Hemophilia Coagulation Factor Treatment Cost Calculator
This calculator estimates the cost of hemophilia coagulation factor treatment in Korea and, first, the dose itself. It covers hemophilia A (factor VIII deficiency, ICD D66) and hemophilia B (factor IX deficiency, ICD D67), and it implements the standard World Federation of Hemophilia (WFH) dosing formula used in clinical practice rather than just looking up a price. Factor concentrate is a covered benefit in Korea but expensive, so the decisive variables are whether the rare-disease special case is registered (a 10 percent copay) and the annual out-of-pocket ceiling. Three treatment modes are modeled — on-demand treatment of a bleed, regular prophylaxis (an annual cost), and perioperative cover — and the result adds the covered self-pay, the ceiling refund, private indemnity, and the medical expense tax credit to show the final real cost under 2026 Korean rules.
The dosing formula (WFH clinical standard)
Factor dosing uses a common clinical formula built on recovery — the percentage rise in the plasma factor level per 1 IU/kg infused. Dose in IU = body weight (kg) x desired rise (%) / recovery = weight x (target factor% − baseline factor%) x K, where K = 1 / recovery.
Factor VIII (hemophilia A) recovers about 2% per IU/kg, so K = 0.5 and dose = weight x rise x 0.5. Factor IX (hemophilia B) recovers about 1% for plasma-derived product (K = 1.0) and about 0.8% for recombinant product (K = 1.25), so hemophilia B — and recombinant FIX in particular — needs more IU to reach the same target. For example, to raise a 60 kg patient from a 1% baseline to a 60% target (a 59% rise), hemophilia A needs roughly 1,770 IU while plasma-derived hemophilia B needs roughly 3,540 IU. Real vials come in 250/500/1,000/2,000/3,000 IU units, so the actual dose is rounded up; the calculator shows both the formula value and the vial-rounded value.
- Hemophilia A (FVIII): recovery ~2% per IU/kg, dose = weight x rise x 0.5, half-life ~8-12 h.
- Hemophilia B (FIX, plasma-derived): recovery ~1%, dose = weight x rise x 1.0, half-life ~18-24 h.
- Hemophilia B (FIX, recombinant): recovery ~0.8%, dose = weight x rise x 1.25 (more IU needed).
- Extended half-life (EHL) products lengthen the dosing interval.
Target factor levels by bleed severity
The target factor level depends on the bleed site and severity, and the calculator offers presets you can adjust.
- Minor bleed (early hemarthrosis, superficial muscle, oral): 30-50%.
- Moderate bleed (advanced hemarthrosis, muscle hematoma): 40-60%.
- Major bleed (intracranial, GI, retroperitoneal, neck, deep laceration): 60-100%.
- Minor surgery (e.g., tooth extraction): 50-80%.
- Major surgery: 80-100% before surgery, then maintain 50-80% for days.
- Prophylaxis: keep the trough above about 1-3%.
Cost by treatment mode
Prophylaxis (regular infusions) is the standard treatment that prevents recurrent joint bleeds and long-term hemophilic arthropathy, typically 25-40 IU/kg two to three times a week. Because the annual IU is very large, the covered factor cost reaches tens or hundreds of millions of KRW per year — but the rare-disease special case sets covered self-pay at 10 percent, and the out-of-pocket ceiling refunds the excess above the income-tier cap.
On-demand treatment infuses factor when a bleed occurs; the target depends on severity and one bleed may need several infusions. Early treatment reduces tissue damage and total factor use, and frequent bleeds are a reason to discuss switching to prophylaxis. Perioperative cover loads the factor to a target (usually 80-100%) before surgery and maintains it for several days after, so a short period consumes a large amount of factor; the special case (10 percent), inpatient indemnity, and the ceiling substantially reduce the real burden.
The key rule: rare-disease special case V009 (10 percent)
The most important cost point is that hemophilia is a registered rare-disease special case in Korea. Under the special-case notice (Ministry of Health and Welfare Notice 2026-101, effective 2026-05-01) Annex 4 (rare diseases), hemophilia is registered with special code V009 and the covered self-pay for related care is 10 percent of the total covered cost, for 5 years from registration.
The covered diagnoses include hemophilia A (D66, hereditary factor VIII deficiency), hemophilia B (D67, hereditary factor IX deficiency), von Willebrand-type disease (D68.0), factor XI deficiency (D68.1), and hereditary deficiency of a coagulation factor (D68.2) — all mapping to V009. The Annex 4 note explicitly applies the special case to factor concentrate and cryoprecipitate drugs and related outpatient/inpatient care, so the special case covers the factor product itself. Without registration, an outpatient drug copay can be 30 percent or more, so registration is the first cost-saving step: register with the National Health Insurance Service and hospital right after diagnosis.
Ceiling, indemnity, and the tax-credit cap exemption
The 2026 annual out-of-pocket ceiling ranges from about KRW 900,000 (income decile 1) to KRW 8,430,000 (decile 10) and refunds covered self-pay above the cap, usually the following August. Because hemophilia prophylaxis often exceeds the cap even at the 10 percent rate, the ceiling is the decisive backstop for annual out-of-pocket cost. Private indemnity reimburses inpatient medical expense for major bleeds and surgery (the ceiling-refunded amount is not double-paid), but prophylaxis is often self-injected or outpatient, where per-visit and annual outpatient/prescription limits make full reimbursement unlikely — so the ceiling and the tax credit are the main levers there.
The Korean medical expense tax credit (Income Tax Act Article 59-4) refunds 15 percent of expense above 3 percent of the payer’s salary. For a registered severe-disease (special-case) patient such as hemophilia (V009), a disabled person, or someone aged 6 or under or 65 or over, the usual KRW 7,000,000 cap does not apply (Enforcement Decree Article 118-5), so even large self-pay is fully creditable. Amounts reimbursed by private indemnity or refunded by the ceiling are excluded, so claim only what you actually paid.
How to read the result
Enter the hemophilia type, the product, body weight, baseline factor level, and the treatment mode, then the mode-specific inputs (target and infusions per episode for on-demand; IU/kg, times per week, and weeks for prophylaxis; target, maintenance days, and daily doses for surgery), the per-IU price, whether the V009 special case is registered, the income decile, the indemnity generation, and the payer’s salary. The result shows the per-infusion dose (formula and vial-rounded IU with a vial breakdown), the mode total IU and covered total, the 10 percent versus general comparison, the ceiling refund, and the final cost after indemnity and the tax credit, plus a half-life-based dosing-interval note.
This is a cost-planning estimate based on 2026 Korean rules and the WFH dosing formula — not medical advice, a prescription, or an insurer decision. Actual doses, target levels, and intervals are set by a hematologist based on the patient’s condition; factor prices per IU are representative estimates to be replaced with the actual drug tariff. Inhibitor patients (who use bypassing agents or non-factor therapy) and acquired hemophilia (D68.4) are out of scope.
This calculator is based on Korean rules (2026 National Health Insurance): hemophilia is a registered rare-disease special case with code V009 at a 10 percent covered copay for 5 years (Notice 2026-101 Annex 4, covering factor concentrate for D66, D67, and D68.0-D68.2), the annual out-of-pocket ceiling (about KRW 0.9-8.43 million by income decile in 2026) that refunds covered self-pay above the cap, and the Income Tax Act Article 59-4 medical expense tax credit with the KRW 7 million cap exemption for registered severe patients. The dose uses the WFH formula. Figures are planning estimates, not medical advice, a prescription, an insurer decision, or a hospital quote; confirm the dose and coverage with a hematologist and the insurer.