The Blood Plasma Industry Explained

The Blood Plasma Industry Explained

Running your veins right now is a yellow-tinted liquid known as blood plasma, the fluid that carries blood components through the body. To some, your plasma means a life saving drug or treatment. To others, it is a financial lifeline in a sea of doubt. And to some, it is simply profit.

The world is facing a plasma shortage. How did we get here? And what does it mean for American donors and plasma recipients worldwide?

The history of the blood plasma industry

Blood plasma, specifically the proteins inside it, are a crucial component in treatments for everything from immune disorders to neurological conditions. A staggering amount of plasma is needed for these treatments; it takes 1300 donations to treat one patient for hemophilia for one year. American pharmaceutical companies have long relied on underhanded methods to get their hands on enough plasma, methods possible due to the lack of regulations on the American plasma industry. The US has one of the least regulated plasma industries, a fact that presents risks to both donors and plasma recipients.

Since 1975, the World Health Organization has strongly recommended against paying for blood or plasma. According to the WHO, a monetary incentive commodifies plasma and endangers impoverished donors who are pressured to give despite concerns for their safety and the integrity of the plasma they give. Only five countries continue to pay for plasma despite WHO recommendations: Germany, Hungary, Austria, the Czech Republic, and the United States. 

As the largest of these countries, the US has become the world’s plasma mill, supplying 71 percent of global plasma. But what about the cogs in the plasma machine? Who are they, and what risks do they face?

It’s easy to tell who pharmaceutical companies are targeting for plasma. According to Business Insider, “plasma centers tend to be concentrated in states with lower minimum wages and cities with more people living under the poverty line.” 

Some donors are motivated by philanthropy or civic duty, but most are simply strapped for cash. A study by the Center for Health Care Research and Policy found that 57 percent of donors at one center relied on plasma donation, or “plassing”, for up to a third of their monthly income. The most common use for money earned at that center was to pay for food or other basic necessities. This desperation for money isn’t a flaw in the plasma market—it’s an integral component.

Testing, and how to get around it

During the AIDS crisis, when “roughly 50 percent of American hemophiliacs contracted HIV from bad plasma-based pharmaceuticals,” American companies were forced to implement health screenings like protein tests and weight limits for donors. But that doesn’t stop the truly desperate. An article by the Atlantic that profiled Albuquerque plassers found that many donors have found ways around these tests. They range from swallowing ketchup after drinking too much to pass protein tests to wearing ankle weights to meet weight minimums, to lying about head injuries or health conditions. These workarounds are part of the reason why the WHO issued its recommendation in the first place: compensating donors doesn’t just compromise the plasma, it endangers the donors. 

Though there is little to no research on the repercussions of frequent plasma donation, a standard plasser can face fatigue and nausea in the short term, and over time can have a higher risk of infection and vein collapse. Many countries recognize these dangers and have mandatory intervals between donations as well as a low yearly limit. But the US, which permits donations twice a week and has a high yearly limit of 104 donations, has little to no regulations to mitigate the danger. Though only 14 percent of US donors made over 50 donations in 2017, the laissez-faire plasma market leaves donors open to being exploited by pharmaceutical companies looking to take advantage of donors.

Where’s the market now?

During the COVID-19 pandemic, demand for blood plasma exploded. The promise of convalescent plasma as a COVID treatment, despite evidence to support its efficacy, accelerated growth in demand beyond the standard 6 percent to 8 percent annual rise. Plasma compensation rates, especially for donors who had recovered from COVID-19, rose with demand. However, donation rates didn’t keep pace with this rise in demand. 

Though measuring national plasma levels is difficult due to the wide array of pharmaceutical companies with plasma stocks, each with its own collection and storage infrastructure, the Immune Deficiency Foundation issued a warning in March 2021 of a coming blood plasma shortage. 

A rise in donor hesitancy could be to blame for the shortage, as well as the newfound financial stability impoverished donors could be experiencing due to governmental stimulus payments. But whatever the reason, the United States and the world are facing a dangerous plasma deficit that could lead to millions of deaths.

Now what?

The $24 billion blood plasma industry is expected to double by 2027, an increase in demand that the US is unprepared to meet—putting millions of hemophiliacs, trauma victims, and immunodeficient people at risk. But increasing plasma supply could come at the expense of American donors and the integrity of the plasma itself. Regulations on the plasma market, such as mandating longer intervals between donations or a lower ceiling on annual donations could help donors, but hurt companies and plasma recipients worldwide.

There is no clear cut solution here. But step one might be looking up a plasma donation center near you.