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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
Wed Mar 11 2026
Journal Name
Modern Sport
Determining standard levels to test the strength endurance characteristic of speed for basketball players for juniors aged under (16) years
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Publication Date
Mon Aug 28 2023
Journal Name
Journal Of Planner And Development
Estimation of urban land price within holly cities by using integrated GIS-regression models: case study Al-Kufa city- Iraq
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        Urban land price is the primary indicator of land development in urban areas. Land prices in holly cities have rapidly increased due to tourism and religious activities. Public agencies are usually facing challenges in managing land prices in religious areas. Therefore, they require developed models or tools to understand land prices within religious cities. Predicting land prices can efficiently retain future management and develop urban lands within religious cities. This study proposed a new methodology to predict urban land prices within holy cities. The methodology is based on two models, Linear Regression (LR) and Support Vector Regression (SVR), and nine variables (land price, land area,

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
The Iraqi opposition press from The P.M. Yaseen Al-Hashimi second term till the death of king Ghazi ( 1935 – 1939 )
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At the beginning of 1935 theMinistry of (Yasin AL-Hashimi) was formed which was the result of the (Sulayikh)Conference .The new ministys policy was towards the authority of the one party and the exclusivity of power.The policy of (Yasin AL-Hashemi)has faced severe campaigns from the AL-Ekhaa and AL-Ahaly newspapers.The new ministry like its predecessor ministries . When it faces criticism from opposition newspapers .its shutting down newspapers and not accepting requests for them. Some opposition newspapers named Yassin AL-Hashemi (the dictator).Iraqi opposition newspapers have been neglected and deprived of press freedom although they were the main factor in educating the community and representing the public opinion of people . Lt appe

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Publication Date
Wed Dec 29 2021
Journal Name
Journal Of The College Of Education For Women
The Skills of Intended Meaning behind the Context when Reading Poetry among Fifth Grade Students- Literary Branch from Teachers’ Perspectives
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        The current research aims to investigate the skills of the intended meaning beyond the context when reading poetry among fifth literary students. To achieve the aim of the research, the researcher has followed the descriptive approach and used two tools: an open questionnaire that includes an inquiry about the skills of the intended meaning beyond the poetic context, and a closed questionnaire that were examined by the juries, and modified accordingly. Besides, its validity and stability were examined by applying the study on an exploratory sample of (15) teachers to reach its final version and determine the time required to answer it. Then, the researcher applied it on the research sample of (9

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Publication Date
Sun Jun 30 2024
Journal Name
Anbar Journal Of Agricultural Sciences
THE GENETIC DIAGNOSIS OF THE BACTERIA ISOLATED FROM THE AGRICULTURAL SOIL SUSTAINED FARMS BY THE POLYMERASE CHAIN REACTION TECHNIQUE QPCR
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The measurements and tests of the samples conducted in the laboratories of the College of Agriculture included isolating bio-fertilizers and testing the efficiency of isolates that fix atmospheric nitrogen and solubilize phosphorous compounds. Bacteria were isolated and identified from the rhizosphere soils of different plants collected from various agricultural areas. A total of 74 bacterial isolates were obtained based on the phenotypic characteristics of the developing colonies, as well as biochemical and microscopic traits. The results of isolation and identification showed that among the 74 bacterial isolates, there were 15 isolates of A. chroococcum, 13 of Az. lipoferum, 13 of B. megaterium, 10 of P. putida, 10 of Actinomycetes, and n

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Scopus (11)
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Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
Single Nucleotide Polymorphism of Interleukin-28β Subunit Genes Predict Host Susceptibility to Hepatitis C virus (HCV) Infection among Iraqi Patients
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Hepatitis C virus (HCV) is a liver disease that affects14 million people. Feasible research was conducted for identifying the genotypes and allele frequency of some single nucleotide polymorphisms (SNPs) of the IL-28β genes and their predictive role in disease incidence in Iraqi patients. The SNPs (rs28416813, rs4803219, rs11881222, and rs8103142) of IL-28β have been associated with susceptibility to several diseases. Ninety eight (98) HCV patients were included in this research; with average age ± SE (42.28 ± 3.44) years. Also, 80 healthy people (with average age ± SE (29.40 ± 2.84) years) were included as a control group. The SNPs were detected by allele-specific PCR (polymerase chain reaction) using specific primers. The re

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Scopus (2)
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Publication Date
Mon Jun 20 2022
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
DESCRIPTION OF THE PREDATOR BUSH CRICKET, SAGA EPHIPPIGERA FISCHER VON WALDHEIM, 1846 (ORTHOPTERA, TETTIGONIIDAE) FROM ERBIL PROVINCE, KURDISTAN REGION- IRAQ
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The predatory bush crickets Saga ephippigera Fischer Von Waldheim, 1846 is the largest Iraqi orthopterans and one of the most active and successful predators in the Kurdistan region. The nymphs and adults prey on all the stages of various species of insects. Twelve adult specimens were collected from Erbil Province during May 2018 and June 2021. Morphological structures of the adult insects were described and illustrated in details; important taxonomic characteristics of body regions with their appendages were chosen; and the results indicated the importance of morphological characteristics which confirmed the identification of this species correctly.

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Choosing the best method for estimating the survival function of inverse Gompertz distribution by using Integral mean squares error (IMSE)
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In this research , we study the inverse Gompertz distribution (IG) and estimate the  survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes

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Crossref
Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Japanese territorial dispute about the Soviet northern provinces )South Kuril Islands until the end of the Cold War( Historical Study
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The imposition of (state) policy on the South Kuril Islands.In the Pacific was a subject
of borders dispute between Japan and Soviet Union which appeared clearly afterthe second
Great War and during the cold war. Despite the end of the Cold War and the collapse of the
Soviet Union in 1991, this conflict has continued, thus both countries had to made a historic
and legitimate claims to demand the rights of sovereignty and ownership of four islands
occupied by the Soviet Union after World War II under the international conventions and
treaties, but these claims are proven failures through the continuation of the regional conflict.

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Publication Date
Fri Sep 30 2022
Journal Name
Journal Of Economics And Administrative Sciences
Choosing the best method for estimating the survival function of inverse Gompertz distribution by using Integral mean squares error (IMSE)
...Show More Authors

In this research , we study the inverse Gompertz distribution (IG) and estimate the  survival function of the distribution , and the survival function was evaluated using three methods (the Maximum likelihood, least squares, and percentiles estimators) and choosing the best method estimation ,as it was found that the best method for estimating the survival function is the squares-least method because it has the lowest IMSE and for all sample sizes

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