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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 Jan 01 2023
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees22fr
Investigate the structural properties of Tl1-xHgxSr2Ca2Cu3O8+δ compound by using Scherrer modified equation
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Publication Date
Thu May 21 2026
Journal Name
Journal Of Physical Education
Analytical Study Of Teaching Efficiency According To Herman Module For Baghdad Governorate Physical Educators
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The importance of the current research lies in the importance of teaching competencies and the ability of the teacher to deal and success in his educational career. The research aimed to identify the degree of teaching competencies according to Hermann model of physical education teachers in Baghdad governorate. The descriptive method using the survey method was used on a randomly selected sample of 462 teachers and 314 school principals. After the completion of the survey, the Hermann scale forms were distributed to the teachers. The forms of the teaching competency scale were distributed to their school principals as the direct supervisors of the teachers' evaluation. After completing the survey, the results of each scale were classified

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Publication Date
Tue Jul 01 2014
Journal Name
Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
THE FIRST RECORD OF FOUR ISOPODS FROM SOME RED SEA FISHES, YEMENI COASTAL WATERS
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    A total of 680 fish specimens belonging to 31 species from the Yemeni coastal waters of the Red Sea were inspected for the isopod infestations. Four isopod species belonging to three families of the suborder Cymothoida were detected. These are: Aega psora (Linnaeus, 1758) from Lethrinus lentjan, Natatolana insignis Hobbins and Jones, 1993 from Abalistes stellatus, Excorallana tricornis (Hansen, 1890) from Epinephelus fuscoguttatus, E. guttatus and E. tauvina and Alcirona krebsi Hansen, 1890 from Epinephelus microdon. All these isopod species are reported here for the first time from the Yemeni coastal waters of the Red Se

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Publication Date
Thu Jan 03 2019
Journal Name
Journal Of Global Pharma Technology
Antibacterial Activity of New Synthesized Derivatives 3-Substituted Imidazo Benzothiazole from 2- amino- benzothiazole
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Publication Date
Wed Jul 01 2020
Journal Name
Journal Of Engineering
Design of Multi-Rate Multi-Zone Wireless Fuzzy Temperature Control System for Greenhouse Application
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sensor sampling rate (SSR) may be an effective and crucial field in networked control systems.  Changing sensor sampling period after designing the networked control system is a critical matter for the stability of the system. In this article, a wireless networked control system with multi-rate sensor sampling is proposed to control the temperature of a multi-zone greenhouse. Here, a behavior based Mamdany fuzzy system is used in three approaches, first is to design the fuzzy temperature controller, second is to design a fuzzy gain selector and third is to design a fuzzy error handler. The main approach of the control system design is to control the input gain of the fuzzy temperature controller depending on the cur

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Publication Date
Fri Jan 01 2021
Journal Name
Journal Of Engineering
Finite Element Analysis of Cracked One-Way Bubbled Slabs Strengthened By External Prestressed Strands
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Bubbled slabs can be exposed to damage or deterioration during its life. Therefore, the solution for strengthening must be provided. For the simulation of this case, the analysis of finite elements was carried out using ABAQUS 2017 software on six simply supported specimens, during which five are voided with 88 bubbles, and the other is solid. The slab specimens with symmetric boundary conditions were of dimensions 3200/570/150 mm. The solid slab and one bubbled slab are deemed references. Each of the other slabs was exposed to; (1) service charge, then unloaded (2) external prestressing and (3) loading to collapse under two line load. The external strengthening was applied using prestressed wire with four approaches, wh

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Publication Date
Thu Dec 01 2011
Journal Name
Journal Of Engineering
MODELING HOUSEHOLD TRIP GENERATION FOR SELECTED ZONES AT AL-KARKH SIDE OF BAGHDAD CITY
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Trip generation is the first phase in the travel forecasting process. It involves the estimation of the
total number of trips entering or leaving a parcel of land per time period (usually on a daily basis);
as a function of the socioeconomic, locational, and land-use characteristics of the parcel.
The objective of this study is to develop statistical models to predict trips production volumes for a
proper target year. Non-motorized trips are considered in the modeling process. Traditional method
to forecast the trip generation volume according to trip rate, based on family type is proposed in
this study. Families are classified by three characteristics of population social class, income, and
number of vehicle ownersh

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Publication Date
Sat Aug 01 2020
Journal Name
Journal Of Engineering
New Approaches of Cloud Services Access using Tonido Cloud Server for Real-Time Applications
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A Tonido cloud server provides a private cloud storage solution and synchronizes customers and employees with the required cloud services over the enterprise. Generally, access to any cloud services by users is via the Internet connection, which can face some problems, and then users may encounter in accessing these services due to a weak Internet connection or heavy load sometimes especially with live video streaming applications overcloud. In this work, flexible and inexpensive proposed accessing methods are submitted and implemented concerning real-time applications that enable users to access cloud services locally and regionally. Practically, to simulate our network connection, we proposed to use the Raspberry-pi3 m

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Biological control of saw toothed beetle Oryzaephilus surinamensis(L.)Using fungi Lecanicillium lecanii(Zimm.)
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This study is conducted to determine the effect of pathogenicity of the fungus Lecanicillium lecanii in some aspects of life of the insect saw toothed beetle Oryzaephilus surinamensis L. (Coleoptera: Silvanidae) under laboratory conditions with three concentrations of spores and mildew commentator (1 × 103, 1 × 105, 1 × 107) spore / ml , on eggs and larvae second phase of the insect .The study also includs the effect of the fungus concentrations of germination on rice (jasmine) by using direct spray treatment. The results show great fungus efficiency in the control of some aspects of life of the insect, where varied efficiency depends on the concentration of spores, The highest percentage loss of eggs is 63.33% at a concentration

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Publication Date
Tue May 28 2019
Journal Name
Al-khwarizmi Engineering Journal
Treatment of Waste Extract Lubricating Oil by Catalytic Cracking Process to Produce Light Fractions
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The catalytic cracking of three feeds of extract lubricating oil, that produced as a by-product from the process of furfural extraction of lubricating oil base stock in AL-Dura refinery at different operating condition, were carried out at a fixed bed laboratory reactor. The initial boiling point for these feeds was 140 ºC for sample (1), 86 ºC for sample (2) and 80 ºC for sample (3). The catalytic cracking processes were carried out at temperature range 325-400 ºC and initially at atmospheric pressure after 30 minutes over 9.88 % HY-zeolite catalyst load. The comparison between the conversion at different operating conditions of catalytic cracking processes indicates that a high yield was obtained at 375°C, according to gasoline pr

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