 Based on the successful pioneer work of Dr Nilsson and her colleagues in Sweden that started in the late 1950s, prophylaxis is recommend as the standard of care for boys with severe haemophilia by WHO and World Federation of Hemophilia WFH. The efficacy and safety of prophylaxis in preventing bleeds and arthropathy in patients with hemophilia has been confirmed in well-designed clinical studies.To keep the factor level above 1, the standard dosage for patients with severe hemophilia A is 20-40 Units kginfusion average 30 Units kg every other day or three times a week. This dosage has a very high consumption of factor, up to 5000-6000 international unitIUkgyear. The high consumption of factor and cost present a major barrier to use the standard prophylaxis in many countries particularly in the developing world. 