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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 Aug 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
A Study on Transportation Models in Their Minimum and Maximum Values with Applications of Real Data
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The purpose of this paper is to apply different transportation models in their minimum and maximum values by finding starting basic feasible solution and finding the optimal solution. The requirements of transportation models were presented with one of their applications in the case of minimizing the objective function, which was conducted by the researcher as real data, which took place one month in 2015, in one of the poultry farms for the production of eggs

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Publication Date
Fri Nov 09 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department
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Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error

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Publication Date
Wed Jan 01 2020
Journal Name
International Journal Of Internet Protocol Technology
A low cost paging scheme for clustered PMIPv6 protocol by head-MAG entity utilisation
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Publication Date
Thu Apr 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
The Role of the values of accounting culture in maximizing financial performance - A field study in a sample of Iraqi banks
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The influence of culture on accounting systems and practices, including financial reports and accounting information through the values ​​identified by Gray and derived from social-cultural values, and the four accounting values ​​were derived from generally accepted accounting principles represented by (Conservatism, Uniformity, Secrecy, and Professionalism). Important and significant in maximizing financial performance, and measuring the extent of the role of these values ​​in improving financial performance through attention to the values ​​of accounting culture, this research

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Publication Date
Tue Dec 06 2022
Journal Name
Iraqi National Journal Of Nursing Specialties
Effectiveness of an Interventional Program on Nurses Practices regarding Removing and Cleaning Burn Dead Tissue
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Abstract

Objective(s): The study aims to measure the effectiveness of the program on removing dead tissue for burn patients by testing the nurses before the program in addition to testing them again after implementing the educational program.

Methodology: The study is quantitative in nature (one experimental) and will employ pre- and post-testing techniques between October 17, 2020 and March 20, 2022. A non-probability (purposive) sample of 24 nurses working in the Azadi Teaching Hospital's Burns and Plastic Surgery Center was chosen. The experimental survey of nursing practice, a literature review, scientific records, and previous research were all taken into considerat

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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
The Effectiveness of Management Information Systems (MIS) and its impact on Governmental Organization Performance in Jouf Region of Saudi Arabia
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The aim of this research is to find the impact of the efficiency of Management information systems (MIS) on the effectiveness of governmental organizations performance.

To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research attemped to answer the following question: To achieve the objective of the research, the analytical descriptive method was adopted. A questionnaire was designed consisting of (35) paragraphs, and the sample consisted of (200) individual. The research tried to answer the following question: What is the actual utilization of modern admi

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Publication Date
Fri Jun 21 2024
Journal Name
Pharmacia
Synthesis and biological activity evaluation of new isatin-gallate hybrids as antioxidant and anticancer agents (in vitro) and in silico study as anticancer agents and coronavirus inhibitors
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Background: The hybrid compounds hold promise for developing novel pharmaceuticals, potentially exhibiting greater activity, mainly against viruses and cancer diseases, than their components.

Objective: In this study, researchers explored the potential synergistic effects of hybrid molecules by designing and synthesizing a series of isatin-gallate hybrids, denoted as N’-(5-substituted-2-oxoindolin-3-ylidene)-3,4,5-trihydroxybenzohydrazide (3a–d).

Methods: Isatin-gallate hybrids (3a–d) were synthesized by reacting gallic hydrazide with each of the isatin analogs (2a–d). The structures of all produced comp

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Publication Date
Sat Jan 01 2011
Journal Name
Organic &amp; Biomolecular Chemistry
Exploring Leishmania major Inositol Phosphorylceramide Synthase (LmjIPCS): Insights into the ceramide binding domain
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Publication Date
Sun Aug 30 2020
Journal Name
Journal Of Economics And Administrative Sciences
Creative thinking and its impact on reengineering hotel service )Comparative field study in premium class hotels(
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The research seeks to identify the dimensions of creative thinking and its impact on the re-engineering of hotel service operations by analyzing the correlation and impact between research variables as well as comparing the research sample The importance of the research comes from the need to motivate managers the importance of creative thinking among workers in the researched hotels because it is an essential part in the re-engineering of hotel services. To achieve this a questionnaire was designed containing (33) items that include the independent research variables (creative thinking) and the accredited (re-engineering the hotel service) and distributed to a sample of (50) individuals represented by (Commissioner Director, Dep

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Crossref
Publication Date
Thu Mar 01 2012
Journal Name
Journal Of Economics And Administrative Sciences
The Absorptive Capacity of Operational Budget and Monetary Policy Fiscal Cost
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In light of the enquiry raised by the Economist Mary Finn in 1995 concluding that high utilization in absorptive capacity of the economy is of inflationary tendency for industrial countries due to the equality between high rates of utilization of absorptive capacity and resource – shortage conditions leading to price inflation, the same idea was used to prove that budget utilization of operational costs and elevating absorptive capacity at the expense of investment budget leads to inflationary tendency that becomes a burden on financing the step- in policy of the Central bank to control prices through its foreign currency reserves at a time when the economy turned  into an importer of non- tradable goods and being subject

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