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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 Dec 01 2021
Journal Name
Baghdad Science Journal
Studying the Photodegradation of Congo Red Dye from Aqueous Solutions Using Bimetallic Au–Pd/TiO2 Photocatalyst
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In this study, the photodegradation of Congo red dye (CR) in aqueous solution was investigated using Au-Pd/TiO2 as photocatalyst. The concentration of dye, dosage of photocatalyst, amount of H2O2, pH of the medium and temperature were examined to find the optimum values of these parameters. It has been found that 28 ppm was the best dye concentration. The optimum amount of photocatalyst was 0.09 g/75 mL of dye solution when the degradation percent was ~ 96 % after irradiation time of 12 hours, while the best amount of hydrogen peroxide was 7μl/75 mL of dye solution at degradation percent ~97 % after irradiation time of 10 hours, whereas pH 5 was the best value to carry out the reaction at the highest degradation percent. In additio

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Publication Date
Wed Dec 01 2021
Journal Name
Baghdad Science Journal
Studying the Photodegradation of Congo Red Dye from Aqueous Solutions Using Bimetallic Au–Pd/TiO2 Photocatalyst
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In this study, the photodegradation of Congo red dye (CR) in aqueous solution was investigated using Au-Pd/TiO2 as photocatalyst. The concentration of dye, dosage of photocatalyst, amount of H2O2, pH of the medium and temperature were examined to find the optimum values of these parameters. It has been found that 28 ppm was the best dye concentration. The optimum amount of photocatalyst was 0.09 g/75 mL of dye solution when the degradation percent was ~ 96 % after irradiation time of 12 hours, while the best amount of hydrogen peroxide was 7μl/75 mL of dye solution at degradation percent ~97 % after irradiation time of 10 hours, whereas pH 5 was the best value to carry out the reaction at the highest degradation percent. In additio

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Publication Date
Thu Oct 01 2020
Journal Name
Journal Of Engineering Science And Technology
GEOMETRIC NONLINEAR TIME DOMAIN SPECTRALMATCHING SEISMIC ANALYSIS OF BASE ISOLATED HIGHRISE BUILDINGS INCLUDING P-DELTA EFFECT
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Time-domain spectral matching commonly used to define seismic inputs to dynamic analysis in terms of acceleration time history compatible with a specific target response spectrum is used in this study to investigate the second-order geometric effect of P-delta on the seismic response of base-isolated high-rise buildings. A synthetic time series is generated by adjusting reference time series that consist of available readings from a past earthquake of the 1940 El Centro earthquake adopted as an initial time series. The superstructure of a 20-story base isolated building is represented by a 3-D finite element model using ETABS software. The results of the base isolated building show that base isolation technique significantly reduces inter-s

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Publication Date
Sun Dec 06 2015
Journal Name
Baghdad Science Journal
Bounded Solutions of the Second Order Differential Equation x ?+f(x) x ?+g(x)=u(t)
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In this paper we prove the boundedness of the solutions and their derivatives of the second order ordinary differential equation x ?+f(x) x ?+g(x)=u(t), under certain conditions on f,g and u. Our results are generalization of those given in [1].

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Publication Date
Mon Jan 01 2024
Journal Name
Aip Conference Proceedings
Testing the cytotoxic potential of biosynthesized nanoparticles using Conocarpus erectus Leaves against human breast cancer cells
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Publication Date
Sun Mar 13 2011
Journal Name
Baghdad Science Journal
The Consumed Natural Diet of Chondrostoma regium (Heckel, 1843) from Tigris River, Salah Al-Deen Province
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The foreguts of a total of 515 fish of Chondrostoma regium (Heckel, 1843) (locally: Bala’aot Malloky) were studied. These fish were collected from Tigris River at Salah Al-Deen Province (between Al-Hagag & Yathrib) for 20 months between March and October of the next year. Detritus, plant in origin materials (19.6%, 23.0% & 24.9%); green and blue green algae, mostly Cladophora, Cosmarium and Merismpedia sp. (17.1%, 12.9% & 12.2%) and diatoms, mostly Diatoma, Chanathes, Amphora and Cyulbella sp. (16.9%, 8.8% & 8.2%) were the main food categories taken by these fishes according to occurrence (O%), volumetric methods (V%) and ranking index (R%). Debris (not part of the diet) took 45.3% of the studied fish foreguts by volume. Detritus was also

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Publication Date
Tue Jul 01 2025
Journal Name
Journal Of Ecological Engineering
Enhancement of &lt;i&gt;Chlorella vulgaris&lt;/i&gt; bioethanol production by optimizing phosphorus concentrations
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This study investigated the bioethanol production from green algae Chlorella vulgaris depending on its carbohydrate-enriched biomass. Four different phosphorous concentrations were employed to stimulate bioethanol production from Chlorella vulgaris. The impact of various phosphorous values on Chlorella vulgaris growth rate as well as primary product (carbohydrate) were evaluated. High performance liquid chromatography was utilized in this work. The stationary phase was identified as day 14, 12, 10 and 6 in treatments 6, 4, 2 and g/L, respectively. The findings suggest that the treatment without phosphorous addition had the highest record of carbohydrate content (22.64% dry weight) as well as the highest bioethanol yield (20.66% dry weight).

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Publication Date
Tue Jan 01 2019
Journal Name
Technologies And Materials For Renewable Energy, Environment And Sustainability: Tmrees19gr
I-V characteristics of n-Si /ZnO/Se/MWCNTs nanocomposite solar cell fabricated by solvothermal technique
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Publication Date
Sat Nov 30 2024
Journal Name
Research Journal Of Chemistry And Environment
Evaluation of blue textile dye decolorization by immobilized polyphenol oxidase using pumice stone under optimum conditions
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Industrial dyes are major pollutants in wastewater and river water with an initial visible concentration of 1 mg/L. Recent studies have shown the possibility of using polyphenol oxidase in catalytic biological treatment due to its ability to oxidize a large number of dyes and pollutants in wastewater and the flexibility to work in wide ranges of temperature, pH and salinity. It is easy availability as well as the low economic cost resulting from its use in biological treatments, this enzyme polyphenol oxidase was used. The findings in this study showed that the extraction of polyphenol oxidase (PPO) from potato peel was homogenized with potassium phosphate buffer (0.1 M, pH 7) at a ratio of 1:10 (weight: volume) for two min. The res

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Publication Date
Sat Feb 01 2020
Journal Name
Journal Of Water Process Engineering
Predominant mechanisms for the removal of nickel metal ion from aqueous solution using cement kiln dust
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