OBJECTIVES: To evaluate the cost-effectiveness and Positive Investment Interval (PII) of ADVATE [Antihemophilic Factor (Recombinant), Plasma/Albumin-Free Method, PFM] as an on-demand/prophylactic modality for hemophilia A (HA) treatment compared to the best current Finnish treatment practice (Kogenate) in a scenario where a pathogen emerges and is transmitted trough non-PFM methods as the Hepatitis C virus (HCV) in the 1980's. METHODS: Incremental cost-effectiveness analysis was performed using probabilistic simulation to depict uncertainty. Conservative information related to treatment practices, costs and survival in Finland were gathered from literature and clinical experts. HIV and HBV were excluded from the modeling, because only 2 HIVs have been transmitted through coagulant products to Finnish HA patients and efficient vaccinations against HBV infection exists. Our innovation, PII, is discussed elsewhere. Here, PII was used to assess the interval when the extra treatment costs of ADVATE are compensated by the treatment costs of emerging pathogen (i.e. interval when no pathogens should emerge, if non-PFM method is used). RESULTS: Current treatment practice was dominated by the ADVATE scenario. 18 years old HA male with and without pathogen transmission had survival estimates of 48 and 55 years, respectively. The expected difference in survival was 3.48 years (51% less pathogen transmissions). Mean treatment cost differences were 7,500–50,200 €/year and 213,700–2,381,600 €/lifetime favoring ADVATE. All PIIs for annual ADVATE investment favored ADVATE and were 1–7 years depending on patient's weight, age, and treatment modality. When production losses and discounting of costs and effectiveness (5%) were included in sensitivity analysis, the relative differences increased (e.g. PIIs became 1-9 years due to production losses). CONCLUSION: ADVATE improves survival, is cost-effective and offers good long-term investment in the treatment of hemophilia A, when known/unknown pathogens transmitted through non-PFM methods emerge. When investment's safety is of concern, PII offers new hands-on interpretation for the political discussion.