Plasma exchange and apheresis (INUSpheresis, plasmapheresis) abroad: one INUSpheresis treatment from ≈ CAD 3,395 per treatment

Apheresis is a group of procedures in which blood is taken from a vein, passed through a machine that separates or filters part of it, and returned. Hospitals use plasma exchange for specific conditions, and some private clinics abroad sell apheresis procedures as single treatments or short courses. This page describes how clinics publish the price and terms.

What does it involve?

Cambridge University Hospitals in the UK describes plasma exchange as a procedure involving the separation and removal of the plasma from the blood. Its leaflet says the blood cells are returned with a replacement fluid such as human albumin solution or fresh frozen plasma, that a session usually takes one to two hours, and that the doctor decides the number of sessions. For one listed condition, acquired thrombotic thrombocytopenic purpura (TTP), the same hospital states that plasma exchange is the first line of treatment.

Private clinics sell three different procedures under related names. The pages here keep them apart and never compare one with another:

• INUSpheresis — a filtration apheresis offered under its own brand name. Clinics describe it as one treatment, and often recommend starting with two treatments a few days apart.
• Plasma exchange — plasma is separated from the blood cells, either in a centrifuge or through a membrane, removed and replaced with a fluid.
• Double filtration plasmapheresis (DFPP) — plasma is separated and then passed through a second filter before it is returned.

The procedure name, the machine and the filter used, and what is given back into the vein are the main things to establish before comparing offers.

How do clinics price it?

Each procedure has its own unit, and prices are compared only within the same procedure and unit:

• INUSpheresis, per treatment — one treatment.
• INUSpheresis, per course of two treatments — two treatments sold together, usually within a few days. A course of two is not compared with a single treatment.
• Plasma exchange, per session — one session.
• DFPP, per session — one session.

In Germany, most published prices are for INUSpheresis. Clinics there often publish an approximate figure or a range rather than a fixed price, because infusions given during the treatment can change the total.

A published price usually covers the procedure itself, the staff and the material. Often charged extra: a first consultation, examinations before the first treatment (blood tests, an ECG and others), laboratory analysis of the removed material, infusions and supplements given at the same time, and follow-up consultations. Some clinics credit the consultation fee against the treatment if you go ahead.

What should I ask the clinic before paying?

• Which procedure is it exactly: INUSpheresis, plasma exchange or DFPP? Which machine and filter are used?
• For plasma exchange: what replacement fluid is given, and how much plasma is processed in a session?
• Which named doctor assesses you before treatment, and who supervises the procedure? See how to check a doctor.
• Which tests are required beforehand, and are they in the price or billed separately by a laboratory?
• Are infusions, supplements and consumables included, or charged separately?
• For a course: how many treatments, over how many days, and what happens to the money if the second treatment does not go ahead?
• Will you receive a written cost plan, and how long is it valid?
• Does the clinic say whether health insurance covers any part of it?

What this page does not tell you

This page reports published prices and terms. It does not say whether any of these procedures suits you or works for any purpose; that decision belongs with your own doctor. The hospital information cited above concerns plasma exchange for listed medical conditions. It does not cover INUSpheresis or DFPP as sold by private clinics, and clinics may offer apheresis for uses that a hospital would not. Apheresis needs access to a vein or a central line; the Cambridge leaflet explains how the lines are placed.