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A Closer Look at Blood Plasma Donations in Canada

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The Alberta legislature will soon be debating a private member’s bill that would allow people to donate their blood plasma … and get paid for it.

This change is being debated as researchers have reported on the growing demand for blood products world-wide as well as global shortages.

As blood plasma plays an incredibly important role in society – from supporting patients with debilitating health issues to helping researchers develop a treatment for viruses such as COVID-19 – we decided to take a closer look at the issue.

What is Blood Plasma?

We’re all familiar with blood. It’s in all of us and most people know that if they have an accident and lose a significant amount of blood, they’re probably going to need a blood transfusion.

But what about blood plasma?

Blood plasma is the straw-coloured part of blood that contains many proteins, including albumin, clotting factors, and antibodies, otherwise known as immunoglobulins. The antibodies help the body fight infections, while clotting factors help our blood to clot.

For example, in this clip, Kate van der Meer describes her condition (Multifocal Motor Neuropathy (MMN)) and explains how if she doesn’t receive regular infusions of intravenous immunoglobulin, a blood plasma therapy, her condition could worsen and her mobility and well-being would be affected.

Kate’s condition is a neurological condition, and is one of a growing number of conditions for which plasma therapies are an effective treatment. These include helping patients with autoimmune and immunodeficiency disorders. Some therapies take plasma from patients with specific antibodies in order to create a therapy called a hyperimmune globulin. These include therapies against rabies and tetanus, and researchers are currently attempting to create just such a treatment against COVID-19.

A key difference between blood and blood plasma donations is that while someone can make a regular blood donation every fifty-six days, a plasma donation can be done twice a week with at least 48 hours in-between.

Canadian Paid Plasma

Currently, there are three locations in Canada where people can get paid for donating their plasma: Canadian Plasma Resources has a plasma center in Saskatoon and Moncton, and Prometic Plasma Resources has a facility in Winnipeg.

However, the provinces of British Columbia, Alberta, Ontario, and Quebec have enacted bans on donors being paid for their plasma through provincial legislation. (These four provinces alone comprise more than 86% of Canada’s population)

The bans appear to be political in nature, rather than based on sound medical and scientific health policy. According to Health Canada, paid plasma is no less safe than unpaid plasma, and makes therapies that are equally effective.

As noted, the Alberta legislature will soon debate a new bill that seeks to repeal the province’s Voluntary Blood Donations Act and allow Albertans to start receiving compensation for their blood plasma donations.

Paid Plasma Supply

As noted, most Canadians live in provinces that ban people from being paid for their plasma donations. This is one reason why Canadians don’t donate enough blood plasma to meet our nation’s demand. As a result, Canada currently imports 80% of our nation’s plasma therapies made from the plasma of paid American donors. (As of 2020, the U.S. is responsible for 70% of the world’s blood plasma supply for plasma therapies.)

You read that right – while most Canadians are banned from being paid for plasma donations our health care system relies heavily on blood plasma that comes from Americans who are paid for their blood plasma donations.

Canada’s reliance on American blood plasma leaves our nation vulnerable in the event of a catastrophic health issue. Alternatively, if the United States were to limit exports, or if demand were to grow significantly, it would cause significant shortages in Canada and that would be dangerous for the patients who rely on plasma therapies for medical treatment.

Currently, demand for plasma therapies, especially immunoglobulin, is increasing at a rate of 6-10% per year. Experts expect that Canada will face serious shortages in the years ahead. Speaking before a Senate of Canada committee hearing in March, 2019, the CEO of Canadian Blood Services noted:

“The question then is not if we will see product shortages but when. It is not a question of if commercial prices will go up but by how much. The time to act is now to protect the critical supply for Canadian patients.”

Allowing Paid Donations

To reduce Canada’s reliance on paid American donors, and meet the growing demand, provincial governments that currently ban paid plasma should lift their bans. Doing so is likely to significantly increase blood plasma donations and help level the playing field between Canada and the U.S.

Further, our health care system could actually save money if paid donations were allowed in more provinces.

This is because blood plasma that comes from unpaid donations is estimated to be 2-4 times more expensive than paid blood plasma donations. For example, in 2017, Canadian Plasma Resources offered all of the Canadian plasma they collect to Canadian Blood Services for $166 per litre. In comparison, Canadian Blood Services has a plan to collect 600,000 litres of plasma at an annual, ongoing operating cost of $247 million dollars by 2024. This works out to $412 per litre, or more than twice as expensive. Similarly, one report estimated that if Australia were to import all of its plasma therapies from the countries that permit payment, it could save $200 million dollars (AUS $) annually.

On an individual basis, the $30 to $50 of compensation provided per donation could provide a little bit of extra income for Canadians – which would help low-income individuals pay rent, or a student purchases a couple of extra textbooks, as it does in the United States, Germany, and Austria.

Objections

According to Peter Jaworski, a Canadian professor of business ethics at Georgetown University, the most frequently cited argument against paid plasma surrounds the issue of safety. In Ontario and Alberta, those who supported a ban on paid plasma argued that we needed a ban because paid plasma was unsafe, and could lead to a repeat of the tainted blood scandal of the 1980s. But not only does Health Canada state that paid plasma is no less safe than unpaid plasma, this objection ignores the fact that we are already using paid plasma for most of our plasma therapies. If this were a genuine concern, opponents would argue against importing paid plasma too. But such arguments were never made.

Interesting Links

If you would like to learn more about this issue, the following resources might be of interest:

https://donationethics.com/ – Letters penned by academics (including Nobel Prize winners) defending payment for blood plasma donations.

https://www.canada.ca/en/health-canada/programs/expert-panel-immune-globulin-product-supply-related-impacts-canada/protecting-access-immune-globulins-canadians.html/ – Health Canada Expert Panel report on improving immune globulin supply.

https://www.adamsmith.org/research/bloody-well-pay-them – Peter Jaworski’s full report on the issue.

By: Gage Haubrich, SecondStreet.org research intern

Kate van der Meer’s story

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