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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 Oct 28 2015
Journal Name
Journal Of Mathematics And System Science
Simulating Particle Swarm Optimization Algorithm to Estimate Likelihood Function of ARMA(1, 1) Model
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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Impact of Instructional Intervention about Personal Hygiene upon Women who complain Pelvic Inflammatory Disease
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Objective: To determine the impact of personal hygiene on woman who complain pelvic inflammatory disease Methodology: A quasi experimental study in the High Institute Infertility Diagnostic and A.R.T.(assistance reproductive technology) in AL-Kadimya city and al-Emamian al Kadmain medical city hospital. The sample collected during (26th ) January – (30th ) April 2014. A purposive sample of (60) women, (30) of them regard as study group and (30) regard as a control group whom they take routine care in the institute and hospital. The questionnaire consisted of socio-demographic data, reproductive heal

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Publication Date
Thu Nov 23 2023
Journal Name
Journal Of Al-farahidi's Arts
Linguistic Analysis of Translating The Iraqi novel "The Corpse Washer" from Arabic to English
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This research aims to conduct a linguistic analysis of the translation of the novel "The Corpse Washer" by the Iraqi author Sinan Antoon. The main objective is to explore the challenges and strategies involved in translating this literary work, particularly the difficulties in translating the Baghdadi dialect and the obstacles it poses for non-native speakers. Employing a descriptive research methodology, the study examines the linguistic aspects of the translation, specifically selected conversational texts in the novel. It identifies the difficulties faced by translators in preserving the essence of the original novel and presents instances where errors occurred in translating vocabulary, conversational expressions, proverbs, and idi

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Publication Date
Fri Mar 01 2019
Journal Name
Al-khwarizmi Engineering Journal
Thermo Elasto-Plastic Analysis of Rotating Axisymmetrical Bodies Using Modified Von-Mises Yield Criterion
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In the present work, the behavior of thick-walled cylinder of elasto-plastic material (polymeric material) has been studied analytically. The study is based on modified Von-Mises yield criterion (for non metallic material). The equations of stress distribution are obtained for the cylinder under general cases of elastic expansion, plastic initiation and elastic-plastic expansion.

        A computer program is developed for evaluating the stress distribution. The solution is carried out for worst boundary conditions when the cylinder is subjected to the combination of pressure load, inertia load, and temperature gradient.

        The results are presente

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Publication Date
Sat Dec 01 2018
Journal Name
Al-khwarizmi Engineering Journal
Analysis the Surface Morphology of the Porous Media by using Atomic Force Microscope technique
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An atomic force microscope (AFM) technique is utilized to investigate the polystyrene (PS) impact upon the morphological properties of the outer as well as inner surface of poly vinyl chloride (PVC) porous fibers. Noticeable a new shape of the nodules at the outer and inner surfaces, namely "Crater nodules", has been observed. The fibers surface images have seen to be regular nodular texture at the skin of the inner and outer surfaces at low PS content. At PS content of 6 wt.%, the nodules structure was varied from Crater shape to stripe. While with increasing of PS content, the pore density reduces as a result of increasing the size of the pore at the fiber surface. Moreover, the test of 3D-AFM images shows that the roughness of both su

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Publication Date
Tue Jan 01 2019
Journal Name
Opcion
Enhancing Islamic Concepts through English Children's Lit-erature: Al- Ibtila, The Test of Patience
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Publication Date
Tue Aug 05 2025
Journal Name
Optik
Optimization of plasmonic Al/TiO₂ thin film characteristics via scanning pulsed fiber laser deposition
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The deposition method of perovskite solar cell layers significantly impacts device functionality and the achievement of industrial goals. Aluminum (Al) nanoparticles with rutile titanium oxide (TiO2) nanoparticle thin films are fabricated on Fluorine Tin Oxide (FTO) glass substrates by nanosecond pulsed fiber laser deposition (PLD) to be used as a plasmonic electron transport layer (ETL) in perovskite solar cell (PSC). The effect of various pulsed fiber laser parameters on the structural, optical, and surface morphology on Al/TiO2 films is extensively examined utilizing a variety of measurement techniques; X-ray diffraction (XRD), Ultraviolet–visible (UV–Vis) spectroscopy, Field emission scanning electron microscopy (FE-SEM) and Atomic

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Mon Dec 01 2025
Journal Name
Materials Today Communications
Green electrospinning synthesis of NiO/Ni nanofiber for efficient soap removal from crude biodiesel
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Publication Date
Wed Dec 13 2017
Journal Name
Al-khwarizmi Engineering Journal
Performance Comparison of Different Advanced Control Schemes for Glucose Level Control under Disturbing Meal
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Abstract

In this work, diabetic glucose concentration level control under disturbing meal has been controlled using two set of advanced controllers. The first set is sliding mode controllers (classical and integral) and the second set is represented by optimal LQR controllers (classical and Min-, ax). Due to their characteristic features of disturbance rejection, both integral sliding mode controller and LQR Minmax controller are dedicated here for comparison. The Bergman minimal mathematical model was used to represent the dynamic behavior of a diabetic patient’s blood glucose concentration to the insulin injection. Simulations based on Matlab/Simulink, were performed to verify the performance of each controll

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Publication Date
Thu Aug 01 2013
Journal Name
Plos One
Reliability Measurement for Mixed Mode Failures of 33/11 Kilovolt Electric Power Distribution Stations
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