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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 Dec 01 2021
Journal Name
International Medical Journal
Effect of Accelerated Canine Retraction by Vitamin D3 Local Administration on Apical Root Resorption, Alveolar Bone Integrity, and Chair-side Time: A Prospective Clinical Study.
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Objectives: To evaluate the effect of vitamin D3 local injections on apical root resorption, alveolar bone integrity, and chair-side time following three and six months of canine retraction. Subjects and Methods: Seventeen adult patients (18-35 years old) of class I and II malocclusions were recruited, who required bilateral maxillary 1st premolars extraction before starting maxillary canines retraction. The experimental side received 25 pg dose of vitamin D3 injected locally into the distal periodontal sulcus of the canine (before force application) every three weeks, while the control side received retraction force only. Periapical radiographic evaluation was conducted after 3 and 6 months of the start of canines' retraction. Results: At

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Publication Date
Wed Sep 14 2016
Journal Name
Journal Of Baghdad College Of Dentistry
Effect of Mouth Rinses on Surface Roughness of Two Methacrylate-Based and Siloraine-Based Composite Resins
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Background: Various fluids in the oral environment can affect the surface roughness of resin composites. This in vitro study was conducted to determine the influence of the mouth rinses on surface roughness of two methacrylate-based resin (nanofilled and packable composite) and siloraine-based resin composites.

Materials and methods: Disc-shaped specimens (12 mm in diameter and 2mm in height) were prepared from three types of composi

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Publication Date
Sat Feb 10 2024
Journal Name
International Development Planning Review
THE IMPACT OF COMPETITIVE SPEED EXERCISES ON JUNIOR BOXERS' EFFECTIVENESS OF SKILL PERFORMANCE AND COUNTERATTACK SPEED
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The competitive environment influences the increase in exercise intensity and hence adds to the growth of training and practice. The study objective.to identify the effect of competitive speed exercises on the effectiveness of skill performance and speed of counterattack for junior boxers, as well as to know the rate of development for these variables.Materials and methods. The research sample consisted of twelve up-and-coming Al-Najda Sports Club players who participated in the national tournament and were selected with care. They were placed into two groups, control and experimental, with six boxers each in the control and experimental groups. The two groups were assigned identical weights on purpose, and their ages range from 15 to 16 ye

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Publication Date
Wed Aug 06 2025
Journal Name
Innovative Infrastructure Solutions
Understanding the effectiveness of elastomeric and plastomeric polymers on the high-temperature performance of asphalt binders
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The global rise in temperature and the desert climatic conditions prevalent in Middle Eastern countries have exacerbated rutting distress in heavily trafficked highways. Conventional asphalt binders with a high-temperature performance grade (PG 70) have proven inadequate under such extreme conditions, necessitating the development of modified binders with enhanced high-temperature performance. While polymer modification using styrene-butadiene-styrene (SBS), an elastomeric polymer, and ethylene-vinyl acetate (EVA), a plastomeric polymer, has been widely studied, limited research provides a direct comparison of their effectiveness at both the binder and mixture levels under extremely high-temperature conditions. This study addresses this gap

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Publication Date
Fri May 15 2026
Journal Name
Chemical And Process Engineering Research
Spectrophotometric Determination of Sulfanilamide in Pure and in Synthetic Sample based on Condensation Reaction Method
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A new, Simple, sensitive and accurate spectrophotometric methods have been developed for the determination of sulfanilamide (SNA) drug in pure and in synthetic sample. This method based on the reaction of sulfanilamide (SNA) with 1,2-napthoquinone-4-sulphonic acid (NQS) to form N-alkylamono naphthoquinone by replacement of the sulphonate  group of the naphthoquinone sulphonic acid by an amino group. The colored chromogen shows absorption maximum at 455 nm. The optimum conditions of condensation reaction forms were investigated by: (1) univariable method, by optimizing the effect of experimental variables; (different bases, reagent concentration, borax concentration and reaction time),     (2) central  composite design (CCD) including

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Publication Date
Sun Sep 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The Impact of Sharing knowledge on organizational innovation Field study in the arab company , for detergents and chemical
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ABSTRACT

Impkact  of  Knowledge  sharing  on  organizational  innovation  Impriscal  study in Arabic company . 

of  Knowledge Management is  the  main  component  Knowledge  sharing  system, it mean the exchange if  Knowledge, ideas, and good  practice with  another  individual . Knowledge sharing between persons, then its values can growth .

It is vry important because it can provide us with the contention between virus peoples . the interaction among the people can pass all kind of Knowledge among them. the connection and interaction and interaction enabl

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Publication Date
Mon May 30 2022
Journal Name
Egyptian Journal Of Chemistry
Design ,Synthesis, Insilco Study and Biological Evaluation of New Coumarin-Oxadiazole Derivatives as Potent Histone Deacetylase Inhibitors
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Publication Date
Sat Jan 01 2022
Journal Name
Materials Today: Proceedings
Molecular Docking, Synthesis, characterization and preliminary cytotoxic evaluation of new 1, 3,4-Thiadiazole derivatives as EGFR inhibitors
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Publication Date
Sat Jun 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The Efficiency Of Physics Forceps In Comparison To The Conventional Dental Extraction Forceps: A randomized Clinical Trial
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Background: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic process often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. The physics forceps is one of those innovations in dental extraction technologies that claim to provide an efficient means for atraumatic dental extractions. Materials and method: A randomized clinical trial was conducted to compare the physics forceps with the conventional forceps for the removal of 28 mandibular single rooted teeth under the following parameters: incidence of crown, root, b

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Publication Date
Fri Nov 11 2022
Journal Name
Eurasian Journal Of Physics, Chemistry And Mathematics
Influence of thermophoresis and thermal radiation on mass transfer and heat of Three Dimensional maxwell fluid in presence of Magnetic field
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The study is about Maxwell , three dimensions of non – Newtonian fluid. Method of th Homotopy applied to analysis mass transfer and heat with thermophoresis effects. (Sc), Impact of therrmophoretic (𝜏), magnetic (M), Biot (γ), radiation (Rd),Schmidt Prandtle (Pr) parameters and ratio parameter(β) on concentration, temperature are offered in the paper.