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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
Thu Sep 01 2016
Journal Name
Injury Prevention
The effectiveness of injury prevention program on reducing the incidence of lower limb injuries in adolescent male soccer players
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The highest incidence of injury is seen in adolescent playing pivoting sports such as soccer, basketball, and handball. Objective: To examine the effectiveness of a neuromuscular prevention program in reducing knee and ankle injuries in adolescent male soccer players.

Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
A turbidimetric method for the quantitative determination of cyproheptadine hydrochloride in tablets using an optoelectronic detector based on the LEDs array
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Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
A turbidimetric method for the quantitative determination of cyproheptadine hydrochloride in tablets using an optoelectronic detector based on the LEDs array
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Publication Date
Sun Jan 01 2023
Journal Name
International Journal Of Research In Social Sciences &amp; Humanities
HRM Management Approaches, With a Focus on Employee Centric Approach: A Case Study In The Rafidain Bank In Iraq
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This research attempts to shed light on a topic that is considered one of the most important topics of HRMs management, which is the Employee centric approach by examining its philosophy and understanding . To achieve the goal, the research relied on the philosophical analytical method, which is one of the approaches used in theoretical studies. The research reached a set of conclusions, the most important of which are the theoretical studies that addressed this entry in the English language and the lack of it in the Arabic language, according to the researcher's knowledge. The research reached a set of recommendations, the most important of which was that this approach needs more research, analysis and study at the practical and th

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Publication Date
Sun Nov 26 2017
Journal Name
Journal Of Engineering
Reservoir Characterizations and Reservoir Performance of Mishrif Formation in Amara Oil Field
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Mishrif Formation is the main reservoir in Amara Oil Field. It is divided into three units (MA, TZ1, and MB12). Geological model is important to build reservoir model that was built by Petrel -2009. FZI method was used to determine relationship between porosity and permeability for core data and permeability values for the uncored interval for Mishrif formation. A reservoir simulation model was adopted in this study using Eclipse 100. In this model, production history matching executed by production data for (AM1, AM4) wells since 2001 to 2015. Four different prediction cases have been suggested in the future performance of Mishrif reservoir for ten years extending from June 2015 to June 2025. The comparison has been mad

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Publication Date
Wed Mar 23 2022
Journal Name
Journal Of Educational And Psychological Researches
The Effectiveness of a Training Program for the Development of Moral Intelligence among Preparatory Students
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This current research aims to identify the effectiveness of a training program in developing moral intelligence and mutual social confidence among middle school students. The researcher made a number of hypotheses for this purpose to achieve the goal of the research.                             

The researcher relied on the (Al Zawaida 2011) scale prepared according to Coles (1997), including (60) items, and the mutual social trust scale for (Nazmi 2001) based on Roter's theory including (38) items.               &nbsp

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Publication Date
Mon Jun 01 2015
Journal Name
Iraqi Journal Of Science
Simulation of Solar Coronal Magnetic Field Using Potential Field Model
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In this paper, 3D simulation of the global coronal magnetic field, which use observed line of sight component of the photosphere magnetic field from (MDI/SOHO) was carried out using potential field model. The obtained results, improved the theoretical models of the coronal magnetic field, which represent a suitable lower boundary conditions (Bx, By, Bz) at the base of the linear force-free and nonlinear force free models, provides a less computationally expensive method than other models. Generally, very high speed computer and special configuration is needed to solve such problem as well as the problem of viewing the streamline of the magnetic field. For high accuracy special mathematical treatment was adopted to solve the computation comp

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Publication Date
Sun Mar 01 2020
Journal Name
Journal Of Engineering
Petrophysical Analysis of an Iraqi Gas Field (Mansuriya Gas Field)
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Mansuriya Gas field is an elongated anticlinal structure aligned from NW to SE, about 25 km long and 5-6 km wide. Jeribe formation is considered the main reservoir where it contains condensate fluid and has a uniform thickness of about 60 m. The reservoir is significantly over-pressured, (TPOC, 2014).

This research is about well logs analysis, which involves the determination of Archie petrophysical parameters, water saturation, porosity, permeability and lithology. The interpretations and cross plots are done using Interactive Petrophysics (IP) V3.5 software.

The rock parameters (a, m and n) values are important in determining the water saturation where (m) can be calcul

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Publication Date
Sun Jan 01 2023
Journal Name
Aip Conference Proceedings
Optimization of Fenton process for removal of chemical oxygen demand (COD) from hospital wastewater using response surface methodology (RSM)
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Publication Date
Tue Jul 01 2025
Journal Name
Nigerian Postgraduate Medical Journal
The Effectiveness of Deep Breathing Exercise Training Program in Reducing Discomfort Symptoms amongst Undergoing Haemodialysis: A Randomised Controlled Trial
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Background:

Chronic kidney disease is one of the leading public health problems that affect millions of women and men worldwide.

Aims:

This study aims to examine the effect of deep breathing to reduce discomfort amongst patient undergoing haemodialysis (HD).

Materials and Methods:

This randomised controlled experimental study was conducted consisted of 108 patients (54 in each group) who undergoing HD in hospitalised adults’ patients between November 2024 an

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