This may be due to several factors as follows: laboratories in these countries are more likely to perform inexpensive (in-house or laboratory-developed) tests, smaller test panels (in our experience via the Royal College of Pathologists of Australasia Quality Assurance Program, some laboratories only perform 2-test panels of FVIII:C and VWF:Ag; these laboratories will never be able to accurately diagnose/exclude VWD), may not use the VWF:CB, nor have available multimer or genetic testing [16,17]. The gene discussed is VWF; the disease is von Willebrand disease (hereditary or acquired).