The choice of treatment for patients with haemophilia is influenced by the availability of replacement products, evidence-based knowledge and the beliefs of patients and their medical practitioners. Decisions are often restrained by wider political and domestic administrative directives to keep within budgetary limits. Issues about the optimal and most cost-effective care still pose a challenge. When choosing treatments there are as yet no certain answers in many areas and myths can develop around a variety of issues. This article addresses the question of whose responsibility it is to separate truth from myth to patient and family, and suggests some basic counselling principles on which to base practice.