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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
Mon May 11 2020
Journal Name
Baghdad Science Journal
A Cryptosystem for Database Security Based on TSFS Algorithm
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Implementation of TSFS (Transposition, Substitution, Folding, and Shifting) algorithm as an encryption algorithm in database security had limitations in character set and the number of keys used. The proposed cryptosystem is based on making some enhancements on the phases of TSFS encryption algorithm by computing the determinant of the keys matrices which affects the implementation of the algorithm phases. These changes showed high security to the database against different types of security attacks by achieving both goals of confusion and diffusion.

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Publication Date
Wed Jan 01 2020
Journal Name
Ieee Access
A New Separable Moments Based on Tchebichef-Krawtchouk Polynomials
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Publication Date
Sun Dec 31 2023
Journal Name
International Journal On Technical And Physical Problems Of Engineering
A Multiple System Biometric System Based on ECG Data
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A Multiple System Biometric System Based on ECG Data

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Publication Date
Tue Jul 31 2012
Journal Name
Journal Of Babylon University/pure And Applied Sciences/
An Evaluation of the Effect of Bleaching Agent on Microhardness of a New Silorane-Based Restorative System and Methacrylate-Based Restorative Material
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Abstract Rasha Hameid Jehad Baghdad University Background: The high reactivity of hydrogen peroxide used in bleaching agents have raised important questions on their potential adverse effects on physical properties of restorative materials. The purpose of this in vitro study was to evaluate the effect of in-office bleaching agents on the microhardness of a new Silorane-based restorative material in comparison to methacrylate-based restorative material. Materials and method: Forty specimens of Filtek™ P90 (3M ESPE,USA) and Filtek™ Supreme XT (3M ESPE, USA) of (8mm diameter and 3m height) were prepared. All specimens were polished with Sof-Lex disks (3M ESPE, USA). All samples were rinsed and stored in incubator 37˚C for 24 ho

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Publication Date
Wed Aug 24 2022
Journal Name
Journal Of Tikrit University For Humanities
A Training Program Based on Integrating Future Thinking Skills and Classroom Interaction Patterns for Mathematics Teachers and Providing Their Students with Creative Solution Skills
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The research aims to recognize the impact of the training program based on integrating future thinking skills and classroom interaction patterns for mathematics teachers and providing their students with creative solution skills. To achieve the goal of the research, the following hypothesis was formulated: There is no statistically significant difference at the level (0.05) between the mean scores of students of mathematics teachers whose teachers trained according to the proposed training program (the experimental group) and whose teachers were not trained according to the proposed training program (the control group) in Pre-post creative solution skills test. Research sample is consisted of (31) teachers and schools were distribut

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Publication Date
Sun Aug 01 2021
Journal Name
Journal Of Engineering
Utilization of Iraqi Metakaolin in Special Types of Concrete: A Review Based on National Researches
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Portland cement concrete is the most commonly used construction material in the world for decades. However, the searches in concrete technology are remaining growing to meet particular properties related to its strength, durability, and sustainability issue. Thus, several types of concrete have been developed to enhance concrete performance. Most of the modern concrete types have to contain supplementary cementitious materials (SCMs) as a partial replacement of cement. These materials are either by-products of waste such as fly ash, slag, rice husk ash, and silica fume or from a geological resource like natural pozzolans and metakaolin (MK). Ideally, the utilization of SCMs will enhance the concrete performance, minimize

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Publication Date
Wed Jan 30 2019
Journal Name
Journal Of The College Of Education For Women
Forced displacement in Iraq its causes and its effects on displaced families (A field study of displaced families to the city of Baghdad)
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After a temporary halt to forced thghebr in different cities of Iraq this methodlogy
opeations returned directiy in the areas of political conflict on the ground which are translated
operations and forced displacement violence es they operations aimed at completing the
forced displacement that occurred after the occupation in(2003)which took an upward curve
publicly after these events and some of which are aimed at the liquidation of some provinces
than any demographic diversity of religious or sectarian or alhens and others aimed at
redemographic distribution within the province itself to produce a net sectarian zones as is the
case in Diyala Nineveh and Babylon Baghdad has the epicenter of sectarian violence and th

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Publication Date
Mon Apr 01 2024
Journal Name
Medical Journal Of Babylon
Clinical Evaluation and Comparison between Effects of Rituximab and Prednisolone with Imuran to Neutrophils and Platelet Counts in Pemphigus Vulgaris Patients
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Background: Pemphigus vulgaris (PV) is an autoimmune vesiculobullous mucocutaneous disease with life-threatening consequences. Rituximab (RTX) has recently emerged as an effective treatment for PV. Objectives: This study aims to determine changes in neutrophil and platelet counts for PV patients treated with RTX or corticosteroids combined with Imuran (azathioprine). Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology at Baghdad Teaching Hospital, Baghdad, Iraq. Thirty PV patients received two types of treatment: 15 patients were administered RTX and 15 patients took corticosteroids with Imuran (azathioprine). Neutrophil and platelet counts were detected at the hospital laboratory. Results

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Publication Date
Sun Oct 01 2017
Journal Name
Applied Energy
Hourly yield prediction of a double-slope solar still hybrid with rubber scrapers in low-latitude areas based on the particle swarm optimization technique
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Publication Date
Wed Nov 01 2023
Journal Name
International Society For The Study Of Vernacular Settlements
Responding to Environmental Changes through Resilient Urban Design: Insights from Iraq
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