美国一项全国代表性调查发现，尽管91%的医疗提供者报告可以获得红细胞交换疗法，但接受过该治疗的镰状细胞病患者不足3%1。这一巨大差距反映出美国医疗系统在疾病治疗方面存在的深层次问题。
研究显示，提供该治疗的医疗机构面临多重难题1。仅有5%的卫生保健提供者在提供这种治疗时没有遇到任何障碍1。主要困难包括不同医学部门间协调不力、捐献血液供应有限、医务人员对该程序缺乏了解、患者对治疗选项认识不足、保险覆盖问题以及地理位置限制1。肯塔基大学药学院的Aaron Haubner博士表示，这些"新疗法"对大多数患者来说"令人兴奋但遥不可及"1。
患者获取新疗法的机会极其不均等1。镰状细胞病在全美影响超过100,000人，全球影响800万人1。确诊患者中90%是非西班牙裔黑人或非裔美国人，3%-9%是西班牙裔或拉丁裔1。约80%的镰状细胞患者依赖医疗补助计划（Medicaid）并面临社经脆弱性1。美国镰状细胞病协会首席医疗官Edward Donnell Ivy指出了地理因素的影响："许多镰状细胞患者生活在农村地区，只能到农村医院就医"1。
A nationwide survey has found a stark gap between the availability of red blood cell exchange therapy and its actual use among American sickle cell disease patients.1 While 91% of healthcare providers report having access to the treatment, fewer than 3% of sickle cell patients have ever received it.1 Only 5% of healthcare providers reported encountering no barriers when delivering this therapy.1
Sickle cell disease affects more than 100,000 people across the United States and approximately 8 million globally.1 Within the diagnosed patient population, 90% are non-Hispanic Black Americans or African Americans, with 3%-9% being Hispanic or Latino.1 About 80% of sickle cell patients rely on Medicaid and face socioeconomic vulnerabilities.1
Multiple systemic obstacles prevent wider adoption of the treatment.1 These barriers include coordination difficulties between different medical departments, limited donated blood supply, insufficient healthcare worker knowledge about the procedure, patient unawareness of treatment options, insurance coverage challenges, and geographic limitations.1 Dr. Aaron Haubner from the University of Kentucky College of Pharmacy noted that these newer therapies remain "exciting but out of reach" for most patients.1 Edward Donnell Ivy, Chief Medical Officer of the American Sickle Cell Disease Association, highlighted geography's role, explaining that "many sickle cell patients live in rural areas and can only access rural hospitals."1 Access to these emerging treatments remains profoundly unequal, driven primarily by geographic location, socioeconomic status, and uneven distribution of medical resources.1
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