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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
Sat Mar 01 2025
Journal Name
Journal Of Ecological Engineering
Synthesis of sulfated zirconia-HY zeolite catalysts doped by platinum metal for hydroisomerization reaction
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Publication Date
Sun Jan 01 2017
Journal Name
Catalysis Science &amp; Technology
Mechanisms governing selective hydrogenation of acetylene over γ-Mo<sub>2</sub>N surfaces
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We demonstrate that the selective hydrogenation of acetylene depends on energy profile of the partial and full hydrogenation routes and the thermodynamic stability of adsorbed C2H2 in comparison to C2H4.

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Towards Sustainable Local Tourism to Conserve the Natural Environment: Foundations of Sustainable Ecolodge Design
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Publication Date
Tue Dec 01 2015
Journal Name
Second Engineering Scientific Conference
SEPARATION OF ALKALOIDS FROM PLANTS BY BULK LIQUID MEMBRANE TECHNIQUE USING ROTATING DISCS CONTACTOR
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This paper describes the transport of Alkaloids through Rotating Discs Contactor (RDC) using n-decane as a liquid membrane. The transport of Pelletierine Alkaloid from a source phase through bulk liquid membrane to the receiving phase has been investigated. The general behaviour of Pertraction process indicates that% Extraction of pelletierine Alkaloid increased with increase in the number of stages and the agitation speed but high agitation speed was not favoured due to the increased risk of droplet formation during the operation. The pH of source and receiving phases were also investigated. The effect of organic solvent membrane on the extraction of Pelletierine was evaluated using ndecane, n-hexane and methyl cyclohexane. The results sho

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Publication Date
Tue Dec 05 2017
Journal Name
Int’l Journal Of Advances In Chemical Engg., & Biological Sciences
Morpho-taxonomic Study of Tabanus indrae Hauser, 1939 (Diptera: Tabanidae). New Record for Iraq
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This work was included external morphological study of horse fly Tabanus indrae Hauser 1939 new record in Iraq, which belongs to family: Tabanidae order: Diptera. The study was involved the most important taxonomic external characters of the: head, thorax, abdomen and their appendages which are: antenna, maxillary palp, wings, legs, spotting in coloring pattern and female genitalia of abdomen

Publication Date
Wed Mar 01 2023
Journal Name
Accounting And Financial Sciences Journal
The Extent to which the Quality of Accounting Information Systems Contributes to Reducing Material
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This research dealt with shedding light on the nature of material misrepresentations, in addition to knowing the extent to which the quality of accounting information systems contributes to reducing material misrepresentations On the theoretical side, a number of sources were relied upon in dealing with the research problem and presentation of the topic, while in the practical side, it was relied on the questionnaire form, where the research sample was (accountants and auditors), where 50 forms were distributed and 50 were received, and the data was analyzed and hypotheses tested through the program Statistical spss to show the relationship between the variables. The research reached a number of conclusions, the most important of which is t

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Publication Date
Tue May 01 2012
Journal Name
Iraqi Journal Of Physics
Studying the optical properties of ( Cr2O3:I ) thin films prepared by spray pyrolysis technique
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Undoped and Iodine (I)–doped chrome oxide (Cr2O3)thin films have been prepared by chemical spray pyrolysis technique at substrate temperatures(773K) on glass substrate. Absorbance and transmittance spectra have been recorded as a function of wavelength in the range (340-800 nm) in order to study the optical properties such as reflectance, Energy gap of allowed direct transition, extinction coefficient refractive index, and dielectric constant in real and imagery parts all as a function of wavelength. It was found that all the investigated parameters affect by the doping ratios.

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Publication Date
Sun Jan 01 2023
Journal Name
Ssrn Electronic Journal
Design of Earthquake-Resistant Buildings by Using Reinforced Concrete or Steel Flexible Corner Joints
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This study focuses on studying the effect of reinforced steel in detail, and steel reinforcement (tensile ratio, compression ratio, size, and joint angle shape) on the strength of reinforced concrete (compressive strength) Fc' and searching for the most accurate details of concrete divisions, their behavior, and corner resistance of reinforced concrete joint. The comparison of this paper with previous studies, especially in the studied properties. The conclusions of the chapter are summarized that these effects had a clear effect and a specific effect on the behavior and resistance of the reinforced concrete corner joints under the negative moments and under their influence and the resulting stress conditions. The types of defects that can

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Publication Date
Sun Mar 30 2003
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Improvement of CIATIM-201 Grease Properties for Use under Severe Conditions using Suitable Additives
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Publication Date
Sat Mar 26 2022
Journal Name
Neuroquantology
Efficiency Evaluation of Optical System Includes Different Stop Apertures When Using Relative Moving Factor
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In this work, optical system with different aperture shapes (circular, square, elliptical and triangle aperture) has been used for efficiency evaluation when the system involved moving factor in ideal case (aberration free). The optical system evaluate far moving object, therefore the image forming at image plane due to point spread function (image formula of incoherently illuminated point object). A mathematical treatment has been used to getting results by Gaussian numerical calculations method. The results show priority of circular aperture when optical system that submits of moving factor.

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