title: Barriers to the Implementation of Lipoprotein Apheresis in Canada.
abstract: This article details the effectiveness of using lipoprotein apheresis (LA) rather than plasmapheresis in patients with homozygous familial hypercholesterolemia (HoFH), using results from the first HoFH pediatric patient treated with LA in Ontario. We further detail the barriers involved in adhering to international guidelines by implementing this as a first-line treatment for this condition in Ontario, and the potential savings that would be gained with treating the remaining HoFH patients in this province with LA. A primary barrier has been the division of responsibility that exists in Canada, where the delivery of medical services and the delivery of blood products are separated, artificially discounting the price of plasmapheresis and making it seem like the less expensive option. We would like to implement LA as a first-line therapy, to not only improve patient quality of life and outcomes, but to also to potentially save our federal and provincial governments' taxpayer money.
authors.affiliation: Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Medicine, Division of Nephrology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address: guido.filler@lhsc.on.ca.
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
authors.affiliation: Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Misan
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Medicine, Division of Endocrinology and Metabolism, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hegele
mesh_terms: D001781:Blood Component Removal / Q000592:standards*; D019983:Guideline Adherence; D019538:Health Care Surveys; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000453:epidemiology / Q000628:therapy*; D015994:Incidence; D009864:Ontario / Q000453:epidemiology