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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
Sun May 17 2026
Journal Name
Journal Of The College Of Basic Education
The effectiveness of upward training with weights to develop explosive power and speed and some functional variables for young volleyball players
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The effectiveness of upward training with weights to develop explosive power, characterized by speed and some functional variables for young volleyball players Many efforts of sports laboratories in various countries have been devoted to laying scientific foundations and rules in caring for the physical, skilled, planning, and psychological preparation of players and creating the conditions and requirements for reaching players to higher standards. The research aims to:1- Preparing an ascending training program with weights to develop explosive strength, which is characterized by speed and some functional variables for volleyball players.2- Identify the effect of the training program with upward training in weights to develop explosive stre

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Publication Date
Thu Jan 23 2020
Journal Name
Iraqi Journal Of Laser
Assisted Non-Surgical Therapy of Periodontal Pockets Utilizing Diode Laser: A Randomized Clinical Trial
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Periodontal diseases are inflammatory diseases, for which, scaling and root planning is the main approach. Diode laser therapy as an adjunct to non-surgical periodontal treatment has shown some beneficial effects.

Aim: The objective of this single randomized controlled clinical study was to assess the effect of a 940 nm diode laser as an adjunct to SRP therapy in the treatment of periodontal pockets.

 Methods: In this study, twenty patients in need of periodontal treatment with periodontal pocket ≥ 4 mm were selected for this split-mouth clinical study. Test group treated by diode laser 940 nm as an adjunct with SRP, control group treated by SRP in contralateral quadrants. Clinical

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Publication Date
Sun Dec 04 2011
Journal Name
Baghdad Science Journal
Effect of Gamma Irradiation on Vegetative Growth of three Sugarcane Genotypes (Saccharum officinarum L.) in field
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I n vitro rooting plantlets of three sugarcane genotypes(Co.j.64, Co.j.86 and Missan) were cultured in the field after exposed at different doses of gamma rays (1,2,3,4,) kr. Data of reduction percentage on vegetative growth, roots number, length per plant and their diameter were investigated. Results showed gradual reductions in number of shoots, length and diameter as according to increasing of gamma doses. The reduction percentage in shoot number, length were reached 57.86,70.36 % at 4 kr respectively which have mean number and length per plant reached (9.27 and 55.33 cm) as compared with the control treatment ,While 1 kr caused higher percent in diameter reached 9.69 % with mean of diameter per plant reached 2.57 cm. Mean time , Ge

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Publication Date
Mon Mar 23 2020
Journal Name
Journal Of Engineering
The Effect of Nano Materials on Lost Circulation Control of Azkand Formation in Khabaz Oil Field
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Experimental tests were carried to control lost circulation in the Khabaz oil field using different types of LCMs including Nano-materials. A closed-loop circulation system was built to simulate the process of lost circulation into formations. Two dolomite plugs were used from different depths of the formation of Azkand in Khabaz oil field. The experimentations were carried out to study the effect of different types of LCMs, cross-linked copolymer (FLOSORB CE 300 S), SiO2 NP, and Fe2O3 NP, on mud volume losses as a function of time.

The rheological measurements of the nanoparticles-reference mud system showed that both of the SiO2 NP and Fe2O3 NP w

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Publication Date
Thu Apr 01 2021
Journal Name
Biochemical And Cellular Archives
Evaluation the Effect of Allium Sativum (garlic) oil on The Expression of Maz E and Maz F Genes in Escherichia Coli Clinical Isolates
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Publication Date
Mon Feb 19 2024
Journal Name
Journal Of Engineering
Predicting Biochemical Oxygen Demand at the Inlet of Al-Rustumiya Wastewater Treatment Plant Using Different Mathematical Techniques
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Water quality planning relies on Biochemical Oxygen Demand BOD. BOD testing takes five days. The Particle Swarm Optimization (PSO) is increasingly used for water resource forecasting. This work designed a PSO technique for estimating everyday BOD at Al-Rustumiya wastewater treatment facility inlet. Al-Rustumiya wastewater treatment plant provided 702 plant-scale data sets during 2012-2022. The PSO model uses the daily data of the water quality parameters, including chemical oxygen demand (COD), chloride (Cl-), suspended solid (SS), total dissolved solids (TDS), and pH, to determine how each variable affects the daily incoming BOD. PSO and multiple linear regression (MLR) findings are compared, and their performance is evaluated usin

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Crossref
Publication Date
Thu Feb 01 2024
Journal Name
Journal Of Engineering
Predicting Biochemical Oxygen Demand at the Inlet of Al-Rustumiya Wastewater Treatment Plant Using Different Mathematical Techniques
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Water quality planning relies on Biochemical Oxygen Demand BOD. BOD testing takes five days. The Particle Swarm Optimization (PSO) is increasingly used for water resource forecasting. This work designed a PSO technique for estimating everyday BOD at Al-Rustumiya wastewater treatment facility inlet. Al-Rustumiya wastewater treatment plant provided 702 plant-scale data sets during 2012-2022. The PSO model uses the daily data of the water quality parameters, including chemical oxygen demand (COD), chloride (Cl-), suspended solid (SS), total dissolved solids (TDS), and pH, to determine how each variable affects the daily incoming BOD. PSO and multiple linear regression (MLR) findings are compared, and their perfor

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Publication Date
Fri Mar 04 2022
Journal Name
Journal Of Water Resources And Geosciences
A Review Study on Gypseous Soils Stabilized with Different Additives in Iraq
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Publication Date
Sat May 14 2022
Journal Name
Oral And Maxillofacial Surgery
Evaluation of crestal sinus floor elevations using versah burs with simultaneous implant placement, at residual bone height ≥ 2.0 _ &lt; 6.0 mm. A prospective clinical study
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Publication Date
Tue Jan 01 2019
Journal Name
African Journal Of Hospitality, Tourism And Leisure
Employing marketing information systems for the success of small and medium enterprises: A field study of some Tourism and Travel companies in Baghdad
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