Factor IX Test Price in Pakistan: Rs 2,100 at Marham Lab

A factor IX assay measures how well one specific clotting protein is working. MedlinePlus explains that the factor IX assay is a blood test that measures the activity of factor IX, one of the proteins in the body that helps the blood clot. At Marham Lab it costs Rs 2,100, reduced from Rs 3,000.

Nobody books this first. It arrives after a screening test has already pointed at a problem.

A long [APTT](/labs/tests/aptt-test-price) says one group of clotting factors is not working, without saying which one. Factor assays answer that question. Factor IX deficiency is haemophilia B, factor VIII deficiency is haemophilia A, and the APTT looks the same in both.

If no screening test has been done yet, start with APTT and PT. They cost less and they decide whether this test is needed at all.

MedlinePlus gives three reasons.

• To find the cause of too much bleeding, meaning decreased blood clotting
• Because a family member is known to have haemophilia B
• To see how well treatment for haemophilia B is working

That middle one matters in Pakistan, where cousin marriage is common and a known family bleeding disorder is a reason to test relatives rather than wait for a bleed. If haemophilia B runs in your family, this test identifies carriers and affected members before a surgery or a delivery turns into an emergency.

MedlinePlus states that a normal value is 50% to 200% of the lab control or reference value.

It adds that normal value ranges may vary slightly among different labs, that some labs use different measurements or may test different samples, and that you should talk to your provider about the meaning of your specific results. Results are reported as a percentage of normal activity rather than a concentration, so the figure on your report is already relative.

MedlinePlus lists these causes of decreased factor IX activity.

• Haemophilia B, which it describes as a bleeding disorder caused by a lack of blood clotting factor IX
• Disseminated intravascular coagulation, a disorder in which the proteins that regulate blood clotting become overactive
• Fat malabsorption, meaning not absorbing enough fat from your diet
• Liver disease such as cirrhosis
• Vitamin K deficiency
• Taking certain blood thinners

Four of those six are not haemophilia, and that is the useful part of this list. Factor IX is one of the vitamin K dependent factors, and the liver makes it. So liver disease, poor fat absorption and vitamin K lack all lower it without any inherited disorder being present. A single low result is a reason to check liver function and vitamin K status, not a diagnosis of haemophilia.

Blood thinners do the same thing by design. Tell your doctor every anticoagulant you take before this test.

MedlinePlus states that you may need to stop taking some medicines before this test, and your health care provider will tell you which ones.

Do not work that out yourself. Stopping an anticoagulant without instruction carries its own risk. Ring whoever ordered the test and ask which medicines to hold and for how long.

No fasting is mentioned.

MedlinePlus notes the usual small risks of a blood draw, then adds a point specific to this test: this test is most often done on people who have bleeding problems, so the risk of excessive bleeding is slightly more than for people without bleeding problems.

Practically, that means holding pressure on the puncture site for longer than you normally would, and telling the phlebotomist in advance that you bruise or bleed easily so they can keep pressure on and check the site before you leave.