Canadian Blood Services (CBS) says commercial plasma collectors may have a role in adding to the national plasma supply, while some donors and advocates say that plan should be more transparent.
CBS said in a statement, which was first reported by the Globe and Mail, it was tasked with looking at ways to meet the demand for immunoglobulins in Canada and that “dialogue with commercial vendors is necessarily part of this.”
The statement from CBS comes amid ongoing shortfalls in plasma collection in Canada. “We have tried for a very long time to get more and more plasma, to collect more plasma. But like every other country in the world that doesn’t compensate donors, we find that we continually fall short of collections,” said Peter Jaworski, a business ethics professor at Georgetown University, who grew up in Canada.
Plasma is the protein-rich liquid in blood that helps blood components circulate throughout the body. It is used by people with immune deficiencies and rare blood disorders, kidney and liver diseases, various cancer patients and others, according to CBS.
Health Canada says on its website that there’s “not enough plasma collected in Canada to meet the demand,” with most of the plasma products distributed by CBS and Héma-Quebec purchased from U.S. manufacturers and made from U.S.–paid donor plasma.
Advocates say instead of turning to private collectors, CBS needs to double its collection strategy to meet demand.
“To be clear, there is no shortage of donors in Canada. This is not a plasma shortage. This is an infrastructure shortage,” said Kat Lanteigne, executive director of BloodWatch.org, a not-for-profit organization that advocates for a safe, voluntary, public blood system in Canada.
“Because Canadian Blood Services has been slow to roll out their plan, that is why we are here today and there is nothing that impedes them from opening more plasma collection centres.”
She added that this was a “secretive deal” to turn Canadian plasma into a profit-driven business.
“They know that the private pharmaceutical companies may sell some of that plasma to Canadian Blood Services or some of that product. And that could be in a contract.
“[CBS] also know that the majority of that plasma that [private companies are] going to collect is going to be sold to the international market,” Lanteigne said.
CBS says it is having ongoing discussions about an end-to-end domestic supply chain for immunoglobulins so it can reduce “Canada’s dependency on the global market.” It says it’s working to have at least half of the plasma come from donors in Canada.
CBS collects plasma from donors at several sites across Canada, but it only collects about 15 per cent of the plasma needed, according to its website.
A spokesperson also went on to say the organization is on track to hit about 25 per cent by recently opening 11 plasma donor centres in Ontario, Alberta and B.C.
For regular donor Tony Reddin, who lives in Bonshaw, P.E.I., hearing about CBS’ discussions is distressing.
“I don’t think I would continue to donate to a for-profit company. It goes against the whole idea of donation, of doing a good deed in effect.”
Lanteigne adds that CBS should be having this discussion in public, so people can understand what’s at stake.
“It is critical for us as a country to have sovereignty and control over our supply chain through our national blood operator. Fundamentally, this is just a bad business deal that is putting our supply chain at risk,” she said.
In 2018, an expert panel assembled by Health Canada released a report that looked at the long-term national supply.
Its members found at the time that some of the biggest obstacles for using paid donors for plasma are concerns about safety of products made from paid donors, ethical concerns around the “commodification of human plasma” and that paying people for plasma would decrease the number of volunteer donors.
In a statement, Health Canada told CBC News that studies have shown that the safety of plasma is the same between voluntary and paid plasma.
“Therefore, paying for plasma is not a safety issue, and is not regulated under the Food and Drugs Act,” the statement reads.
Provincial and territorial governments currently decide how plasma is collected in their areas. Ontario, Quebec, and British Columbia are the only provinces that do not allow for paid plasma donations, Health Canada said in a statement.
Buying plasma ‘more economical’
The federal panel in 2018 also said that plasma programs based on volunteer donations can’t meet the country’s targets.
The report went on to say that using volunteer donors is two to four times more expensive than commercial plasma collection, making it “more economical” for jurisdictions to purchase immunoglobulins from the commercial market.
Plasma is primarily used in two ways in the country: It can be transfused into people directly at hospitals and can be made into specialized medications.
In Canada and around the world, the most used plasma protein products are immunoglobulins, says the national blood organization.
Jaworski says Canada is currently having trouble securing immunoglobulin and says Canada is currently over-reliant on the U.S. for plasma. That’s why it should look at plasma from paid donors.
“This is a way to ensure that we can have enough therapies for every Canadian patient who needs it,” he said.
The national blood organization says it will provide more information on plans to increase supply “as soon as there is something to share.”