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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 May 16 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of systemic administration of Simvastatin on dental implant stability: A random clinical study
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Background: the primary objective for many researches carried out in dental implantology was to reduce the period needed for functional implant loading, simvastatin (cholesterol lowering medication) had many pleiotropic effects, one of which was increasing bone density around titanium implants (1) and subsequently establishing faster osseointegrated dental implants (2,3). This study aims to reduce the period of time needed to establish secondary stability of dental implant measured in ISQ (Implant Stability Quotient) by investigating the effect of orally administered simvastatin on bone. Materials and methods: simvastatin tablets (40mg/day for three months) were administered orally for 11 healthy women aged (40-51) years old who received 1

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Publication Date
Wed Dec 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Clinical and Sonographic Changes of Parotid Gland in Patients with Type I and Type II Diabetes Mellitus and Its Effect on Physical Properties of Saliva
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Background: Sialosis described as a specific consequence of diabetes. In diabetic sialosis, the increased volume of the glands is due to the infiltration of adipose in the parenchyma. The B-scan ultrasonography is a generally accepted tool for determining parotid gland enlargement. Oral health is, to a greater extent, dependent on quality and quantity of saliva, both of which may be altered in diabetics. This study was established to detect the enlargement of parotid gland in diabetic patient and study the changes in physical properties of saliva and its relation with the salivary gland enlargement. Subjects, Materials and Methods: A cross-sectional study with highly specified criteria with ages ranged (20-65) years, male and female subject

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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The influence of human resources Accounting on cost reduction
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The development of human resources training programs has an applied and important role in the preparation of human cadresin terms of capacity to absorb technical sciences and skills and scientific and practical practices at faster rates in order to bealighed with continous development. Hence the recognition of the significant role that human resources play in the economy of any country,which has stressed the interest towards the economic unity of the qualified staff that it needsin atimely manner through the ongoing training process in the era of high technology day by  day  In this regard ,the current research deal with accounting of human resources and its impact on reducing costs in the military establishment and the

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Publication Date
Wed Aug 11 2021
Journal Name
Neuroquantology
Correlation of Vitamin D Level with Electrophysiological Findings and Clinical Grading in Carpal Tunnel Syndrome
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Carpal tunnel syndrome is a neurological disease that presented with paresthesias, pain, and numbness in the hand's median nerve compression. Vitamin D was assumed to affect both electrophysiological &clinical gradings, the study aims to assess the correlation between the deficiency of vitamin D and both electrophysiological and clinical gradings. This study was conducted in Ghazi Alhariri Hospital during the period from the first of November/2020 to the twenty-eighth of February/2021, fifty five individuals were referred to as Carpal tunnel syndrome patients, and compared to (55) control individuals, blood samples were withdrawn from the patients (3ml), centrifuged and kept in the freezer (-20°C) until the time of analysis of

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Publication Date
Thu Jun 30 2011
Journal Name
Al-kindy College Medical Journal
THE PREVALENCE AND CLINICAL SIGNIFICANCE OF PERINUCLEAR ANTINEUTROPHIL CYTOPLASMIC ANTIBODY IN PATIENTS WITH INDETERMINATE COLITIS
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Background: Indeterminate colitis (IC), a term
originated by pathologists to characterize confounding
histopathlogic appearance of resected mucosa, has
become catch phrase for cases in which diagnostic
criteria at all levels elude classification as Crohn's
disease (CD) or ulcerative colitis (UC).
OBJECTIVES: evaluate the prevalence of pANCA
expression in the sera and its isotypes.
Patients and methods: PATIENTS GROUP
consisted of 60 patients (40 males and 20 females)
with indeterminate colitis and their age range was (19-
84 years). CONTROL GROUP consisted of 30 (15
males and 15 females) healthy volunteers and their
age range was (20- 66 years).
Antineutrophil cytoplasmic ( pANCA and cANCA)
te

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Publication Date
Wed Oct 07 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Effectiveness of Deep Brain Stimulation in Iraqi Patients with Parkinson Disease
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Publication Date
Sun Dec 30 2018
Journal Name
Journal Of Engineering
A Cognition Path Planning with a Nonlinear Controller Design for Wheeled Mobile Robot Based on an Intelligent Algorithm
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This paper presents a cognition path planning with control algorithm design for a nonholonomic wheeled mobile robot based on Particle Swarm Optimization (PSO) algorithm. The aim of this work is to propose the circular roadmap (CRM) method to plan and generate optimal path with free navigation as well as to propose a nonlinear MIMO-PID-MENN controller in order to track the wheeled mobile robot on the reference path. The PSO is used to find an online tune the control parameters of the proposed controller to get the best torques actions for the wheeled mobile robot. The numerical simulation results based on the Matlab package show that the proposed structure has a precise and highly accurate distance of the generated refere

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Publication Date
Mon Apr 04 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of Electronic System Based on Cloud Computing to Develop Electronic Tasks for Students of the University of Mosul
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The present research aims to design an electronic system based on cloud computing to develop electronic tasks for students of the University of Mosul. Achieving this goal required designing an electronic system that includes all theoretical information, applied procedures, instructions, orders for computer programs, and identifying its effectiveness in developing Electronic tasks for students of the University of Mosul. Accordingly, the researchers formulated three hypotheses related to the cognitive and performance aspects of the electronic tasks. To verify the research hypotheses, a sample of (91) students is intentionally chosen from the research community, represented by the students of the college of education for humanities and col

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Publication Date
Thu Feb 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
The Insights of Experienced Pharmacists Regarding the Iraqi health Insurance Program: A Qualitative Study(Conference Paper )#
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The aim of study was to explore pharmacist insights toward the impact of prospective implementation of the national health insurance program on patients, providers and Iraqi health system.

This was a qualitative study including semi-structured face-to-face (mostly) interviews with experienced pharmacists. The interview guide included open-ended questions about the impact of the national health insurance program on patients and healthcare providers at three levels: quality of services, costs, and frequency of visits. Potential challenges were also discussed. Interviews were conducted in four provinces from March to May 2022. Thematic analysis was used to analyze the interview findings and generate themes and subthemes.

The

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of Educational And Psychological Researches
Factors associated with the phenomenon of marriage outside the court And the consequences of it A field study in Sadr City
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Marriage outside the court is a manifestation of the oppression that women are subjected to in Iraq its seriousness comes out of the consequences that it leads to The. It overlooks the age of the girl and her marriage in younger age or coerced to marry as it leads to neglecting the affordability of marital relationship as long as the marriage does not have any legal or material consequences. The present study aims to detect Characteristics of both wives, husbands and families Who agree to marry her daughters outside the court. And the reasons that lead them to marry outside the courts. It also aims to provide information on the circumstances of marriage and reasons for refusing to ratify it in court. The study was based on the sample soc

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