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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 Mar 09 2022
Journal Name
Journal Of Craniofacial Surgery
The Use of Osseodensification for Ridge Expansion and Dental Implant Placement in Narrow Alveolar Ridges: A Prospective Observational Clinical Study
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The osseodensification (OD) drilling technique was suggested as an alveolar ridge expansion technique, so the aim of this prospective clinical study was to evaluate the amount of bone expansion obtained by the OD drilling technique and its effect on implant stability in patients with narrow alveolar ridges. The width of the alveolar ridge was measured at the crest before and after implant site preparation, whereas the implant stability was measured using Osstell Beacon implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. Twenty-three patients were included; they received 40 implants. The mean (± standard deviation [SD]) amount of expansion was 1.29 (± 0.41) mm, and the difference b

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Publication Date
Sat Jan 01 2022
Journal Name
International Journal Of Economics And Finance Studies
THE ROLE OF COSTING TECHNIQUES IN REDUCTION OF COST AND ACHIEVING COMPETITIVE ADVANTAGE IN IRAQI FINANCIAL INSTITUTIONS
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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Gas Lift Optimization for Zubair Oil Field Using Genetic Algorithm-Based Numerical Simulation: Feasibility Study
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The gas-lift method is crucial for maintaining oil production, particularly from an established field when the natural energy of the reservoirs is depleted. To maximize oil production, a major field's gas injection rate must be distributed as efficiently as possible across its gas-lift network system. Common gas-lift optimization techniques may lose their effectiveness and become unable to replicate the gas-lift optimum in a large network system due to problems with multi-objective, multi-constrained & restricted gas injection rate distribution. The main objective of the research is to determine the possibility of using the genetic algorithm (GA) technique to achieve the optimum distribution for the continuous gas-lift injectio

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Publication Date
Thu Jul 31 2025
Journal Name
Indonesian Journal Of Chemistry
Evaluation of the Antioxidant and Anticancer Effectiveness of Some New Metal Ions Complexes with Azo Dye: Synthesis and Characterization
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This paper presents a new azo dye 3-[2-(1H-indol-2-yl)ethyldiazenyl]quinolin-2-ol] from the reaction of the diazonium salt derived from tryptamine and 2-hydroxyquinoline. Azo dye was used to prepare a series of complexes with the chlorides of Ni(II), Pt(IV), Pd(II), Cd(II), and Zn(II). Compounds were analyzed and characterized using elemental analysis, magnetic measurement, UV-vis, IR, MS, NMR, and conductivity. The findings demonstrated that the ligand acts as ionic in complex form, O-bidentate, supporting the proposed formula. The complexes generally exhibited tetrahedral and octahedral geometries, except the palladium complex, which adopted a square planar geometry. TGA was used to investigate the thermal characteristics of compo

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Publication Date
Tue Sep 19 2017
Journal Name
Al-academy
Technology manufacturing Ghazi oven and sessile cost of production of ceramic
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The ceramic work of the business that was stationed with the history of its evolution of man on earth, and this gives him a linking formula and the reality of life, including asking as inherited civilized . Operation creativity over several stages and developments have helped in the formation of human hands, including a reflection on productions are large and diverse.

To search for new horizons in ceramic art began to form new technologies outside the traditional frameworks ,devoted  technical and scientific expertise and access to an advanced stage in porcelain from technical and aesthetic point of view the field, shall be deemed to contemporary ceramic civilized idea of ​​Modernism from the ceramic work can in no way b

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Publication Date
Tue Mar 15 2022
Journal Name
Al-academy
Symbolic significance and its effectiveness in industrial product design
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The current research dealt with the symbolic significance and its effectiveness in the design of the industrial product, the aesthetic communicative discourse that embodies the imagination and human conscience. Whether according to what has been termed custom or what has been approved by traditions long ago, symbolism may be the main actor in linking the identifying components of the product. In addition, symbolism provides the user with the key to accessing a direct awareness of the product’s shape and function, as an identification of the product by stimulating the symbolic form of the consumer’s imagination and inviting him to To meditate in order to realize the implicit meaning behind these forms and thus achieve the symbolism of

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Publication Date
Sun Mar 15 2020
Journal Name
Al-academy
Digital Media and its Role in Marketing Artistic Products " A Field Study": احمد عبد الستار حسين
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This research addresses a problem manifested in a main question: what is the role of the digital media in marketing the artistic products? in order to determine the role played by the digital media in  the disclosure and promotion of  the artistic product, its price and places of distribution, as the basic elements of the marketing mixture. 

                This is a descriptive research in which the researcher used the survey method to check the opinions of a sample chosen according to the (proportion) method from the research community represented by instructors and students of the college of Fine Arts- University of Dayala. 

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Publication Date
Fri Feb 08 2019
Journal Name
Journal Of The College Of Education For Women
A Unit Plan Based Upon The MI Theory: A theoretical study with an application Inside The Classroom
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This research basically gives an introduction about the multiple intelligence
theory and its implication into the classroom. It presents a unit plan based upon the
MI theory followed by a report which explains the application of the plan by the
researcher on the first class student of computer department in college of sciences/
University of Al-Mustansiryia and the teacher's and the students' reaction to it.
The research starts with a short introduction about the MI theory is a great
theory that could help students to learn better in a relaxed learning situation. It is
presented by Howard Gardener first when he published his book "Frames of
Minds" in 1983 in which he describes how the brain has multiple intelligen

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Publication Date
Wed Mar 18 2020
Journal Name
Baghdad Science Journal
A Software Defined Network of Video Surveillance System Based on Enhanced Routing Algorithms
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Software Defined Network (SDN) is a new technology that separate the ‎control plane from the data plane. SDN provides a choice in automation and ‎programmability faster than traditional network. It supports the ‎Quality of Service (QoS) for video surveillance application. One of most ‎significant issues in video surveillance is how to find the best path for routing the packets ‎between the source (IP cameras) and destination (monitoring center). The ‎video surveillance system requires fast transmission and reliable delivery ‎and high QoS. To improve the QoS and to achieve the optimal path, the ‎SDN architecture is used in this paper. In addition, different routing algorithms are ‎used with different steps. First, we eva

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Publication Date
Mon Jan 25 2021
Journal Name
Engineering And Technology Journal
Performance evaluation of Photovoltaic Panels by a Proposed Automated System Based on Microcontrollers
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