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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
Tue Mar 31 2015
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Formation Evaluation for Nasiriyah Oil Field Based on The Non-Conventional Techniques
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The unconventional techniques called “the quick look techniques”, have been developed to present well log data calculations, so that they may be scanned easily to identify the zones that warrant a more detailed analysis, these techniques have been generated by service companies at the well site which are among the useful, they provide the elements of information needed for making decisions quickly when time is of essence. The techniques used in this paper are:

  • Apparent resistivity Rwa
  • Rxo /Rt

   The above two methods had been used to evaluate Nasiriyah oil field formations (well-NS-3) to discover the hydrocarbon bearing formations. A compu

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Publication Date
Wed Mar 02 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program Based on Employing the Educational Portal in Developing the Skills of the Administrative Body in Basic Education Schools in Dhofar Governorate
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The objective of the study was to identify the effectiveness of a training program based on the employment of the educational portal in the development of the skills of the administrative body in the basic education schools in Dhofar Governorate. To achieve the goal, a training program was designed that includes the skills of the educational portal to be met by the administrative body and measuring its effectiveness. A questionnaire to identify training needs, and a notecard to evaluate performance. The study sample consisted of (70) individuals of the administrative staff. The researchers used the descriptive-analytical method to identify the training needs, design and build the training program and the experimental method for applying

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Publication Date
Tue Aug 15 2023
Journal Name
Journal Of Economics And Administrative Sciences
Estimating Demand for Imported Food Categories in Iraq
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Iraq is highly dependent on international markets to provide food for its residents. As imported food prices are highly dependent on crude oil prices in global markets, any shock in oil prices will have an impact on food consumption in the country. As a result, it is essential to study the demand for imported food at every time period. To the best of our knowledge as researchers, as not even a single study is available in the literature, this paper is considered the first to study the demand for imported food groups in Iraq. Therefore, the main objective of this research is to estimate demand elasticities for several imported food categories in Iraq. This study uses an Almost Ideal Demand System model to analyze the demand for imported f

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Publication Date
Thu Mar 30 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Effect of COX-2 Inhibitors Selectivity on Lipid Profile in Hyperlipidemic and Normolipidemic Type 2 Diabetics
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Development of NSAIDS based on inhibiting cyclooxygenase activity. However, the different physiological consequences arrised by appearance of new drugs with different selectivity to COX-2 enzyme upon their administration with their relevant affects on some cardiovascular risk factors. To study the potential effects of relatively  diclofenac and highly specific  celecoxib COX-2 inhibitors on lipid profile and serum C-reactive protein in type 2 diabetes, whom have hyperlipidemia to be compared by their effects with normolipidemic patients. A total number of 34 type 2 diabetics (14 normolipidemics and 20 hyperlipidemics) treated with either diclofenac 100mg/day or celecoxib 200mg/day for eight weeks. Analysis  of results indi

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Publication Date
Fri Sep 27 2019
Journal Name
Journal Of Baghdad College Of Dentistry
The role of prophylactic antibiotics in compound facial fractures treated by closed and open reduction
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Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as co

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Publication Date
Wed Sep 01 2021
Journal Name
Journal Of Language Teaching And Research
Islamification vs. Islamophobia: A Message to the Youth in the Occident: Critical &amp; Rhetorical Inquiries
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Drawing upon the recent theoretical framework of Burkean concept of identification (ID), the current study aims at probing the interaction of content and form in two letters penned by Iran’s Supreme Leader and addressed to the Youth on Jan. and Nov. 2015. To this end, the study seeks (i) to determine a role ID takes in the conveyance of intended assumptions to the targeted readers; and (ii) to observe if the writer’s objectives, i.e. to identify himself with the readers and to realize his politically-religiously-infused creeds, result in success or failure; moreover, (iii) it seeks to determine how he achieved his end to attenuate the impacts of blazing inferno of Islamophobia and anti-Islam sentiments in his addressees. The who

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Publication Date
Sun Dec 30 2012
Journal Name
Al-kindy College Medical Journal
A typical clinical presentation of molluscum contagiosum in Iraqi patients;clinical descriptive study
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Background Molluscum contagiosum is skin disease caused by the molluscum contagiosum virus (MCV) usually causing one or more small dome shaped umbilicated papules with symptoms that maybe self-resolve. MCV was once a disease primarily of children, but it has evolved to become a sexually transmitted disease in adults. It is believed to be a member of the pox virus family. In addition to the classic presentation of the disease; it can also come in different clinical forms that simulate large number of dermatolological disease.
Objective: To study different clinical forms of Molluscum contagiosum presentation in different age groups of Iraqi patients.
Method:This clinical descriptive study was performed in the outpatient department of

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Publication Date
Sat Feb 01 2025
Journal Name
Saudi Medical Journal
Spectrum and classification of ATP7B variants with clinical correlation in children with Wilson disease
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Publication Date
Tue Sep 15 2020
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary mucoepidermoid carcinoma, auclair vs brandwein grading system: A histopathological comparative study
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Background: The grading systems of salivary mucoepidermoid carcinoma depend on different histologic and morphologic features. The aim of this study was to compare between Auclair and Brandwein systems according to their histologic criteria, and the type of cell predominant. Materials and Methods: Twenty-one case included hematoxylin-eosin (H&E) stained tissue slides that were diagnosed as MEC, originally categorized into low and high grade type regardless of the grading system, have meticulously undergone histopathologic review. The sample was graded according to criteria owing to Auclair and Brandwein methods. The predominant type of cells was determined by microscopic examination according to grade of tumor. Results: Regarding the

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Publication Date
Mon Aug 21 2017
Journal Name
Biomedical And Pharmacology Journal
Gene Expression and Clinical Manifestations in Iraqi Patients with Acromegaly
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