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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
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
The Role of Talent Management on Strategic Performance Reinforcement A field research on some of Sumer's university colleges.
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In this research we have tackled the role of Talent management (as a private variable) within (the Talent attraction, the Talent management performance, Talent development and Talent retention) on strategic performance reinforcement ( accredited variable) within its dimensions ( financial perspective, costumer perspective, internal operations perspective and learning and development perspective). The research conducted on sample of some college teachers from two of Sumer's colleges. The research problem represented by the broad organization's competition as well as universities; which led these colleges to investigate it's skillful human staff to meet it's strategic performance. 

To meet the aims of

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Publication Date
Mon Mar 27 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Evaluation of the Clinical use of Metformin or Pioglitazone in Combination with Meloxicam in Patients with Knee Osteoarthritis; using Knee Injury and Osteoarthritis outcome Score
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Osteoarthritis is the most prevalent arthritic disease and a leading cause of disability. The pathogenesis of osteoarthritis involves multiple etiologies, including variable degree of synovial inflammation. Metformin and pioglitazone could potentially reduce the levels and activity of inflammatory mediators. This may consider as a new therapeutic approach added to the current used drugs in an attempt to decrease the pain, inflammation, and improve daily activity and quality of life in patients with knee osteoarthritis.

This study designed to evaluate the clinical utility of using metformin or pioglitazone as anti-inflammatory agents in combination with non-steroidal anti-inflammatory drugs (NSAID) of selective type of cyclooxygen

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Publication Date
Mon Mar 16 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of some salivary enzymes levels in type 2 diabetic patients with chronic periodontitis (Clinical and biochemical study)
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Background: Diabetic patients have been reported to be more susceptible to gingivitis and periodontitis than healthy subjects. Many intracellular enzymes like (alkaline phosphatase- (ALP), aspartate aminotransferase- (AST) and alanine aminotransferase- (ALT) that are released outside cells into the gingival crevicular fluid (GCF) and saliva after destruction of periodontal tissue during periodontitis. This study was conducted to determine the periodontal health status and the levels of salivary enzymes (ALP, AST and ALT) of the study and control groups and to correlate the levels of these enzymes with clinical periodontal parameters in each study group. Subjects, Materials and Methods: One hundred subjects were enrolled in the study, with a

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Publication Date
Thu Dec 25 2025
Journal Name
Sultan Qaboos University Medical Journal
Clinical and Molecular Analysis of ATP7B Variants Identified by Next-Generation Sequencing in Iraqi Adults With Wilson Disease
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Objectives: This study aimed to identify and analyse ATP7B variants in Iraqi adults with Wilson disease (WD) by long-read next-generation sequencing. Methods: This cross-sectional study was conducted at the Poisoning Consultation Center at Ghazy Al-Hariri Hospital for Surgical Specialties and the Gastroenterology Consultation Clinic at Baghdad Teaching Hospital, Medical City in Baghdad, Iraq. Unrelated patients with clinical and biochemical features suggestive of WD were recruited between October 2022 and October 2023. DNA was extracted from peripheral blood samples. Variants in the ATP7B gene were identified using long-read next-generation sequencing and then analysed by in-silico tools. Results: A total of 45 patients were recruited in

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Scopus
Publication Date
Mon Oct 22 2018
Journal Name
Journal Of Economics And Administrative Sciences
Using Mehar method to change fuzzy cost of fuzzy linear model with practical application
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  Many production companies suffers from big losses because of  high production cost and low profits for several reasons, including raw materials high prices and no taxes impose on imported goods also consumer protection law deactivation and national product and customs law, so most of consumers buy imported goods because it is characterized by modern specifications and low prices.

  The production company also suffers from uncertainty in the cost, volume of production, sales, and availability of raw materials and workers number because they vary according to the seasons of the year.

  I had adopted in this research fuzzy linear program model with fuzzy figures

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Publication Date
Sun Jan 01 2012
Journal Name
Tikrit Journal For Dental Sciences
Microleakage Evaluation of a Silorane-Based and Methacrylate-Based Packable and Nanofill Posterior Composites (in vitro comparative study)
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This study compared in vitro the microleakage of a new low shrink silorane-based posterior composite (Filtek™ P90) and two methacrylate-based composites: a packable posterior composite (Filtek™ P60) and a nanofill composite (Filtek™ Supreme XT) through dye penetration test. Thirty sound human upper premolars were used in this study. Standardized class V cavities were prepared at the buccal surface of each tooth. The teeth were then divided into three groups of ten teeth each: (Group 1: restored with Filtek™ P90, Group 2: restored with Filtek™ P60, and Group 3: restored with Filtek™ Supreme XT). Each composite system was used according to the manufacturer's instructions with their corresponding adhesive systems. The teeth were th

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Publication Date
Wed Jan 01 2020
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of Health Educational Program on Nurses’ Knowledge About Communication Skills with Children at Welfare Children Teaching Hospital in Baghdad City
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Background: Therapeutic communication is the basis of interactive relationships among nursing team and their children: that affords opportunities to establish rapport, understand the client’s experience, formulate individualized or client interventions and optimize health care resources.

Objectives: The main aim of the study is to determine the Effectiveness of Education Program on Nurses’ Knowledge about Communication Skills with Children.

Methodology: A quasi-experimental study was conducted in Children Welfare Teaching Hospitals from 7th, October 2018 to the 20th, May 2019. The program and instruments have been constructed by the researcher for the purpose of the study. A non- prob

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Publication Date
Tue Mar 28 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Implementation of a Clinical Pharmacy Training Program in Iraqi Teaching Hospitals : Review Article
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Pharmaceutical care is a patient-centered, outcomes oriented practice that requires the pharmacist to work in concert with the patient and the patient’s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. In addition, the presence of clinical pharmacists has led to a higher quality of patient education and provision of complete detailed information for patients. In developed countries Pharm D has become the professional degree for practice of Pharmacy. The graduates will be enrolled in a pharmacy residency program; admission to the residency programs is available to Pharm D graduates of an accredit

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Publication Date
Tue Jan 10 2017
Journal Name
International Journal Of Dynamics And Control
On local approximation-based adaptive control with applications to robotic manipulators and biped robots
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Publication Date
Sat Oct 01 2022
Journal Name
The Egyptian Journal Of Hospital Medicine
Some Clinical Features of Trichomoniasis Associated with Pelvic Organs Tenderness in Sample of Iraqi women
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