The Rise of America's Blood Plasma Trade: Why Demand is Soaring in 2024

Blood has always been a vital element of life, playing a critical role in medical treatments worldwide. However, within this liquid lies a component that not only saves lives but also fuels a growing global trade. In 2024, one particular part of blood—plasma—is stirring up the healthcare and economic worlds alike.The US is leading the way in this industry now worth 37 billion USD, a big help in the global market. Plasma’s unique properties make it indispensable for creating life-saving medicines, and with rising demand across the globe, the US is increasingly becoming a key player in plasma exports.

Graphic showing the increase in America's blood plasma trade and global demand

Yet, why the plasma demand is increasing? And why does the US dominate the global market? Let’s dive into the complex dynamics behind America's growing blood plasma trade and the ethical, economic, and medical factors driving its rapid expansion.

What is Blood Plasma?

To get straight to the point, before we discuss the reasons behind the plasma trade surge, first, we should cover the concept of plasma and its significance in the medical sector.

Plasma is the yellowish liquid that constitutes approximately 55% of our blood. It is mainly composed of water, proteins, and antibodies. While red and white blood cells transport oxygen and fight infections, plasma has a different purpose. It serves as the medium for transporting nutrients, hormones, and proteins to different body parts and helping in clotting blood. Plasma also does the important function of transporting waste products out of the body as well as blood pressure regulation.

But its most significant role in medicine is its use in producing plasma-derived medicinal products (PDMPs). Among them such as the life-saving therapies for hemophilia, immune diseases, and liver conditions. Plasma proteins, especially immunoglobulins, are essential in treating patients with weak or compromised immune systems. This life-saving ability has made plasma an increasingly valuable commodity worldwide.

America’s Dominance in the Global Plasma Trade

When you think of global exports, items like oil, machinery, or even agricultural products might come to mind. But blood plasma is an unexpected player in the US economy, with the country serving as the largest exporter of plasma globally. Indeed, the US takes care of nearly 70% of the plasma requirements of the world. To put this into perspective, in 2023, the United States earned a staggering $37 billion from blood plasma exports—exceeding its revenues from traditional exports like coal and gold.

While this figure represents only about 2% of the US’s total exports, the plasma trade is unique. Plasma-derived products are in continuous demand due to the nature of the medical conditions they treat, and unlike other commodities, their necessity only grows with time. Hence, the United States has grown to be a global hot spot for the collection, extraction, and export of plasma.

But how did the US attain this dominant position in the plasma trade?

Why Plasma Donation Is Not Like Giving Blood Donation

In contrast, plasma is actually not the same blood type because it is donated and then processed in a different way. Although blood donation is considered a duty from a moral point of view and the donors do not get a reward, most countries are different. However, the scenario for plasma donation in the U.S. is not as such.

The US allows plasma donors to be financially compensated, which has created a more robust and consistent supply compared to other nations. Plasma donation which is really a special treatment takes a longer time to complete than blood donation as plasma has to be removed from the blood cells via the process of plasmapheresis. This makes the donation process longer—typically lasting around 1-2 hours. As a result, incentivizing donors with compensation has become the norm, enabling companies to attract a steady stream of donors.

This system is in contrast to many countries where paid plasma donation is banned or heavily restricted. Ethical concerns and health risks associated with plasma donation have led countries like the UK to prohibit payment for donations, while others maintain strict guidelines about donation frequency.

But in the US, compensated plasma donation has grown into a thriving industry, especially during times of economic hardship when individuals are more inclined to donate for financial gain.

The Ethical Debate: Paying for Plasma Donations

The practice of paying individuals for plasma donations raises numerous ethical questions. Critics argue that offering money for plasma might exploit economically disadvantaged individuals, especially since they may donate repeatedly for financial reasons. This concern is compounded by the fact that frequent plasma donation can lead to health complications, although plasma regenerates within 24-48 hours.

