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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 Nov 02 2023
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Appraising the Role of Pharmacists in Medication Reconciliation at Hospital Discharge: A Field-Based Study
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Objective: To measure the effect of the pharmacist-led medication reconciliation service before hospital discharge on preventing potential medication errors. Methods: This behavioral interventional study took place in a public teaching hospital in Iraq between December 2022 and January 2023. It included inpatients who were taking four or more medications upon discharge from the internal medicine ward and the cardiac care unit. The researcher provided the patients with a medication reconciliation form and reconciliation form (including medication regimen and pharmacist instructions) before discharging them home. Any discrepancies between the patients’ understanding and the actual medication recommendations prescribed by the physici

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Publication Date
Sun Mar 01 2026
Journal Name
Interdisciplinary Neurosurgery
Surgical outcomes and challenges in spinal cord tumor resection: a comparative study of elderly vs. young patients
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Publication Date
Sat Aug 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Comparison of Single and Group Jet Grout Columns Settlement Based on Field Test and Theoretical Methods
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Abstract<p>The settlement evaluation for the jet grouted columns (JGC) in soft soils is a problematic matter, because it is influenced by the number of aspects such as soil type, effect mixture between soil and grouting materials, nozzle energy, jet grouting, water flow rate, rotation and lifting speed. Most methods of design the jet-grouting column based on experience. In this study, a prototype single and group jet grouting models (single, 1*2, and 2*2) with the total length and diameter were (2000 and 150 mm) respectively and clear spacing (3D) has been constructed in soft clay and subjected to vertical axial loads. Furthermore, different theoretical methods have been used for the estimation </p> ... Show More
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Publication Date
Sat Jan 01 2022
Journal Name
Journal Of Pharmaceutical Negative Results
CD49d and CD26 in chronic lymphocytic leukemia: their correlation with clinical Binet staging and clinical parameters
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The study aimed to assess the expression of CD49d and CD26 in newly diagnosed CLL patients and find their correlation with clinical Binet stage, and other clinical parameters. This study was conducted on 51 newly diagnosed CLL patients based on lymphocyte count > 5×109/L and immunophenotyping. The expression of CD49d, and CD26 were investigated using eight-color flow cytometer. The expression of CD49d and CD26 were detected in 56.9 %, 68.8 % of CLL patients, respectively. The correlation between CD49d expression and CD26 expression was statistically significant (p < 0.001) with high concordance rate between them. The positive expression of both CD49d and CD26 had statistically significant association with clinical Binet staging (p < 0.001,

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Publication Date
Fri Jun 18 2021
Journal Name
International Journal Of Emerging Technologies In Learning (ijet)
The Effectiveness of Educational Pillars Based on Vygotsky's Theory in Achievement and Information Processing Among First Intermediate Class Students
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The aim of the research is to identify the effectiveness of the educational pillars strategy based on Vygotsky's theory in mathematical achievement and information processing of first-grade intermediate students. In pursuit of the research objectives, the experimental method was used, and the quasi-experimental design was used for two equivalent groups, one control group taught traditionally and the other experi-mental taught according to the educational pillars strategy. The research sample consisted of (66) female students from the first intermediate grade, who were inten-tionally chosen after ensuring their equivalence, taking into account several factors, most notably chronological age and their level of mathematics, and they we

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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Effectiveness of conservative management of uncomplicated acute appendicitis: A single hospital based prospective study
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<bold>ABSTRACT</bold> <sec> <title>Background:

Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.

Patients and methods:

This was a single hospital-based prospective study with a durat

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Publication Date
Thu Sep 04 2025
Journal Name
The Open Dentistry Journal
Clinical and Salivary Antioxidant Effects of Matcha Tea in Patients with Gingivitis: A Randomized Controlled Trial
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Introduction

Gingivitis, the initial stage of periodontal disease, is characterised by inflammation driven by dental biofilm and associated with oxidative stress. Matcha tea, a powdered green tea rich in antioxidants, has shown potential health benefits. This study aimed to investigate the effect of Matcha tea consumption on clinical periodontal parameters and salivary antioxidant levels in patients with gingivitis.

Methods

A randomised controlled clinical trial was conducted with 41 participants diagnosed with gingivitis.

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Publication Date
Sat Feb 01 2020
Journal Name
Iop Conference Series: Materials Science And Engineering
Field study of the effect of jet grouting parameters on strength based on tensile and unconfined compressive strength
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Abstract<p>The improvement of the mechanical soil characteristics of jet grouting technique is very attractive. The jet grouted soil cement columns in soft is a complicated issue because it depends on a number of factors such as, soil nature, mixture, influence among soil and grouting materials, jetting force of nozzle, jet grouting and water flow rate, rotation and lifting speed. This paper discusses the estimation of shear strength parameters of soil-cement column (soilcrete) in soft clayey soil based on the relationships between the unconfined compressive and split tensile strength for the soilcrete and the effect of the jet grouting and water pressure in the values of cohesion and internal f</p> ... Show More
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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Improving Nursing process Performance based on service scheduling dimensions. ( Field research)
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Abstract :

This present paper sheds the light on dimensions of scheduling the service that includes( the easiness of performing the service, willingness , health factors, psychological sides, family matters ,diminishing the time of waiting that improve  performance of nursing process including ( the willingness of performance, the ability to perform  the performance , opportunity of performance) . There is genuine problem in the Iraqi hospitals  lying into the weakness of nursing staffs , no central decision to define and organize schedules. Thus the researcher has chosen  this problem as to be his  title . The research come a to develop  the nursing service

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Publication Date
Fri Jan 01 2016
Journal Name
Journal Of Sensors
WDARS: A Weighted Data Aggregation Routing Strategy with Minimum Link Cost in Event-Driven WSNs
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Realizing the full potential of wireless sensor networks (WSNs) highlights many design issues, particularly the trade-offs concerning multiple conflicting improvements such as maximizing the route overlapping for efficient data aggregation and minimizing the total link cost. While the issues of data aggregation routing protocols and link cost function in a WSNs have been comprehensively considered in the literature, a trade-off improvement between these two has not yet been addressed. In this paper, a comprehensive weight for trade-off between different objectives has been employed, the so-called weighted data aggregation routing strategy (WDARS) which aims to maximize the overlap routes for efficient data aggregation and link cost

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