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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
Sun Jan 27 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Quality and cost characteristics of tourist
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The tourism services provided in the hotel organizations are a set of material and moral elements that represent tourist attractions that are offered to the guests in order to satisfy their needs and desires are accommodation, food, drink and other facilities to reach the satisfaction and satisfaction of guests.Where these tourist services need a mechanism to ensure their quality by working to identify and calculate the costs of these services properly and accurately with the attempt to referendum and reduce the waste and loss to reduce these costs while providing the finest types of tourism services by calculating the cost of production and the administration seeks to reduce Non-essential activities through hotel activities that add val

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
A Population based Study on Self Medication Practice in Pakistan
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Background: The risk of antibiotics resistance (AR) increases due to excessive of antibiotics either by health care provider or by the patients.

Objective: The assessment of the self-medication Practice of over the counter drugs and other prescription drugs and its associated risk factor.

Subjects and Methods: Study design: A descriptive study was conducted from “20th December 2019 to 08th January 2021”. A pre validated and structured questionnaire in English and Urdu language was created to avoid language barrier including personal detail, reasons and source and knowledge about over the counter drugs and Antibiotics. Sample of the study was randomly selected.

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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 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
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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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
Tue May 01 2012
Journal Name
Journal Of Engineering
Study on wind loads coefficients and flow field characteristics around the parabolic trough with stiffeners
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wind load coefficient

Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Strategic planning of human resources and its impact on the stages of a career path :A field research in the Ministry of Health
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Abstract

The objective of this research is to analyze the relationship between the strategic planning for human resources and career path, and I have tested Search the Ministry of  Health and some health centers headquarters in the Karkh district, that is applied in sample Consist of (45) Deputy Director, Head of Depts, Departmental Manager, and health center Manager.

Find interested in studying the two subjects are important and vital, at the level of organizations at the present time, namely the strategic planning of human resources and career path. To achieve the objectives of the research was designed Qusestionnair (31) items to collect  Primary data. and collected t

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Publication Date
Sat Mar 01 2014
Journal Name
Renewable Energy
Field study of various air based photovoltaic/thermal hybrid solar collectors
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In the present work a comparative study for thermal and electrical performance of different hybrid photovoltaic/thermal collectors designs for Iraq climate conditions have been carried out. Four different types of air based hybrid PV/T collectors have been manufactured and tested. Three collectors consist of four main parts namely, channel duct, glass cover, axial fan to circulate air and two PV panels in parallel connection. The measured parameters are, the temperature of the upper and the lower surfaces of the PV panels, air temperature along the collector, air flow rate, pressure drop, power produced by solar cell, and climate conditions such as wind speed, solar radiation and ambient temperature. The thermal and hydraulic performances o

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Publication Date
Mon Nov 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Building a model to reduce the cost of hajj in the Iraqi Authority for Hajj and Umrah
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The research is summarized in the construction of a mathematical model using the most common methods in the science of Operations Research, which are the models of transportation and linear programming to find the best solution to the problem of the high cost of hajj in Iraq, and this is done by reaching the optimum number of pilgrims traveling through both land ports and the number Ideal for passengers traveling through airports by Iraqi Airways, instead of relying on the personal experience of the decision-maker in Hajj and Umrah Authority by identifying the best port for pilgrim's travel, which can tolerate right or wrong, has been based on scientific methods of Operations Research, the researcher built two mathematical models

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