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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 Feb 01 2024
Journal Name
Baghdad Science Journal
Association of pvc genes expression with Biofilm formation in Clinical Isolates of Pseudomonas aeruginosa
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PvcABCD are cluster of genes found in Pseudomonas aeruginosa. The research was designed to examine the relationship between the pvc genes expression and cupB gene, which plays a crucial role in the development of biofilm, and rhlR, which regulates the expression of biofilm-related genes, and to investigate whether the pvc genes form one or two operons. The aims were achieved by employing qRT-PCR technique to measure the gene expression of genes of interest. It was found that out of 25 clinical isolates, 21 isolates were qualified as P.aeruginosa. Amongst, 18(85.7%) were evaluated as biofilm producers, 10 (47.6%), 5 (23.8%), and 3 (14.2%) were evaluated as strong, moderate and weak producers respectively, while, 3 (14.2%) were considered

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Publication Date
Tue Oct 01 2024
Journal Name
Science Progress
Jaw vs abdominal Burkitt's lymphoma: An analysis of 25 Iraqi cases
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This study compared the clinicopathological, immunohistochemical characteristics and Epstein-Barr virus (EBV) detection of Burkitt's lymphoma (BL) in the abdomen and jaw of Iraqi patients. A cohort/retrospective study was carried out between August and September 2024 using 25 tissue blocks (14 gnathic and 11 abdominal BL) from the Oral and Maxillofacial Laboratory, University of Baghdad, College of Dentistry, and the National Centre for Educational Laboratories. The sections were stained with haematoxylin and eosin (H&E), while CD10, CD20, Bcl-2, BCl-6, C-Myc and Ki-67 markers were used for diagnosis. The DNA detection of the EBV was performed by polymerase chain reaction (PCR). The tumours showed 22 classical and 3 atypical histologi

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Publication Date
Wed Dec 09 2015
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
Effect of Sodium sulfite treatment on the trypsin inhibitors activity, protein isolate and protein solubility of complete and dehulling white bean seeds Phaseolus vulgaris.: Effect of Sodium sulfite treatment on the trypsin inhibitors activity, protein isolate and protein solubility of complete and dehulling white bean seeds Phaseolus vulgaris.
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The study aimed to increase the biological value of white bean. The effect of different concentrations 0.01 ,0.02,0.03,and 0.04 M of sodium sulfite solutions for 1hr at 70 ºC on the trypsin inhibitors activity, protein isolate and protein solubility of complete and dehulling white bean flour were studied.Trypsin inhibitors activity were reduced by 42.97, 58.69, 68.59 and 69.58% in complete white bean flour at 0.01 ,0.02, 0.03, 0.04 M respectively, while the corresponding values were 50.43, 61.00, 75.61 and 85.66% respectively in dehulling white bean flour .Protein isolate value was 13.41% and protein solubility was 2.2% in control sample, Furthermore, the using of chemical treatment showed that protein isolate was reduced gradually and

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Taboo Words Vs. Social Deixis: A sociolinguistic Analysis of La Justice or The Cock that Crew: A Play from the Theatre of Ridiculous
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Linguistic taboos exist in most cultures. Tabooed words are generally being culturespecific
and relating to bodily functions or aspects of a culture that are sacred. Such words are
avoided, considered inappropriate and loaded with affective meaning and failing to adhere to.
Strict rules, often, governing their use and lead to punishment or public shame. These taboo
words can be used as a way of violating social deixis represented by four types of honorifics;
addressee, referent, bystander, and finally setting honorifics. This paper shows how these
taboo words are used in Kenneth Bernard's play La Justice or The Cock that Crew from the
theatre of the Ridiculous as means of violating social deixis in its four types. Th

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Publication Date
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effectiveness of Ombitasvir with Paritaprevir/Ritonavir plus Ribavirin on the Treatment of Naïve Patients with Chronic Hepatitis C Virus Genotype 4
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Background Direct-acting antivirals (DAAs) combination therapies from various mechanisms of action and families have been revolutionized the management landscape of chronic hepatitis C virus (HCV). Ombitasvir, paritaprevir with ritonavir (OBV/PTV/r) ± ribavirin (RBV) is approved to treat HCV genotype 4 (GT4) infection. Here, our objective was to delineate the efficacy and safety of OBV/PTV/r plus RBV in treating of Egyptian naïve patients infected with HCV GT4.

Methods a cohort of 100 Egyptian patients infected with HCV GT4 was allocated and administered orally OBV/PTV/r with RBV. The primary endpoint of our study was a sustained virological response (HCV RNA < 12 IU/mL) 12 weeks after the c

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Publication Date
Sat Jan 01 2022
Journal Name
Clinical And Experimental Hepatology
Effectiveness of sofosbuvir/ledipasvir in hepatitis C virus infection in children and adolescents with malignancy: tertiary center experience
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Publication Date
Tue Sep 28 2021
Journal Name
Journal Of The College Of Education For Women
Forced Displacement during the Syrian Forced Displacement during the Syrian Crisis, and its Impact on Jaramana’s Children's Education: A Field Study , and its Impact on Jaramana’s Children's Education: A Field Study: نهال ريحاوي جلب , قاسم الربداوي
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The study aims to examine the problem of forced displacement and its social and economic problems in light of the Syrian crisis. Such an aim helps to know the difficulties and challenges facing the children of displaced families in learning, and the reasons for their lack of enrolment. It also clarifies whether there are significant statistical differences at  among the attitudes of the children of the displaced families towards education regarding the following variables: (the work of the head of the family, the economic level of the family, and the work of the children). The study has adopted the descriptive-analytical approach;  a questionnaire was adopted as a tool to collect information. The study was applied to a sample o

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Publication Date
Thu Aug 01 2013
Journal Name
Biochemistry
Mechanistic Insights from the Binding of Substrate and Carbocation Intermediate Analogues to Aristolochene Synthase
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Publication Date
Sat Jul 27 2024
Journal Name
International Journal Of Economic Perspectives
The impact of strategic leadership on the building of intelligent organizations: A field study of a group of economic institutions in Algeria
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This study aims to highlight the role of strategic leadership in adopting the intelligent organization model. The study was conducted on 7 economic organizations in Algeria. The study population consisted of 354 leaders, of whom a random sample of 176 leaders (managers, department heads, division heads, engineers) was selected. The researcher used a questionnaire as the main tool of the study. Statistical analysis and hypothesis testing were conducted using SEM (Structural Equation Modeling) with the aid of SPSS.v26 and AMOS.v24 software. The study concluded with a set of results, most notably: there is a statistically significant direct positive effect between strategic leadership and building intelligent organizations at a significance le

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Publication Date
Sun Aug 10 2025
Journal Name
Central Asian Journal Of Medical And Natural Science
Microbial Load Comparison Between Clinical and Non-Clinical Student Environments in Al-Kindy College of Medicine
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The environmental surfaces hygiene of college premises like classrooms play role in spreading different pathogenic bacteria, furthermore a Medical students are often potential vectors for resistant bacteria to their entourage. This study aimed to assess bacterial contamination and their susceptibility to various antimicrobial agents in the educational classroom of Al-Kindy College of medicine in two classrooms: one occupied by clinical visitor and non-clinical visitor students to evaluate and determine its health risk. In this cross-sectional study, different sites of the educational classroom of Al-Kindy College of medicine were studied.&nbsp; Ninety-sex Different swab samples were collected from 8 different sites of college across bot

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