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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
Tue Jan 08 2013
Journal Name
Arabian Journal Of Geosciences
Petroleum geochemistry of oil samples from shallow boreholes at Sakran site, western Iraq
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Publication Date
Sat Jan 05 2019
Journal Name
Iraqi Journal Of Physics
Characterization of (SnO2)1-x(TiO2:CuO)x films as NH3 gas sensor
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Tin dioxide (SnO2) were mixed with (TiO2 and CuO) with concentration ratio (50, 60, 70, 80 and 90) wt% films deposited on single crystal Si and glass substrates at (523 K) by spray pyrolysis technique from aqueous solutions containing tin (II) dichloride Dihydrate (SnCl2, 2H2O), dehydrate copper chloride (CuCl2.2H2O) and Titanium(III) chloride (TiCl3) with molarities (0.2 M). The results of electrical properties and analysis of gas sensing properties of films are presented in this report. Hall measurement showed that films were n-type converted to p- type as titanium and copper oxide added at (50) % ratio. The D.C conductivity measurements referred that there are two mechanisms responsible about the conductivity, hence it possess two act

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Publication Date
Thu Jan 01 2026
Journal Name
Novel Research In Microbiology Journal
Turning Barrier Cells into Invaders: The Epithelial-Mesenchymal Transition Signature of Porphyromonas gingivalis
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Publication Date
Tue Dec 05 2023
Journal Name
Baghdad Science Journal
Recognizing Different Foot Deformities Using FSR Sensors by Static Classification of Neural Networks
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Sensing insole systems are a promising technology for various applications in healthcare and sports. They can provide valuable information about the foot pressure distribution and gait patterns of different individuals. However, designing and implementing such systems poses several challenges, such as sensor selection, calibration, data processing, and interpretation. This paper proposes a sensing insole system that uses force-sensitive resistors (FSRs) to measure the pressure exerted by the foot on different regions of the insole. This system classifies four types of foot deformities: normal, flat, over-pronation, and excessive supination. The classification stage uses the differential values of pressure points as input for a feedforwar

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Publication Date
Tue Jun 01 2021
Journal Name
Iop Conference Series: Earth And Environmental Science
Adsorption of heavy metal ions using activated carbon derived from Eichhornia (water hyacinth)
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Abstract<p>Removal of heavy metal ions such as, cadmium ion (Cd <sup>2+</sup>) and lead ion (Pb <sup>2+</sup>) from aqueous solution onto Eichhornia (water hyacinth) activated carbon (EAC) by physiochemical activation with potassium hydroxide (KOH) and carbon dioxide (CO<sub>2</sub>) as the activating agents were investigated. The Eichhornia activated carbon was characterized by Brunauer Emmett Teller (BET), Fourier Transform Infrared spectroscopy (FTIR), and Scanning Electron Microscopy (SEM) techniques. Whereas, the effect of adsorbent dosage, contact time of pH, and metal ion concentration on the adsorption process have been investigated using the batch process t</p> ... Show More
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Publication Date
Tue Sep 04 2018
Journal Name
Al-khwarizmi Engineering Journal
Studying the Mechanical Properties of Denture Base Materials Fabricated from Polymer Composite Materials
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In this research, the effect of adding two different types of reinforcing particles was investigated, which included: nano-zirconia (nano-ZrO2) particles and micro-lignin particles that were added with different volume fractions of 0.5%, 1%, 1.5% and 2% on the mechanical properties of polymer composite materials. They were prepared in this research, as a complete prosthesis and partial denture base materials was prepared, by using cold cure poly methyl methacrylate (PMMA) resin matrix. The composite specimens in this research consist of two groups according to the types of reinforced particles, were prepared by using casting methods, type (Hand Lay-Up) method. The first group consists of PMMA resin reinforced by (nano-ZrO

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Publication Date
Fri Nov 01 2019
Journal Name
Journal Of Engineering
Assessment the Engineering Characteristics of the Smear Zone around PVDs Using Laboratory Tests
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Smear zone is usually formed around the prefabricated vertical drains (PVD’s) due to mandrel driving. The geotechnical properties of the soil in this zone exhibit significant changes that affect the performance of the PVD’s. The most relevant property in this respect is the coefficient of permeability. So far, no serious attention is paid to investigate the effects of shearing under large shear strains on the geotechnical properties of the soft soil in Fao region. In this study, an extensive laboratory testing program was conducted to assess the characteristics of the smear zone with an emphasis on the permeability coefficient of Fao soft soil. The results show that the permeability of the smear zone is about 70% of

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Publication Date
Wed Jul 06 2022
Journal Name
International Journal Of Biomaterials
Extracellular Enzyme of Endophytic Fungi Isolated from Ziziphus spina Leaves as Medicinal Plant
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Endophytic fungi live inside plants or any part of them without creating any visible pathogenic signs. Endophytic fungi are found within medicinal plants and have shown strong biologic activity, such as anticancer and antioxidant activities, as well as producing extracellular enzymes. In this study, different fungal strains were isolated from the leaves of the medicinal plant Ziziphus spina, including Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Cladosporium sp., Rhizopus sp., and Mucor sp. Extracellular enzymes have been quantified using agar plate-based methods in which fungi were grown in specified growth media to detect the enzymes produced. The results showed that A. niger has the highest ability to produce amy

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Publication Date
Mon Dec 18 2017
Journal Name
Al-khwarizmi Engineering Journal
Batch Sorption of Copper (II) Ions from Simulated Aqueous Solution by Banana Peel
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This research presents the possibility of using banana peel (arising from agricultural production waste) as biosorbent for removal of copper from simulated aqueous solution. Batch sorption experiments were performed as a function of pH, sorbent dose, and contact time. The optimal pH value of Copper (II) removal by banana peel was 6. The amount of sorbed metal ions was calculated as 52.632 mg/g. Sorption kinetic data were tested using pseudo-first order, and pseudo-second order models. Kinetic studies showed that the sorption followed a pseudo second order reaction due to the high correlation coefficient and the agreement between the experimental and calculated values of qe. Thermodynamic parameters such as enthalpy change (ΔH

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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Medicine And Life
Nephroprotective effect of vitamin D Against Levofloxacin-induced renal injury: an observational study
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