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This paper will explore medication adherence with all its inherent issues and suggest policy and structural changes that must happen in order to transform medication adherence levels in the U.S. and achieve the AHA/ASA's health impact goals.Severe familial hypercholesterolemia (SFH) is characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) and severe early-onset cardiovascular disease if left untreated. We report on the decade-long therapeutic journey of a 15-year-old boy with SFH due to a severe compoun