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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
Sat Feb 02 2019
Journal Name
Journal Of The College Of Education For Women
Research and Development Programs Effectiveness in the Central Library of Baghdad University
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Research and Development Programs Effectiveness in the Central Library of Baghdad University

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Publication Date
Sun Jun 12 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Understanding the Experience of Hospital Pharmacists with the Effectiveness, Safety, Adverse Drug Reaction Reporting and Interchangeability of Biopharmaceutical Medicines
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The study objectives were to 1) explore the real-world experience of hospital pharmacists with the differences in effectiveness safety, and interchangeability between biosimilar medicines and their reference biological counterparts, 2) reveal pharmacist recommendations to enhance the safety of biopharmaceutical medicines in public hospitals.

The study has a mixed-method design where the core component was qualitative (interviews) and the supplemental component was quantitative (adverse drug reaction, ADR, reports). This qualitative component included semi-structured (mostly face-to-face) interviews involving hospital pharmacists from different hospitals with experience with biological or biosimilar medicines. The interviews were c

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Publication Date
Fri Nov 01 2024
Journal Name
Current Medicinal Chemistry
Synthesis, In Silico Prediction, and In Vitro Evaluation of Anti-tumor Activities of Novel 4'-Hydroxybiphenyl-4-carboxylic Acid Derivatives as EGFR Allosteric Site Inhibitors
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Introduction:

Allosteric inhibition of EGFR tyrosine kinase (TK) is currently among the most attractive approaches for designing and developing anti-cancer drugs to avoid chemoresistance exhibited by clinically approved ATP-competitive inhibitors. The current work aimed to synthesize new biphenyl-containing derivatives that were predicted to act as EGFR TK allosteric site inhibitors based on molecular docking studies.

Methods:

A new series of 4'-hydroxybiphenyl-4-carboxylic acid derivatives, including hydrazine-1-carbothioamide (S3-S6) and 1,2,4-triazole (S7-S10) derivatives, were synthesized and characterized using IR, 1HNMR, 13CNMR

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Publication Date
Sat Dec 30 2017
Journal Name
Al-khwarizmi Engineering Journal
Low Cost Hardware Back Propagation Algorithm
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The first successful implementation of Artificial Neural Networks (ANNs) was published a little over a decade ago. It is time to review the progress that has been made in this research area. This paper provides taxonomy for classifying Field Programmable Gate Arrays (FPGAs) implementation of ANNs. Different implementation techniques and design issues are discussed, such as obtaining a suitable activation function and numerical truncation technique trade-off, the improvement of the learning algorithm to reduce the cost of neuron and in result the total cost and the total speed of the complete ANN. Finally, the implementation of a complete very fast circuit for the pattern of English Digit Numbers NN has four layers of 70 nodes (neurons) o

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Publication Date
Thu Mar 01 2007
Journal Name
Al-khwarizmi Engineering Journal
Low Cost Hardware Back Propagation Algorithm
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The first successful implementation of Artificial Neural Networks (ANNs) was published a little over a decade ago. It is time to review the progress that has been made in this research area. This paper provides taxonomy for classifying Field Programmable Gate Arrays (FPGAs) implementation of ANNs. Different implementation techniques and design issues are discussed, such as obtaining a suitable activation function and numerical truncation technique trade-off, the improvement of the learning algorithm to reduce the cost of neuron and in result the total cost and the total speed of the complete ANN. Finally, the implementation of a complete very fast circuit for the pattern of English Digit Numbers NN has four layers of 70 nodes (neurons) o

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Publication Date
Sun Dec 03 2017
Journal Name
Journal Of Babylon University
Spectrophotometric Determination of Sulfamethoxazole in Pure and Pharmaceutical Preparations Based on Condensation Reaction Method
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A new, Simple, sensitive and accurate spectrophotometric methods have been developed for the determination of sulfamethoxazole (SMZ) drug in pure and dosage forms. This method based on the reaction of sulfamethoxazole (SMZ) with 1,2-napthoquinone-4-sulphonic acid (NQS) to form Nalkylamono naphthoquinone by replacement of the sulphonate group of the naphthoquinone sulphonic acid by an amino group. The colored chromogen shows absorption maximum at 460 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 the effect of

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Publication Date
Thu Oct 01 2009
Journal Name
Iraqi Postgraduate Medical Journal
Ventral Penile Papillae as a New Anatomical Structure: A Clinical-Epidemiological Study Among Iraqi Male
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KE Sharquie, JR Al-Rawi, AA Noaimi, MM Jabir, Iraqi Postgraduate Medical Journal, 2009

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Publication Date
Thu Oct 01 2009
Journal Name
Journal
Ventral penile papillae as a new anatomical structure: a clinical-epidemiological study among Iraqi males
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S Khalifa E, AR Jamal R, N Adil A, J Munqithe M…, 2009

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Publication Date
Fri Sep 05 2014
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences0975-1491
THE CORRELATION BETWEEN FRAMINGHAM RISK SCORE AND THE CLINICAL AND BIOCHEMICAL PARAMETERS THAT MEASURE FUNCTIONAL DISABILITY AND DISEASE ACTIVITY IN IRAQI PATIENTS WITH RHEUMATOID ARTHRITIS
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Objective: Rheumatoid arthritis (RA) patients have increased morbidity and mortality from premature cardiovascular (CV) disease (CVD). Framingham risk score (FRS) is a simplified coronary prediction tool developed to enable clinicians to assess the risk of a cardiovascular event and to identify candidate patients for risk factors modifications worldwide. The predictive ability of the FRS varies between populations, ethnic groups, and socio-economic status. The aim of this study is to find if there is any correlation between the Framingham risk score and the inflammatory and biochemical parameters used to measure disease activity and functional ability in Iraqi patients with active RA.

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Publication Date
Thu May 30 2024
Journal Name
Iraqi Journal Of Science
Bifurcation and Stability Analysis of Stagnation Point for Fluid Flow in an Inclined Channel with Inclined Magnetic Field for Peristaltic Transport
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Streamlined peristaltic transport patterns, bifurcations of equilibrium points, and effects of an inclined magnetic field and channel are shown in this study. The incompressible fluid has been the subject of the model's investigation. The Reynolds values for evanescence and an infinite wavelength are used to constrain the flow while it is being studied in a slanted channel with a slanted magnetic field. The topologies over their domestic and cosmopolitan bifurcations are investigated for the outcomes, and notion of the dynamical system are employed. The Mathematica software is used to solve the nonlinear autonomous system. The flow is found to have three different flow distributions namely augmented, trapping and backward flow. Outc

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