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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 Sep 26 2018
Journal Name
Communications In Computer And Information Science
A New RGB Image Encryption Based on DNA Encoding and Multi-chaotic Maps
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Publication Date
Wed Aug 28 2024
Journal Name
Mesopotamian Journal Of Cybersecurity
A Novel Anomaly Intrusion Detection Method based on RNA Encoding and ResNet50 Model
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Cybersecurity refers to the actions that are used by people and companies to protect themselves and their information from cyber threats. Different security methods have been proposed for detecting network abnormal behavior, but some effective attacks are still a major concern in the computer community. Many security gaps, like Denial of Service, spam, phishing, and other types of attacks, are reported daily, and the attack numbers are growing. Intrusion detection is a security protection method that is used to detect and report any abnormal traffic automatically that may affect network security, such as internal attacks, external attacks, and maloperations. This paper proposed an anomaly intrusion detection system method based on a

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Publication Date
Wed Aug 28 2024
Journal Name
Mesopotamian Journal Of Cybersecurity
A Novel Anomaly Intrusion Detection Method based on RNA Encoding and ResNet50 Model
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Cybersecurity refers to the actions that are used by people and companies to protect themselves and their information from cyber threats. Different security methods have been proposed for detecting network abnormal behavior, but some effective attacks are still a major concern in the computer community. Many security gaps, like Denial of Service, spam, phishing, and other types of attacks, are reported daily, and the attack numbers are growing. Intrusion detection is a security protection method that is used to detect and report any abnormal traffic automatically that may affect network security, such as internal attacks, external attacks, and maloperations. This paper proposed an anomaly intrusion detection system method based on a

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Publication Date
Fri Dec 01 2017
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Tax Exemptions and their impact in reducing the phenomenon of tax evasion: A field study
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The research aims to verifying the tax exemptions granted in accordance with the Iraqi tax legislations, showing their suitability for basic tax rules, and identifying their role to reduce the tax evasion phenomenon and the negative effects resulting therefrom, which arerepresented by a decrease in the proceeds of tax revenue and therefore leadings to a reduction of public revenues of the state. Also, the research tries to identify the ways to reduce cases of tax evasion due to their reflection positively on the public budgetof the state. The data of the research was collected through two models of questionnaires distributed to a sample of taxpayers from some professions and a sample of the tax administration staff. The research has reac

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Publication Date
Fri Oct 07 2022
Journal Name
Texas Journal Of Engineering And Technology
Estimation of Pore Pressure and In-Situ Stresses for Halfaya Oil Field: A Case Study
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Publication Date
Wed Jan 08 2020
Journal Name
Environment, Development And Sustainability
Groundwater availability and water demand sustainability over the upper mega aquifers of Arabian Peninsula and west region of Iraq
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Publication Date
Thu Jun 15 2023
Journal Name
Alustath Journal For Human And Social Sciences
The Effectiveness of a Cognitive-Behavioral Treatment Program to Reduce Nervous Fatigue for Mothers of Children with Cerebral Palsy
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Cognitive-behavioral therapy is one of the most important relatively recent; treatment programs that attempt to modify behavior and control psychological disorders by modifying the individual's thinking style and awareness of himself and his environment, and cognitive reconstruction by replacing negative thoughts with positive ones. The current study aimed to know the effectiveness of a cognitive behavioral treatment program in reducing nervous fatigue among mothers of children with cerebral palsy. The sample on which the nervous fatigue scale was applied consisted of (30) mothers whose son suffers from cerebral palsy, and the results indicated that (24) mothers suffer from nervous fatigue. This sample was divided

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of The College Of Education For Women
Topic Management in Selected Dementia Patients' Speeches: A Clinical Discourse Analysis Study
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Topic management is the awareness of how speakers deal with initiating, developing, changing, and ending a topic and how they fix the relationship when a misunderstanding occurs. It is such an important unit of conversation as it includes the transition from one strategy to the other to be accomplished in a systematic and orderly manner. These strategies are impaired in dementia patients thus lead to communication breakdown. This study aims at detecting the dementia patients' topic management strategies in selected speeches and answering the questions of which of these strategies are fully or partially detected in these speeches. The researchers use a qualitative method to examine the speeches of those patients and they adopt an eclectic

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Publication Date
Wed Mar 01 2023
Journal Name
Al-khwarizmi Engineering Journal
Expired Colxacillin, Amoxicillin, and Ceflaxin Drugs as Inhibitors for Low Carbon Steel Corrosion in Sodium Chloride
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The ability to inhibit corrosion of low carbon steel in a salt solution (3.5%NaCl) has been checked with three real expired drugs (Cloxacillin, Amoxicillin, Ceflaxin) with variable concentrations (0, 250, 500, 750) mg/L were examined in the weight loss. The inhibition efficiency of the Cloxacillin 750 mg/L showed the highest value (82.8125 %) and the best inhibitor of the rest of the antibiotics. The different concentrations of Cloxacillin drug (0, 250, 500, 750) mg/L and temperature (25, 35, 45, 55) oC were studied as variables with potentiodynamic polarization, Scanning Electron Microscopy (SEM) for surface morphology and electrochemical impedance spectroscopy (EIS) depending on current values and the resistance of charge to

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Publication Date
Thu Jun 01 2023
Journal Name
Medicinal Chemistry
New Niflumic Acid Derivatives as EGFR Inhibitors: Design, Synthesis, In silico Studies, and Anti-proliferative Assessment
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Background:

1,3,4-oxadizole and pyrazole derivatives are very important scaffolds for medicinal chemistry. A literature survey revealed that they possess a wide spectrum of biological activities including anti-inflammatory and antitumor effects.

Objectives:

To describe the synthesis and evaluation of two classes of new niflumic acid (NF) derivatives, the 1,3,4-oxadizole derivatives (compounds 3 and (4A-E) and pyrazole derivatives (compounds 5 and 6), as EGFR tyrosine kinase inhibitors in silico and in vitro.

Methods:

The designed compounds were synthesized using convent

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