Countries like the United Kingdom banned plasma donations in 1998 over fears related to the transmission of Creutzfeldt-Jakob Disease (commonly known as ‘mad cow disease’). The end product is that the UK had to resort to the buying of plasma from other countries to satisfy its medical requirements. Though the ban was lifted in 2021, the country still depends on external suppliers, with much of its plasma coming from the US.

The ethical concerns about payment, the risk of donor exploitation, and potential health risks haven’t deterred the US from becoming the leading plasma exporter. In fact, other countries that restrict paid donations—such as Spain, Japan, and Australia—have set up plasma collection centers in the US to supply their domestic pharmaceutical needs.

COVID-19 and Its Impact on Plasma Donations

The COVID-19 pandemic significantly impacted the plasma trade, causing shortages as blood donation centers across the globe struggled to meet demand. In the US, the Food and Drug Administration (FDA) had to relax restrictions to allow more individuals to donate plasma, especially amid a growing need for convalescent plasma (used to treat COVID-19 patients).

At the same time, the pandemic underscored the critical importance of maintaining a strong plasma supply for non-COVID-related treatments. Plasma donations became an even more significant source of income for many Americans who lost their jobs or faced economic uncertainty due to the pandemic.

In 2023, the FDA relaxed regulations on plasma donation, allowing more people who were previously banned to donate, e.g. men who are sexual partners of other men. This regulatory shift helped alleviate plasma shortages but also sparked discussions about safety and long-term health effects.

The Business of Plasma: Major Players in the Industry

While the US may be the leader in plasma collection, the industry itself is controlled by a handful of private companies—many of which aren’t even based in the US. Firms like CSL Plasma (Australia), Biolife (owned by Japan’s Takeda), Grifols (Spain), and Octapharma (Switzerland) dominate the American plasma collection market.

The irony here is that these countries either ban or heavily regulate plasma donation within their borders, yet they rely on the US to supply their pharmaceutical industries with plasma. These companies have built extensive donation networks in the US, offering payments to donors in exchange for frequent plasma donations. This dynamic has turned plasma collection into a significant economic force within the US.

Why Global Demand for Plasma is Rising

Thus, the question what the causes of the ultra-high density of the demand for a plasma are.

The answer lies in plasma-derived medicinal products (PDMPs). Among the various applications of immunoglobulin products, its specific form has been excellently customized for some rare but vital diseases like immunodeficiency, hemophilia, and neurological disorders. The need for PDMPs is on a constant upward trend for over two decades, and there are no signs of it ending at any time. Rare diseases and chronic conditions are becoming more common among patients which leads to the increased requirement of plasma-derived treatments.

According to the World Health Organization (WHO), more than half of the countries surveyed rely on plasma imports to meet their healthcare needs. This global shortage has put tremendous pressure on plasma-exporting nations like the US to ramp up production.

Potential Risks and Concerns

Although blood plasma donation is usually considered to be a safe process, especially in comparison with full blood donation, it has nevertheless some safety questions about the long-term effects of regular plasma donations. In the US, private plasma centers typically allow donors to give plasma twice a week. Ultimately, this could bring about some worried health issues like low protein levels, tiredness, and vulnerable immune responses.

These risks are still not fully known, but the lack of thorough investigation spreads a doubt over the donors' safety, particularly those whose income is entirely depending on the donations.

Additionally, the ethical debate surrounding paid plasma donations—whether it’s right to compensate people for their blood—persists. Is it good for everyone or makes poor people worse?

The Future of America’s Plasma Trade

The rising global demand for plasma-derivative medicines and the US's special role in the provision of such a vital resource, emphasize the American plasma trade's importance. As the world continues to grapple with plasma shortages, the US will likely maintain its status as the leading plasma exporter, capitalizing on the economic benefits while navigating the complex ethical landscape.

However, as demand rises, so too will the need for more rigorous research into the long-term health effects of frequent plasma donations and discussions about fair compensation. Overcoming the challenge of the health and economic needs of the entire world with the consideration of the ethical impacts will be the challenge of the future.

Ultimately, plasma will continue to power the global medical industry, and America’s role as the world’s plasma powerhouse seems poised to grow even further.

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