 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical importance of gingival biotype (Review of literature)
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This review discusses the gingival biotypes, their characteristics, analysis based on the measurement of the dentopapillary complex. Also discuss their response to inflammation, surgery, and ridge healing after tooth extraction, their influence in the behavior of the peri-implant tissue

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Publication Date
Mon Apr 01 2019
Journal Name
Journal Of Engineering
Outdoor Testing of a Zig-Zag Solar Air heater with and without Artificial Roughness on Absorber Plate
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In this paper, thermal performance of a zig-zig solar air heater (ZZSAH) with and without using steel wire mesh on the absorber plate of the collector is experimentally investigated. The experimental work includes four inclination angles of the collector 20o, 30o, 45o, and 60o and four air mass flow rates of 0.03, 0.04, 0.06, and 0.08 kg/s under varieties of operating conditions of a geographic location of  Baghdad. New correlation equations of Nusselt number are obtained from experimental results for both types of collectors where the effect of varying of the inclination angle of collector taken into consideration in the experiment. The correlations show good agreement wi

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Publication Date
Wed Sep 16 2020
Journal Name
International Journal Of Dentistry And Oral Science
Attitude and Knowledge of Orthodontics among General Dentists and Non-Orthodontic Specialists: A Questionnaire Based Survey
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Aim: This study aimed to assessing orthodontic knowledge and attitude among general dentists and non-orthodontic specialists. Background: Early detection of orthodontic disorders is essentialin motivating patients to intervene prior to long term complications when the disorders are not recongised. Methods: A questionnaire was distributed amongst dentistsother than orthodontists. This questionnaire consisted of three sections. The first one aimed to collect demographic, educational level and practice type information. Further two sections consisted of closed-end questions designed to evaluateknowledge and attitude of orthodontics. Results: A total of 313 responses to the survey were submitted. No significant correlation was observed, e

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Statistical Design based on Response Surface Methodology to Optimize the Production of a Yellow Pigment by Streptomyces thinghirensis AF7
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Although its wide utilization in microbial cultures, the one factor-at-a-time method, failed to find the true optimum, this is due to the interaction between optimized parameters which is not taken into account. Therefore, in order to find the true optimum conditions, it is necessary to repeat the one factor-at-a-time method in many sequential experimental runs, which is extremely time-consuming and expensive for many variables. This work is an attempt to enhance bioactive yellow pigment production by Streptomyces thinghirensis based on a statistical design. The yellow pigment demonstrated inhibitory effects against Escherichia coli and Staphylococcus aureus and was characterized by UV-vis spectroscopy which showed lambda maximum of

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Publication Date
Fri May 23 2025
Journal Name
Reproductive Health Of Woman
Molecular detection of Rubella virus (1E genotype) in clinical sample of pregnant women, and it’s related to abortion
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Pregnant women who have rubella may potentially pass the infection on to their unborn offspring. A congenital rubella infection can result in a miscarriage, stillbirth, and congenital rubella syndrome. The only member of the Togaviridae family’s Rubivirus genus, the Rubella virus (RV) is a positive-polarity, single-stranded RNA virus genome surrounded by a lipoprotein envelope with spike-like, hemagglutinin-containing surface projections.The objective: to determine the Rubella virus (1E genotype) in pregnant woman and its relation to spontaneous miscarriage.Materials and methods. A total of 174 women which visited Al-Elweya Teaching Hospital, Baghdad, Iraq, were screened according to the following criteria: women with a history of

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Publication Date
Sun Sep 27 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Education Program on Health Care Providers’ Knowledge toward Immunization of Children at Primary Health Care Centers in Kirkuk City
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Objectives: The study aims to evaluate effectiveness of health education program on health care providers’ knowledge toward immunization of children at primary health care centers in Kirkuk city.

 

Methodology: A quasi –experimental study design two- group (pre-test, post-test 1 and post-test 2) conducted at primary health care centers in Kirkuk city during the period from 28 October 2019 to 10 August 2020. By collecting (50) samples divided into two groups, each one (25) participant as control & study group. The study group exposed to the education program only.

 

Results: Results showed a clear positive

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Publication Date
Wed Jun 29 2022
Journal Name
College Of Islamic Sciences
Obscene speech in the Qur'anic perspective An objective study based on the verses and interpretation of the Noble Qur’an in diagnosis and treatment
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The most famous thing a person does is talk. He loves and hates, and continues with it confirming relationships, and with it, too, comes out of disbelief into faith. Marry a word and separate with a word. He reaches the top of the heavens with a kind word, with which he will gain the pleasure of God, and the Lord of a word that the servant speaks to which God writes with our pleasure or throws him on his face in the fire. Emotions are inflamed, the United Nations is intensified with a word, and relations between states and war continue with a word.

What comes out of a person’s mouth is a translator that expresses the repository of his conscience and reveals the place of his bed, for it is evidence of

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Publication Date
Sat Nov 10 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Clinical Learning and Training Environment for Maternal and Child Health Nursing Students
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Objective: To assess the clinical learning environment and clinical training for students' in maternal and child
health nursing.
Methodology: A descriptive study was conducted on non probability sample (purposive) of (175) students' in
Nursing College/ University of Baghdad for the period of June 19th to July 18th 2013. A questionnaire was used as a
tool of data collection to fulfill with objective of the study and consisted of three parts, including demographic,
clinical learning environment and clinical training for students' in maternal and child health nursing. Descriptive
statistical analyses were used to analyze the data.
Results: The results of the study revealed that the 65.1% of student at age which ranged b

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Publication Date
Sun Mar 10 2019
Journal Name
Al-mustansiriyah Journal Of Science
Effect of Inclined Magnetic Field on Peristaltic Flow of Carreau Fluid through Porous Medium in an Inclined Tapered Asymmetric Channel
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During this article, we have a tendency to show the peristaltic activity of magnetohydrodynamics flow of carreau fluid with heat transfer influence in an inclined tapered asymmetric channel through porous medium by exploitation the influence of non-slip boundary conditions. The tapered asymmetric channel is often created because of the intrauterine fluid flow induced by myometrial contraction and it had been simulated by asymmetric peristaltic fluid flow in an exceedingly two dimensional infinite non uniform channel, this fluid is known as hereby carreau fluid, conjointly we are able to say that one amongst carreau's applications is that the blood flow within the body of human. Industrial field, silicon oil is an example of carreau

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