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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
Sun Dec 10 2017
Journal Name
Current Research In Microbiology And Biotechnology
the Efficiency of Dettol as Detergent against Microbial Biofilm formation isolated from UTI infections‏
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Publication Date
Sun Nov 01 2020
Journal Name
Conference
Study the Response Of The Wind Turbine System under Realistic Working Conditions Using Simulink
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Abstract<p>In recent years, there has been a very rapid development in the field of clean energy due to the huge increase in the demand, which prompted the manufacturers and the designers to increase the efficiency and operating life of the energy systems and especially for wind turbine. It can be considered that the control unit is the main key of the wind turbines. Consequently, it’s essential to understanding the working principle of this unit and spotlight on the factors which influence significantly on the performance of wind turbine system. Simulink technique is proposed to find the response of the wind turbine system under different working conditions. In this paper, it was investigated</p> ... Show More
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Publication Date
Wed May 13 2015
Journal Name
International Journal Of Current Microbiology And Applied Sciences
First Record of Hairy Rove Beetle, Creophilus maxillosus (Linnaeus, 1758)(Coleoptera; Staphylinidae) for Iraq
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Publication Date
Fri Oct 01 2021
Journal Name
The Iraqi Postgraduate Medical Journal
Knowledge of Hypertensive Patients Attending Al-Imamein Kadhimein Medical City Regarding Follow-Up Visits
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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The extent of the industrial company's response to blue market strategy indicators: Applied research
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The current research aims to describe the level of responsiveness and awareness of the officials of the General Company for Construction Industries to the indicators of the blue market strategy of (1. reduction 2. exclusion 3. increase 4. innovation) and the degree of prioritization according to their importance as well as the differences in the responses of the sample investigated according to the personal variables. As a main tool in the collection of data from the sample, which consisted of(34) officers (Associate, Manager, Section Manager, Division Officer) in the company being investigated, and computed mean, standard deviations, percentage weights,and test (x2 )  based on the SPSS. The research reached the following

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Publication Date
Wed Jul 13 2016
Journal Name
International Journal Of Mathematics Trends And Technology
Designed Algorithms for Compute the Tenser Product of Representation for the Special Linear Groups
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The main objective of this paper is to designed algorithms and implemented in the construction of the main program designated for the determination the tenser product of representation for the special linear group.

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Publication Date
Thu Dec 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Simulation the Radiation Zone of Al-Mussaib Power Plant by Using Monte Carlo Method
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The temperature distributions are to be evaluated for the furnace of Al-Mussaib power plant. Monte Carlo simulation procedure is used to evaluate the radiation heat transfer inside the furnace, where the radiative transfer is the most important process occurring there. Weighted sum of gray-gases model is used to evaluate the radiative properties of the non gray gas in the enclosure. The energy balance equations are applied for each gas, and surface zones, and by solving these equations, both the temperature, and the heat flux are found.

   Good degree of accuracy has been obtained, when comparing the results obtained by the simulation with the data of the designing company, and the data obtained by the zonal method. In

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Publication Date
Fri Jan 01 2021
Journal Name
Poll Res.
ADSORPTION ABILITY STUDY OF YELLOW (W6GS) DYE FROM AQUEOUS SOLUTION BY IRAQI SILICEOUS ROCKS
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Removing of terasil yellow (W-6GS) dye it was studied by using Iraqi Siliceous Rocks Powder (SRP). The study included adsorption isotherms and some effects: temperature, salty medium and the acidity the study that the adsorption isotherms obeys to Temkin equation more than other equations the results showed that the adsorption increased with increasing temperature (Endothermic process. Based on the results, thermodynamic functions (˜H, ˜G, ˜S) were estimated. The amount of adsorbent on the surface increasing with increasing the acidity solution. The kinetics study of the adsorption treated according (Lagergren equation). The kinetic data of experiments properly correlated with the first order kinetic equation.

Publication Date
Tue Jan 01 2019
Journal Name
Fme Transactions
Thermal-hydraulic hot-spot analysis of IRT-5000 nuclear research reactor: Comparative safety evaluation
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A detailed methodology is presented in this paper for the calculation of nucleate boiling safety margin (NBSM) in nuclear research reactors using a temperature function with three different thermal-hydraulic hot-spot analyses: nominal, cumulative and statistical for normal operating condition and coolant flow variation. A computer simulation program is developed for applying the methodology to the IRT-5000 reactor based on experimental core data. According to cumulative analysis as the overconservative approach, the NBSM at normal operating condition of thermal power 5 MW and coolant velocity 1.672 m/s was 2.3% with reactor power limit 5.13 MW. However, during power or coolant flow trip condition, transient nucleate boiling would occur for

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Publication Date
Thu Oct 01 2009
Journal Name
Iraqi Journal Of Physics
Calculation of the Longitudinal Electron Scattering Form Factors for the 2s-1d Shell Nuclei
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Inelastic longitudinal electron scattering form factors have been calculated for isoscaler transition
T = 0 of the (0+ ®2+ ) and (0+ ®4+ ) transitions for the 20Ne ,24Mg and 28Si nuclei. Model
space wave function defined by the orbits 1d5 2 ,2s1 2 and 1d3 2 can not give reasonable result for
the form factor. The core-polarization effects are evaluated by adopting the shape of the Tassie-
Model, together with the calculated ground Charge Density Distribution CDD for the low mass 2s-1d
shell nuclei using the occupation number of the states where the sub-shell 2s is included with an
occupation number of protons (a ) .

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