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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 Nov 19 2019
Journal Name
Iranian Journal Of Science And Technology, Transactions A: Science
Systematic Study of the Nuclear Structure for Some Exotic Nuclei Using Skyrme–Hartree–Fock Method
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The ground state charge, neutron, proton and matter densities, the associated nuclear radii and the binding energy per nucleon of 8B, 17Ne, 23Al and 27P halo nuclei have been investigated using the Skyrme–Hartree–Fock (SHF) model with the new SKxs25 parameters. According to the calculated results, it is found that the SHF model with these Skyrme parameters provides a good description on the nuclear structure of above proton-rich halo nuclei. The elastic charge form factors of 8B and 17Ne halo nuclei and those of their stable isotopes 10B and 20Ne are calculated using plane-wave Born approximation with the charge density distributions obtained by SHF model to investigate the effect of the extended charge distributions of proton-rich nucl

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Publication Date
Thu Oct 29 2020
Journal Name
Indian Journal Of Forensic Medicine &amp; Toxicology
Testing the New Parameters affecting The Outcome of Extracorporeal Shockwave Lithotripsy for Upper Ureteric Stones
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Background: Extracorporeal Shock wave lithotripsy (ESWL) is widely used in treating patients with ureteralstones because it is effective, safe, and noninvasive. Based on factors such as size and the location of stones,there is a significant variation in the overall stone-free rate (SFR).Aim of the study: To evaluate the effect of ureteral wall thickness (UWT), stone attenuation, the time fromfirst attack of pain till first session of ESWL and stone/ rib density on the outcome of SWL in the treatmentof upper ureteral stones (UUS).Patient and methods: A prospective study when 127 patients with radio-opaque UUS ranging from 7 to 20mm and treated by ESWL were included in this study. The effect of (stone/ 12th rib) density by KUB, ureter

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Publication Date
Mon Apr 24 2023
Journal Name
Materials Research Innovations
Surface modification of poly(methyl methacrylate)-sulphadiazine complexes as self photostabilizer against Ultraviolet (UV) Irradiation
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Publication Date
Sun Apr 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Bayes Estimators for the Parameter of the Inverted Exponential Distribution Under different Double informative priors
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In this paper, we present a comparison of double informative priors which are assumed for the parameter of inverted exponential distribution.To estimate the parameter of inverted exponential distribution by using Bayes estimation ,will be  used two different kind of information in the Bayes estimation; two different priors have been selected for the parameter of inverted exponential distribution. Also assumed Chi-squared - Gamma distribution, Chi-squared - Erlang distribution, and- Gamma- Erlang distribution as double priors. The results are the derivations of these estimators under the squared error loss function with three different double priors.

Additionally Maximum likelihood estimation method

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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Optical Design of Laser Zoom Beam Expander at near & far Ranges for Tracked Atmospheric Target
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In this research, beam expander, BEX, is explained and designed for illuminating the
remote flying target. The BEX is optically designed to be suited for Nd:YAG laser of given
specifications. The BEX is modified to be zoom one to meet the conditions of preventing the
receiving unit; i.e the photodetector, from getting saturated at near and far laser tracking.
Decollimation could be achieved by automatic motor, which controls zoom lens of the BEX
according to the required expansion ratio of beam expander

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Publication Date
Mon Apr 23 2018
Journal Name
Ibn Al- Haitham Journal For Pure And Applied Science
Performance of Strelitzia reginae Flowers Dye as Sensitizer for New Dye-Sensitized Solar Cell Fabrication
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        In current study, the dye from flowers petals of Strelitzia reginae used for the first time to prepare natural photosensitizer for DSSC fabrication. Among five different solvents used to extract the natural dye from S. reginae flowers, the ethanol extract of anthocyanin dye revealed higher absorption spectrum of 0.757a.u. at wavelength of 454nm.  A major effect of temperature was studied to increase the extraction yield. The results show that the optimal temperature was 70 °C and there was a sharp decrease of dye concentration from 0.827 at temperature of 70 °C to 0.521 at temperature of 90°C. The extract solution of flowers of S. reginae showed higher concentration in acidic media, especially at pH 4 (0.902). The

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Publication Date
Mon Oct 10 2022
Journal Name
International Journal Of Mathematics In Operational Research
Modelling time-series process of an agricultural crop production process by EWMA quality control chart
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Publication Date
Wed Jan 01 2014
Journal Name
Babylon University Journal\applied Pure Sciences
Detection of the perfect condition to produce the tannase from Aspergillus niger at different medium
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Publication Date
Thu May 13 2021
Journal Name
International Journal Of Development In Social Science And Humanities
The Impact of Teachers using Storytelling Techniques through Virtual Instruction to Increase English Speaking Ability
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DBN Rashid, INTERNATIONAL JOURNAL OF DEVELOPMENT IN SOCIAL SCIENCE AND HUMANITIES, 2021

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Screening Program for Urinary Tract Infection of Prepubertal Children at Al Nasiriya City Primary Schools
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Objective(s): The study aims Finding relationship between UTI and demographic variable include: child's age, child's gender, if males are circumcised or not, child's order in his family, father's level of education, mother's level of education, place of residence and family socioeconomic status. Methodology: A descriptive study was conducted on students of primary schools for both sexes, for the period from 19th. February 2014 through to 4th March 2014. A selected sample from two steps the first stage is to choose a school by a stratified- cluster sample, getting schools that have been selected (12) sch

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