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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
Thu Jun 18 2020
Journal Name
Biochem. Cell. Arch.
NEW DERIVATIVE OF CHITOSAN BASED ON EPICHLOROHYDRNE, SYNTHESIS, CHARACTERIZATION, ANTIBACTERIAL ACTIVITY AND SWELLING STUDY
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A novel series of chitosan derivatives were synthesized via reaction of chitosan with carbonyl compounds and grafted it’s by with different amine compounds substituted hydrogen. The produced polymers were characterized by different analyses FTIR, 1HCNMR, XRD, DSC and TGA. Solubility in water as well as many solvent was investigated, antibacterial activity of chitosan and its derivatives against two types of bacteria E. coli and S. aureus was also investigated. The results showed that derivatives sort of have antibacterial activities against Esherichia coli (Gram negative) better than chitosan whilst compound IX has better antibacterial against Staphylococcus aureus (Gram positive). SEM analysis showed that increase of surface roughness wi

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Publication Date
Sun Sep 01 2013
Journal Name
Baghdad Science Journal
Synthesis And Characterization Of Some New Acetylenic Mannich Bases Based On Biphenyl – 4,4 - Dithiol
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One of the most important , compound which have active hydrogen is the compound possessing (thiol group) Biphenyl-4,4-dithiol is agood example utilized in a wide field for preparation mannich bases , avariety of new acetylenic mannich bases have been Synthesized and all proposed structure were Supported by FTIR , 1H – NMR, 13C-NMR , Elemental analysis and microbial study .

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Publication Date
Tue Feb 21 2023
Journal Name
International Journal Of Operational Research
Aggregate production planning of Abu Ghraib Dairy factories based on forecasting and goal programming
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Publication Date
Tue Dec 29 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Preparation, Characterization and Optimization of Etoposide-Loaded Gold Nanoparticles Based on Chemical Reduction Method
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In recent years, observed focus greatly on gold nanoparticles synthesis due to its unique properties and tremendous applicability. In most of these researches, the citrate reduction method has been adopted. The aim of this study was to prepare and optimize monodisperse ultrafine particles by addition of reducing agent to gold salt, as a result of seed mediated growth mechanism. In this research, gold nanoparticles suspension (G) was prepared by traditional standard Turkevich method and optimized by studying different variables such as reactants concentrations, preparation temperature and stirring rate on controlling size and uniformity of nanoparticles through preparing twenty formulas (G1-G20). Subsequently, the selected formula that pr

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Publication Date
Mon Dec 01 2014
Journal Name
Advances In Engineering Software
System identification and control of robot manipulator based on fuzzy adaptive differential evolution algorithm
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Publication Date
Tue Sep 01 2020
Journal Name
Al-khwarizmi Engineering Journal
Pre-Processing and Surface Reconstruction of Points Cloud Based on Chord Angle Algorithm Technique
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Abstract

Although the rapid development in reverse engineering techniques, 3D laser scanners can be considered the modern technology used to digitize the 3D objects, but some troubles may be associate this process due to the environmental noises and limitation of the used scanners. So, in the present paper a data pre-processing algorithm has been proposed to obtain the necessary geometric features and mathematical representation of scanned object from its point cloud which obtained using 3D laser scanner (Matter and Form) through isolating the noised points. The proposed algorithm based on continuous calculations of chord angle between each adjacent pair of points in point cloud. A MATLAB program has been built t

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Publication Date
Tue Sep 30 2025
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Geomechanical properties evaluation of Mauddud formation based on experimental measurements and well log data
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    Mauddud formation is one of the most prominent formations in Northeastern Iraq due to its significant hydrocarbon reserves, making accurate geomechanical characterization essential for safe drilling operations and informed development planning. This study constructs a calibrated post-drill one dimensional mechanical earth model (1D-MEM) for selected wells, levering Techlog software to integrate rock mechanical data, image logs, multi-arm caliper measurements, conventional well logs, drilling reports, and core analyses. The methodology provides a detailed workflow for estimating geomechanical properties from log and image analysis to model calibration. Validation of the 1-D MEM performed through cross-comparison with direct me

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Publication Date
Thu Oct 20 2022
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
A study of Hepcidin levels and other Biochemical parameters in woman with Osteoporosis with Type 2 Diabetes Mellitus
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Background: Diabetes mellitus (DM) could be regarded as a set of chronic metabolic disorders which have a common aspect of hyperglycemia. The resistance in the peripheral actions of insulin or impaired insulin secretion could be the reason  hepcidin which is a peptide hormone derived from liver, in systemic iron homeostasis is an essential regulator, and its lopsided production participates in the pathogenesis of iron disorders in spectrum. Osteoporosis often accompanies many diseases like ß-thalassemia, hemochromatosis, sickle liver diseases, cell disease and hemosiderosis featured by iron overload, evidences suggest that Iron overload and iron deficiency are suggested by evidences that they affect bone in a negative way, acting

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Publication Date
Thu Feb 28 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
A Proposed Framework to Developing the Auditor's Reporting in Iraq in Accordance With the International Standards on Auditing
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The international reporting auditor witness rapidly developed over the past years, where profession began give attention to the development of auditor reporting and improve its informational report through the issuance and amendment of some relevant international auditing standards. The reality of the situation refers to the failure to inform the auditor in Iraq in  many areas, including: Clearly defined management responsibility for the preparation of financial and auditor's responsibility to express an opinion on these statements and Amendment of opinion when the financial statements as a whole is free from material misstatement based on the evidence is sufficient and appropriate audit, or not to build the auditor's ability to obt

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Publication Date
Wed Oct 01 2014
Journal Name
Journal Of Economics And Administrative Sciences
knowledge strategic abilities And impact in the building of competitive advantage Field research the views of a sample of the administrative leaders of the Iraqi private banks
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The research synthesis variables of competitive advantage and the mechanism achieved by focusing on knowledge abilities and strategic of the administrative leadership, and governments and the developed countries took the racing frantically and my destiny to invest more money and resources to development of wealth and human knowledge is so choice investment winner always and who Aaikhyee never, because God Almighty give humans the abilities of all other creatures and that these abilities varying from person to person, there is the problem of search provoking questions about the essence of what it's about research and both sides theoretical and field, the objective of this research

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