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However, population-based studies performed in Catalonia and the Canary Islands [7, 8], both of which used a serum vitamin B12 cut-off of 200 pg/ml, returned values of 1.9% and 3.4% respectively

Side effects increase with higher doses

Another option is the use of value-based agreements, similar to the CMMIs Cell and Gene Therapy Model in which 33 states are participating to increase access to treatments for sickle cell disease

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