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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
Mon Apr 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Effect of potassium nitrate, licorice extract and planting date on field emergence and growth of maize (Zea mays L.) in spring season
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Low temperature and high relative humidity in the spring season led to decrease of field emergence ratio and growth in maize. Planting dates and seeds stimulation can be appropriate fix. Field experiment was conducted in the two spring seasons of 2022 and 2023. Randomize complete block design with split-plot arrangement and four replications was used. Planting date treatments (February 15th, March 1st and 15th and April 1st, 15th) were placed in main plots. Seeds stimulation treatments (potassium nitrate 6 mg L-1 + licorice extract 6 g L-1 as well as treatment of soaking with distilled water only) were placed in subplots. Seeds stimulation (potassium nitrate+licorice extract) or planting date of February 15th were superior at traits of fiel

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Publication Date
Fri Nov 01 2019
Journal Name
International Journal On Interactive Design And Manufacturing (ijidem)
A real-time automated sorting of robotic vision system based on the interactive design approach
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Publication Date
Sun Dec 27 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Analysis of Docetaxel Adverse Drug Reactions: A Retrospective Study Based on Iraqi Pharmacovigilance Center Database
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Docetaxel is an effective treatment approved for many types of cancers, but its effectiveness in clinical practice can be compromised by significant occurrence of adverse drug reactions. The aim of the current study was to measure the distribution of adverse drug reactions of docetaxel reported in Iraq and to assess the causality, severity, seriousness, preventability, expectedness and outcome of these adverse reactions. A retrospective study conducted on individual case safety reports from the Iraqi Pharmacovigilance Center / Ministry of Health. The study included 118 individual case safety report containing 236 adverse drug reactions.
Most of the adverse drug reactions were related to skin and subcutaneous tissue disorders(26.7%), f

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Publication Date
Mon Sep 30 2024
Journal Name
Medical Journal Of Babylon
Effectiveness of Deep Breathing Technique on Pain Level of School Children during Catheterization
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Publication Date
Wed Aug 10 2011
Journal Name
Ibn Al- Haitham J. For Pure & Appl. S Ci.
A Complete (k,r)-Cap in PG(3,p) Over Galois Field GF(4)
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The aim of t his p aper is t o const ruct t he (k,r)-caps in t he p rojective 3-sp ace PG(3,p ) over Galois field GF(4). We found t hat t he maximum comp let e (k,2)-cap which is called an ovaloid, exist s in PG(3,4) when k = 13. Moreover t he maximum (k,3)-cap s, (k,4)-cap s and (k,5)-caps.

Publication Date
Fri Mar 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
The Impact of Applying the Accounting Islamic Standards on the Cost Efficiency: An applied study in kingdom of Bahrain Islamic banks -Wholesale
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This research highlights the light on the general framework of accounting discloser in the Islamic banks, and show the types and the concepts of Cost Efficiency, In this present study, the sample included Fourteen Islamic banks, where the data was collected from the annual financial reports. Accordingly, the study in order to achieve the aims and access to the results based on the analytical method and the descriptive analysis, and conducted a Simple & Multiple Linear Regression analysis, in order to test hypotheses of the research by using of statistical analysis software (SPSS). The research has arrived to many results such as: the commitment of Islamic banks working in the Kingdome of Bahrain (Wholesale) to the requirements of the

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Publication Date
Mon Dec 08 2025
Journal Name
Pigment &amp; Resin Technology
Sustainable automotive interior trim components based on SBR-expanded polystyrene composites reinforced with biomass fibers
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Purpose

The purpose of this paper is to apply styrene butadiene rubber (SBR) as virgin alongside expanded polystyrene (EPS) resin as a recycled polymer after consumption in the presence of bagasse fibers (BF) as biomass source derived from sugarcane in different concentrations to reinforce this polymeric matrix to form affordable composites that can be used in manufacturing low-cost and sustainable car interior-trim constituents.

Design/methodology/approach

SBR and EPS represent an example for thermoplastic elastomers (

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Publication Date
Wed Jun 01 2022
Journal Name
Res Militaris
The Effect of Internal Control in Supporting the Implementation of Cost Techniques in Iraqi Companies
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In the last few years, there have been a lot of changes in the economy, society, and the environment. This has led to much competition between companies, directly and indirectly affecting production and marketing processes. Most companies are trying to cut production and manufacturing costs by using modern cost techniques such as product life cycle costing and Continuous Improvement (Kaizen) technology, in the method of measuring production costs or service costs, and the need for internal control to keep an eye on how these technologies are being used and how well they work. And to find out the effect of internal control on the implementation of costing techniques in Iraqi companies, 64 questionnaires were given to people who work in the i

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Scopus
Publication Date
Tue Jul 31 2018
Journal Name
Online Journal Of Veterinary Research
Clinical pathology and immuno-histochemistry of mammary tumors from military and pet dogs in Iraq.
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Mammary tumors (CMT) in dogs in Iraq may be induced by carcinogenic war ordnance. In our study, 10 virgin un- spayed military/pet bitches aged 5-15 years presented with abnormal masses in the abdomen with painful oedema, swelling, anorexia, weight loss, weakness and mild fever. Examination of regional lymph nodes and thoracic radiography confirmed metastasis. Tumors were excised and determined to be mostly adenocarcinomas involving multiple glands, solid in texture, 5-15 cm in size, mostly in the inguinal mammary glands at stage T3: >5 cm. Microscopy confirmed presence of adenocarcinoma in 8 dogs and solid carcinoma in 2 with half of tumors being grade III. Tumors had pleomorphic hyperchromatic cell nuclei in stroma, epithelial cells of duc

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Publication Date
Sun May 17 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Occlusal features, perception of occlusion and orthodontic treatment need and demand among 13 years aged Baghdadi students Part II: (Cross sectional epidemiological study)
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Background: The present study aimed to assess the distribution, prevalence, severity of malocclusion in Baghdad governorate in relation to gender and residency Materials and Methods: A multi-stage stratified sampling technique was used in this investigation to make the sample a representative of target population. The sample consisted of 2700 (1349 males and 1351 females) intermediate school students aged 13 years representing 3% of the total target population. A questionnaire was used to determine the perception of occlusion and orthodontic treatment demand of the students and the assessment procedures for occlusal features by direct intraoral measurement using veriner and an instrument to measure the rotated and displaced teeth. Results a

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