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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 Jan 01 2018
Journal Name
Current Research In Microbiology And Biotechnology
Detection of some Physiological and Immunological parameters in Iraqi clinical and subclinical hypothyroid patients: Relationship study
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The present study was performed to evaluate the level of some risk factors (biochemical and immunological) in hypothyroid Iraqi patients considering the different thyroid functional states (hypothyroidism and subclinical hypothyroidism).The study includes 82 patients clinically diagnosed with hypothyroidism. Three study groups have been investigated: (47 clinical hypothyroid patients, 12 subclinical hypothyroid patients 23 healthy individuals) of different ages. This study, show that the proportion of females (83.3 %), (87.2%) in subclinical and clinical hypothyroidisim respectively higher than the proportion of males (16.7%),(12.8%) in subclinical and clinical hypothyrodism respectively of the total patients.The majority of subclinical hyp

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Publication Date
Sun Jun 30 2024
Journal Name
Iraqi Journal Of Science
Detection of Zn Water Pollution by a Biosensor Based on Alkaloids Derived from Iraqi Catharanthus Roseus
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     In this work, the detection of zinc (Zn) ions that cause water pollution is studied using the CSNPs- Linker-alkaloids compound that was prepared by linking extracted alkaloids from Iraqi Catharanthus roseus plant with Chitosan nanoparticles (CSNPs) using maleic anhydride. This compound is characterized by an X-ray diffractometer (XRD) which shows that it has an orthorhombic structure with crystallite size in the nano dimension. Zeta Potential results show that the CSNPs-Linker-alkaloids carried a positive charge of 54.4 mV, which means it possesses high stability.  The Fourier transform infrared spectroscopy (FTIR) shows a new distinct band at 1708.93 cm-1 due to C=O esterification. Scanning electron microscope (SEM) image

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Publication Date
Tue Dec 13 2005
Journal Name
Iraqi Journal Of Laser
Clinical Observation and Performance of High Power Diode Laser in the Treatment of Oral Lesions
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In this work, oral lesions belong to 17 patients, 7 males and 10 females. Their ages range between 15 and 45 years. Follow up was conducted after one day, 7 days, 14 days, one month, and finally 3 months postoperatively. The study lasted for 1.5 year. Surgical diode laser with wavelength of 810 ± 20 nm, with two power levels of 10 and 15 W were used in contact and in non-contact mode via optical fiber. The postoperative outcome revealed; greater haemostatic capability, dry, sealed wound and noticeable lack in pain sensation

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Publication Date
Mon Dec 25 2017
Journal Name
Biomedical And Pharmacology Journal
Evaluation of Crestal Bone Loss and Alkaline Phosphatase Level in Saliva According To Different Flap Designs in Single-Tooth Dental Implant Surgery (A Clinical Comparative Study)
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Publication Date
Wed Sep 07 2011
Journal Name
International Journal Of Pharmacy And Pharmaceutical Sciences
CLINICAL EFFICACY OF LOCALLY INJECTED CALCITRIOL IN ORTHODONTIC TOOTH MOVEMENT
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Orthodontic treatment has two major problems: being lengthy and costly procedure. The present study was designed to evaluate the clinical efficacy of locally injected vitamin D3 Keywords: Orthodontic, Calcitriol, Local injection, OTM (calcitriol) in accelerating orthodontic teeth movement (OTM) and reducing treatment time and cost in humans. The study was performed on 15 Iraqi adult orthodontic patients within the age range 17-28 years, they are randomly allocated into three groups, each of five patients and treated with either 15 pg, 25 pg, or 40 pg/0.2ml calcitriol diluted with 10% dimethylsulfoxide (DMSO). The maxillary arch of every patient was divided into control (right) and experimental (left) sides. In addition to force application,

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Publication Date
Sat Apr 01 2017
Journal Name
Al–bahith Al–a'alami
Palestinian Media Elite Attitudes towards Recording Cinemas in Addressing the Internal Situations: A Field Study
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The follower of the history of cinema in the world notes that cinema started recording one and these films are varied in their subjects, while the life of man was the material of these films to be in a creative artistic style.
If the Palestinian films produced by Palestinian directors do not have an impact on the local, Arab and international levels, this is due to the weakness in several technical fields or with the intention to make them bad or negligence of those who produce these films.
This research deals with the role played by Palestinian films in dealing with the internal situation from the point of view of the Palestinian media elite in terms of their exposure to films and the motives of this exposure and the expectation

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Publication Date
Sun Sep 03 2017
Journal Name
Baghdad Science Journal
Gravity Field Interpretation for Major Fault Depth Detection in a Region Located SW- Qa’im / Iraq
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This research deals with the qualitative and quantitative interpretation of Bouguer gravity anomaly data for a region located to the SW of Qa’im City within Anbar province by using 2D- mapping methods. The gravity residual field obtained graphically by subtracting the Regional Gravity values from the values of the total Bouguer anomaly. The residual gravity field processed in order to reduce noise by applying the gradient operator and 1st directional derivatives filtering. This was helpful in assigning the locations of sudden variation in Gravity values. Such variations may be produced by subsurface faults, fractures, cavities or subsurface facies lateral variations limits. A major fault was predicted to extend with the direction NE-

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Publication Date
Sun Apr 15 2001
Journal Name
University Of Baghdad, College Of Veterinary Medicine
A Study of Antimicrobial Effect of Oil Extracts of Black Seed (Nigella sativa L.) on some Pathogenic Microorganism that is isolated from Clinical Pathogenic Cases.
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Publication Date
Wed Jun 11 2025
Journal Name
Academic Science Journal
Review Article: Tumor Markers, Types and Clinical Applications
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Over the past ten years, tumor markers have played an increasingly important role in clinicaloncology. This trend is expected to continue as technology advances and our knowledge of thehuman body and disease processes grows. In the treatment of cancer, tumor markers are widelyused for a variety of purposes, including screening, selecting a management strategy,determining the prognosis, and post-therapy follow-up. A comprehensive of the fundamentalsof pathophysiology and identification strategies for each specific malignancy is necessary fortheir prudent application in clinical practice. Oncology's use of cancer biomarkers hastransformed the way that cancer is treated, and led to notable improvements in patient outcomesand cancer tre

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Publication Date
Mon Jan 01 2018
Journal Name
Journal Of Cosmetics, Dermatological Sciences And Applications
Pityriasis Alba versus Vitiligo Clinical and Histopathological Study
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