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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 Jul 01 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The effectiveness of intense pulsed light (home use) device in facial hair reduction
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Background: Intense pulsed light (IPL) devices produce polychromatic incoherent high-intensity pulsed light with a specified wavelength spectrum, fluence, and pulse duration through the use of flashlamps and bandpass filters. Similar to lasers, IPL devices operate on the selective photothermolysis principle, with melanin acting as the chromophore. Despite this similarity, they are constructed differently and produce different amounts of light Aim of the study: To investigate the efficacy of IPL home-use device in hair reduction technique for women with unwanted facial hair. Subjects and methods: The study was conducted in Baghdad on forty-five female subjects with Fitzpatrick skin phototype (II to IV) and black, brown hair in a period of ei

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Educational Program in Enhancing Nurses’ Knowledge about Occupational Health Hazards
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Objective: To determine the effectiveness of an Educational Program in Enhancing Nurse’s Knowledge about Occupational Health Hazards at Medical City Hospitals in Baghdad City.

Methodology: The present study employed a quasi-experimental design held at Medical City Hospitals in Baghdad City. A non-probability sample (convenience sample) consisted of (60) nurse. Data were collected by using a self-report questionnaire which consisted of six parts (a) socio-demographic characteristics (b) physical hazards knowledge (c) chemical hazards knowledge (d) biological hazards knowledge (e) psychological hazards knowledge and (f) mechanical hazards knowledge. Data were analyzed using the statistical packag

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Publication Date
Sat Sep 30 2017
Journal Name
Pharmacy Practice
Physician-pharmacist agreement about off-label use of medications in private clinical settings in Baghdad, Iraq
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Publication Date
Mon Jun 28 2021
Journal Name
Journal Of The College Of Education For Women
The Developmental Role of Social Work in Reducing Social Extremism:A Field Study in Baghdad University-College of Mass Communication as a Model: محمد حميد علوان
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This study deals with the role that social work profession plays in all its fields to reduce social extremismat home, or school or within society. The study aims to: examine the historical roots of social work in the Iraqi society, investigate the objectives of the developmental role of social work, review the theories of social extremism, its characteristics, and causes, and to analyze the developmental role of social work to limit social extremism. To meet the objectives of the study, a descriptive analytical approach has been adopted. It involves using the social sampling survey method, i.e., a questionnaire tool in the University of Baghdad community-College of Media. The sample was randomly selected to include (100) students from th

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Publication Date
Tue Dec 01 2020
Journal Name
Baghdad Science Journal
A Competitive Study Using UV and Ozone with H2O2 in Treatment of Oily Wastewater
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          In this study, ultraviolet (UV), ozone techniques with hydrogen peroxide oxidant were used to treat the wastewater which is produced from South Baghdad Power Station using lab-scale system. From UV-H2O2 experiments, it was shown that the optimum exposure time was 80 min. At this time, the highest removal percentages of oil, COD, and TOC were 84.69 %, 56.33 % and 50 % respectively. Effect of pH on the contaminants removing was studied in the range of (2-12). The best oil, COD, and TOC removal percentages (69.38 %, 70 % and 52 %) using H2O2/UV were at pH=12. H2O2/ozone experiments exhibited better performance compared to

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
A Comparative Biochemical Study of Proteins Profile in Iraqi Children and Adolescent with ?-Thalassemia
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The aim of the present research is to study different protein fractions in sera of children and adolescent with  β –thalassemia major and minor and to compare the results with that of healthy control.One hundred fifty children and adolescents were enrolled in this study,including 50 patients with β- thalassemia major , 50 patients with  β- thalassemia minor as pathological control group and another apparently 50 healthy individuals as a control group. The age of all studied  groups ranged from (4-18)years.Total protein, albumin and immunoglobulins were estimated in sera of all subjects.  A Significant  decrease  was  found  in  the  total  protein and  albumin&nb

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Publication Date
Mon Nov 06 2023
Journal Name
Communications In Mathematical Biology And Neuroscience
Effect of hunting cooperation and fear in a food chain model with intraspecific competition
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Taking into account the significance of food chains in the environment, it demonstrates the interdependence of all living things and has economic implications for people. Hunting cooperation, fear, and intraspecific competition are all included in a food chain model that has been developed and researched. The study tries to comprehend how these elements affect the behavior of species along the food chain. We first examined the suggested model's solution properties before calculating every potential equilibrium point and examining the stability and bifurcation nearby. We have identified the factors that guarantee the global stability of the positive equilibrium point using the geometric approach. Additionally, the circumstances that would gu

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Publication Date
Mon May 27 2019
Journal Name
Al-academy
Improvisation Effectiveness in the Performance of the Actor in the Theatrical Show: مصطفى عباس خلف
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Improvisation is that spontaneous automatic achievement which is formed by a new cognition that is not based on something prior to it or a previous cognition. It is instantaneous. Whereas in art, improvisation also inters in all types of applied and performance arts as a foundation for launching and initiating it in music, painting, cinema, television and theater. In order to study the improvisation of the actor, the researcher put forward a theoretical study that included two sections. The first section is (the improvisation concept) and the second section is (improvisation in the show). The researcher, in the research procedures, took an intentional sample that was represented by the theatrical show (Rehearsal in Hell Play) and after t

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Publication Date
Sat Mar 26 2022
Journal Name
Indian Journal Of Ecology
Assessment of Antimicrobial Resistance to Klebsiella pneumonia Isolated from Various Clinical Samples in Baghdad
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Klebsiella pneumoniae is a severe opportunistic strain of enteric bacteria that is a major cause of urinary tract infection and pneumonia. This study was conducted in Baghdad City during September 2020-November 2020 on 50 clinical samples of urine, vaginal, sputum, wound swabs, ear swabs, and burn swabs. strains were identified using the VITEK-2 compact system and tested in K. pneumoniae terms of susceptibility to various antimicrobial drugs by Kirby-Bauer test. The isolates were more predominant in the females (56%) compared to males (44%). The antibiotic resistance rate of varied among different isolated clinical sample sources. K. pneumoniae K. pneumoniae isolated from different clinical specimens differed with respect

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Publication Date
Thu Sep 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
12- months color stability of direct resin composite veneers in anterior teeth: Clinical trial
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Background: This clinical trial aims to evaluate the color changes of direct resin composite veneer (DCV) restorations based on spectrophotometric analysis of 4 different types of resin composites between the baseline immediately after polishing and after one year of follow-up. Materials and methods: 28 patients were assessed for eligibility for participation, aged between 18 and 38 years old, who indicated for DCV restorations in anterior maxillary teeth were considered for participation in this study. In total, 25 patients who met the inclusion criteria were selected (6 males and 19 females, mean age: 20.9 at the time of restoration placement), and 3 patients were excluded. Partic

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