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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
Fri Dec 06 2019
Journal Name
Karbala International Journal Of Modern Science
Stereo Photogrammetry vs Computed Tomography for 3D Medical Measurements
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Publication Date
Sun Apr 01 2018
Journal Name
Aquatic Geochemistry
The Origin and MgCl2–NaCl Variations in an Athalassic Sag Pond: Insights from Chemical and Isotopic Data
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Publication Date
Fri Mar 13 2026
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparison of the Effectiveness of Reciprocating System with Continuous Rotary Systems in Non-Surgical Endodontic Retreatment (An In vitro study)
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Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota

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Publication Date
Tue Mar 01 2016
Journal Name
Journal Of Baghdad College Of Dentistry
A Comparison of the Effectiveness of Reciprocating System with Continuous Rotary Systems in Non-Surgical Endodontic Retreatment (An In vitro study)
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Background: Optimal root canal retreatment was required safe and efficient removal of filling material from root canal. The aim of this in vitro study was to compare the efficacy of reciprocating and continuous motion of four retreatment systems in removal of root canal filling material. Materials and Methods: Forty distal roots of the mandibular first molars teeth were used in this study, these roots were embedded in cold clear acrylic,roots were instrumented using crown down technique and rotary ProTaper systemize Sx to size F2 ,instrumentation were done with copiousirrigation of 2.5% sodium hypochlorite and 17% buffered solution of EDTA was used as final irrigant followed by distilledwater, roots were obturated with AH26 sealer and Prota

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Publication Date
Tue Jul 01 2025
Journal Name
South African Journal Of Chemical Engineering
Expired azithromycin and cephalexin as corrosion inhibitors for aluminum in saline-acidic solution
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Publication Date
Thu Nov 25 2021
Journal Name
Engineering And Technology Journal
Pentacene Based Organic Field Effect Transistor Using Different Gate Dielectric
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This paper presents the electrical behavior of the top contact/ bottom gate of an organic field-effect transistor (OFET) utilizing Pentacene as a semiconductor layer with two distinctive gate dielectric materials Polyvinylpyrrolidone (PVP) and Zirconium oxide (ZrO2) were chosen. The influence of the monolayer and bilayer gates insulator on OFET performance was investigated. MATLAB software was used to simulate and determine the electrical characteristics of a device. The output and transfer characteristics were studied for ZrO2, PVP and ZrO2/PVP as an organic gate insulator layer. Both characteristics show a high drain current at the gate dielectric ZrO2/PVP equal to -0.0031A and -0.0015A for output and transfer characteristics respectively

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Publication Date
Sat Jan 01 2011
Journal Name
Iraqi Journal Of Science
A CRYPTOGRAPHIC TECHNIQUE BASED ON AVL TREE
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Publication Date
Sun May 22 2022
Journal Name
International Journal Of Early Childhood Special Education
A training program based on integrating futuristic thinking skills with classroom interaction patterns and its effect on the academic self- efficacy of mathematics teachers
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The research aims to identify the effect of the training program that is based on integrating futuristic thinking skills with classroom interaction patterns on mathematics teachers in order to provide their students with creative solution skills. The research sample consisted of 31teachers (15 teachers for the experimental group and 16 for the control groups). The researcher developed a measure for the academic self-efficacy consisting of (39) items. Its validity, reliability, coefficient of difficulty and discriminatory power were estimated. To analyze the findings, the researcher adopted the Mann-Whitney (U) test and the effect size, and the findings were as follows: There is a statistically significant difference at the significance leve

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Publication Date
Mon Sep 30 2019
Journal Name
Engineering Journal
Effects of Water Table Level on Slope Stability and Construction Cost of Highway Embankment
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Highway embankments stability during its service period represents an important factor for the safety of highway users and vehicles. Consequently, the cost of construction of these embankments should be adequate to maintain the safety and durability during this period through proper estimation of the loading on asphalt pavement, slope stability, horizontal and vertical deformation, etc. Slope stability of the embankment mainly depends on the shear strength of the soil layers materials; this shear strength is affected by the water table level through the contribution of the capillary water. Negative pore water pressure above the water table level evolves matric suction in the unsaturated zone above water table; this matric suction increases

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Innovation Creativity And Change.
The Role of Strategic Improvisation on the Entrepreneurial Orientation; a Field Study in a Sample from the Rafidain Bank
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The research aims to identify the role of strategic improvisation as an independent variable with its dimensions (Building the Solution, Intuition, Adaptation, and Spontaneity) and the Entrepreneurial Orientation as a dependent variable with its dimensions (Identifying Opportunities, Creativity, Adopting risk, and Vision). This research has been applied in the Rafidain Bank and its branches (Sunk, People, Al-Firdaws, and Alawiya); it used the questionnaire as a basic tool for collecting information. The sample was intentionality, which included all the heads of departments in the bank’s branches, which amounted to (33) workers, and data on the questionnaire paragraphs of 28 were processed using the SPSS V.23 and AMOS V.23). The most impor

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