Bled Dry: How the Plasma Donation Industry Profits from Vulnerable Communities

ANNA PHAM – Each year, millions of Americans file into plasma donation centers, rolling up their sleeves and watching as their blood gets drawn for some quick cash. To some, donating plasma is a charitable act; to others, it is simply a means to get by. Yet behind this growing trend is a billion-dollar industry that doesn’t only profit from plasma — it profits from people’s need for cash.

Plasma is the liquid component of blood that suspends red blood cells, white blood cells, and platelets throughout the body. It primarily consists of water, proteins, and electrolytes which support various functions such as maintaining blood pressure, boosting immunity, balancing pH levels, and transporting nutrients. Aside from this, plasma is used to create treatments and therapies for blood disorders, immunodeficiencies, and various genetic conditions, as well as transfusions for burn, shock, and trauma patients. With the emergence of new life-threatening conditions, along with complications associated with producing synthetic plasma, the demand for plasma-derived medicinal products is expected to rise globally.

To meet this demand, the plasma industry relies on millions of individual donors across the country. According to the Department of Health and Human Services (HHS), plasma is obtained through a process known as plasmapheresis, where plasma is separated from the other components of blood, which are then returned to the donor’s body. The process takes slightly longer than regular blood donation and is known to be more intensive, which is why individuals are strongly encouraged to take breaks in between donations to allow their bodies to recover.

The United States is one of only five countries in the world that allows donors to be financially compensated for plasma. This incentivization system draws in low-income and marginalized groups who rely on plasma donation as a source of income in the absence of stable employment opportunities and other forms of financial support such as unemployment benefits, housing subsidies, and food assistance programs. One study by Dooley and Gallagher revealed that access to plasma centers was associated with decreased demand for installment and payday loans, along with a notable increase in foot traffic within various retail establishments. Similarly, in her article with The Guardian, Kathleen McLaughlin, the author of Blood Money: The Story of Life, Death, and Profit Inside America’s Blood Industry, highlights how plasma donation is often promoted as a “side hustle” for college students and other low-income individuals seeking a quick and easy way to earn money, demonstrating how plasma donation has become a form of supplementary income within many households. 

Individuals can expect to receive anywhere from $35 to $65 for a single donation in the United States, adding up to roughly $400 a month for those who donate regularly. While plasma is known to replenish within days, frequent donation could lead to various long-term health consequences including fatigue, scarring, immunoglobulin depletion, and in rare cases, anemia. Despite the fact that these risks could be prevented through maintaining a healthy lifestyle, this is often unattainable for low-income individuals who may face existing barriers to accessing food, housing, transportation, and healthcare – factors that make it difficult to sustain the effects of long-term donation. For individuals struggling financially, however, the rewards far outweigh the potential risks, pushing many to donate more often than what is recommended.

The market for plasma and plasma-derived medicinal products (PDMPs) is among the fastest-growing sectors within the pharmaceutical industry, expanding from $5 billion in global sales in 2000 to over $30 billion in 2022. Driving this growth is the United States, which supplies roughly 70% of the world’s plasma – partly due to its compensation model, which provides monetary awards among other incentives to individual donors. This approach encourages greater and more frequent donations, allowing countries such as Austria, Hungary, Germany, the Czech Republic, and the US to remain largely self-sufficient in terms of plasma supply. This was highlighted in a report by the Canadian Agency for Drugs and Technologies in Health, which states that the US had achieved a surplus in 2017, supplying more than twice the amount of plasma it consumed worldwide. In contrast, countries that practice voluntary donation such as Australia, the UK, the Netherlands, and France often face plasma shortages and rely on imported plasma to meet their healthcare needs.

Despite the many advantages of compensated donation, critics are concerned about the potential ethical and safety issues that come with it. The WHO strongly advises against paid plasma donation, arguing that this approach is highly exploitative towards low-income and marginalized individuals, who may be encouraged to make frequent, unsafe donations in order to supplement their income. Furthermore, the FDA expresses concerns that monetary incentives may compromise the safety and quality of donated plasma, stating that donors are more likely to conceal potential diseases and health issues to get paid. This was similar to the results of a systematic review by Daes et al., which found that frequent donations, particularly those that are performed twice a week, led to significant reductions in critical proteins such as immunoglobulin and ferritin, potentially compromising the quality of subsequent plasma donations. Because of this, voluntary donation is strongly encouraged, as it carries the lowest health risk for both patients and plasma donors. 

Overall, the United States’ plasma donation system exemplifies how perverse rewards can lead to perverse incentives: when money becomes a primary motivating factor, individuals are more likely to make frequent donations, regardless of the potential consequences to their own health. This not only encourages unsafe donation practices but also perpetuates a cycle of dependency within low-income and socioeconomically disadvantaged communities, where individuals may feel pressured to commodify their own bodies in order to simply make ends meet.

Copy Editor – Mahima Bhat

Photography Source – https://www.drugdiscoverynews.com/making-blood-in-the-lab-15596