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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
Thu Oct 30 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Penetrating Cardiac Injury in a Child Following Nail Gun Accident: Clinical Implications and Public Health Concerns
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Penetrating cardiac injuries caused by nail guns are exceedingly rare but often life-threatening, with reports showing an increasing trend. We described the case of an adolescent male who sustained accidental cardiac penetration by an iron nail while performing carpentry work. Rapid referral to a specialized cardiac center enabled timely surgical intervention, illustrating the pivotal role of early recognition, expedited transfer, and expert management in optimizing outcomes. This case also highlights the grave risks associated with the employment of minors in hazardous occupational settings, where exposure to unsafe environments may lead to catastrophic consequences.

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Publication Date
Sat Dec 02 2023
Journal Name
Journal Of Engineering
The Cost of Technology Transfer in Construction Companies (In Iraq)
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The construction sector is considered an important and influential pivot in the national economy of any country.  Nations are working to develop this sector, receiving modern and developed techniques. So, this sector can be a carrier or a receiver of modern technologies. The cost of technology transfer between the international companies that sponsor this sector is a matter of great importance, especially since different factors affect the need for this advanced technology. The cost of technology transfer in construction is related to multiple factors presented by Knowledge, equipment, plant, hardware and software. The lack of distinguishing and evaluating the direct and indirect costs in the construction sector during

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Publication Date
Wed Oct 29 2025
Journal Name
Nursing Science Quarterly
Effectiveness of an Educational Program in Reducing Pressure Injuries in Patients With Spinal Cord Injury in Iraq
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Persons with spinal cord injury are at high risk of developing pressure injuries, and their caregivers are in a critical position to help prevent them. The objective of this study was to evaluate the effectiveness of an educational program for caregivers of persons with spinal cord injuries to prevent pressure injuries in Iraq. A pre- and post-test design was used and involved 25 caregivers of persons with spinal cord injury during the acute care phase in an SCI-specific unit of a hospital. A scale and questionnaire were used to gather the participants’ demographic information, pre- and post-educational program knowledge, and observations of their pre- and post-program performance of pressure injury preventive tasks. Descriptive s

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Publication Date
Sat Jan 01 2022
Journal Name
Archives Of Civil Engineeringthis Link Is Disabled
Factors affecting time and cost trade-off in multiple construction projects
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Scopus
Publication Date
Tue Jan 01 2019
Journal Name
Advances On Computational Intelligence In Energy
A Theoretical Framework for Big Data Analytics Based on Computational Intelligent Algorithms with the Potential to Reduce Energy Consumption
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Within the framework of big data, energy issues are highly significant. Despite the significance of energy, theoretical studies focusing primarily on the issue of energy within big data analytics in relation to computational intelligent algorithms are scarce. The purpose of this study is to explore the theoretical aspects of energy issues in big data analytics in relation to computational intelligent algorithms since this is critical in exploring the emperica aspects of big data. In this chapter, we present a theoretical study of energy issues related to applications of computational intelligent algorithms in big data analytics. This work highlights that big data analytics using computational intelligent algorithms generates a very high amo

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Publication Date
Fri Jun 01 2018
Journal Name
J. Pharm. Sci. & Res
Periodontal health status for post-menopausal women with and without osteoporosis (Clinical and radiographical study)
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Scopus (4)
Scopus
Publication Date
Thu Jun 30 2016
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Study the Efficiency of Drilling With Casing Operation in an Iraqi Oil Field
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Drilling with casing (DWC) can be considered as a modern drilling technique in which both of drilling and casing operations done in the same time by using the casing to transfer the hydraulic and mechanical power to the bit instead of traditional drilling string. To overcome oil well control, minimizing the total cost through enhancing drilling efficiency, drilling with casing was proposed as an enabling technology.

   Two surface sections (17 1/2 - and 12 1/4- inch) were drilled successfully in Rumaila oil field with  casing strings which reached 655m and 1524m measured depths respectively.

   By using DWC technique, the total drill/case phase time was reduced up to 20% comparing to conventional

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Publication Date
Mon Aug 22 2022
Journal Name
World Bulletin Of Management And Law
THE IMPACT OF OUTSOURCING OF HUMAN RESOURCE ACTIVITIES ON ORGANIZATIONAL WINNING(FIELD RESEARCH IN A SAMPLE OF PREMIUM CLASS HOTELS -IN IRAQ)
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The aim of the research is to test the effect of outsourcing human resources activities (independent variable) with its dimensions (outsourcing of staffing, outsourcing of training and development, outsourcing of wages and compensation, outsourcing of human resources information systems) on organizational winning (dependent variable) with its dimensions (the culture of winning, successful organizational change, continuous improvement, and adoption of risk). The research problem was the questions posed by the researcher, the most important of which is the extent to which the research sample realizes the importance of applying outsourcing to human resources activities and its role in organizational vi

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Publication Date
Sun Feb 03 2019
Journal Name
Journal Of The College Of Education For Women
Social indications (Marriage websites) - A field study in internet cafes
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Marriage is considered one of the strongest ties that links between two human beings , but after the evolutions that happened in our Arab communities and specifically in the Iraqi community , marriage through the internet websites appeared . this kind of marriage is considered one of the new phenomena that appeared in the present time in many societies. That was through internet websites like yahoo , Facebook and other websites that have chat features.
The Islamic sharia looks negatively at marriage through the internet announcing that this way is harmful for both the man and the woman

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Publication Date
Mon Aug 01 2016
Journal Name
Journal Of Engineering
Exploring the Factors Affecting the Elemental Cost Estimation with Relationship Analysis Using AHP
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Cost estimation is considered one of the important tasks in the construction projects management. The precise estimation of the construction cost affect on the success and quality of a construction project. Elemental estimation is considered a very important stage to the project team because it represents one of the key project elements. It helps in formulating the basis to strategies and execution plans for construction and engineering.  Elemental estimation, which in the early stage, estimates the construction costs depending on  . minimum details of the project so that it gives an indication for the initial design stage of a project. This paper studies the factors that affect the elemental cost estimation as well as the rela

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