Advocacy group concerned pay-for-plasma clinics expanding to Ontario will hurt voluntary donations

A group that advocates for a voluntary blood supply is concerned clinics that pay people to donate plasma are expanding to Ontario over the next year, through a partnership between Canadian Blood Services and a private Spanish com‐ pany.

Three clinics in total - in Whitby, Hamilton and Cam‐ bridge - are set to open be‐ tween 2024 and 2025, with two more being planned for yet-to-be-determined loca‐ tions.

The plans build on a 15year agreement signed in 2022 between Canadian Blood Services (CBS) and pri‐ vate pharmaceutical com‐ pany Grifols to boost the na‐ tional blood plasma supply.

BloodWatch, a non-profit organization that advocates for a safe and voluntary do‐ nation system, said pay-forplasma clinics are a "danger‐ ous field."

"We have to become more self-sufficient and there's no reason Canadian Blood Services can't open five additional plasma sites in order to collect that plasma," executive director Lanteigne told CBC News.

Plasma is the yellow liquid that makes up the majority of the body's blood volume. It's rich in proteins that play a vi‐ tal role in creating medica‐ tions to treat many condi‐ tions, including immune defi‐ ciencies, CBS's website says.

The process for donating plasma is similar to giving blood.

In plasma donation, how‐ ever, blood components are separated through a tech‐ nique called apheresis, dur‐ ing which blood passes through a special machine that collects plasma and re‐ turns the other blood com‐ ponents into the donor's body.

Other provinces with private plasma clinics

The planned clinics in On‐ tario will be run by the Spanish company Grifols, which will pay for plasma do‐ nations "as per their operat‐ ing model," Canadian Blood Services said in an email to CBC News.

"Grifols will then use that

Kat plasma to make im‐ munoglobulins for purchase by Canadian Blood Services only. None of the im‐ munoglobulins can be sold offshore," CBS said.

It says a global shortage of immunoglobulins (anti‐ bodies that are extracted from plasma to make lifesaving medications) makes it critical for countries to in‐ crease their plasma collec‐ tions.

Paid plasma clinics oper‐ ating in Winnipeg and cities in Saskatchewan, Alberta and New Brunswick are run by Grifols and Canadian Plasma Resources.

In 2023, an agreement was signed that would see Grifols acquire centres run by Canadian Plasma Resources by the end of 2025.

It's not clear how much plasma donors at the Ontario clinics will be paid. The web‐ site for Canadian Plasma Re‐ sources says up to $70 is of‐ fered and people can donate twice in every seven-day peri‐ od.

Lanteigne said Blood‐ Watch is concerned about vulnerable people selling their plasma for cash and the impact pay-for-plasma clinics may have on companies with alternative immunoglobulin therapy options.

"Competition in plasmaderived products is critical for patient access," she said. "As new products come to the market, what Canadian Blood Services has done is locked us in a 15-year con‐ tract when other products on the market could be avail‐ able."

Law preventing paid blood plasma has exemp‐ tion

CBS manages the coun‐ try's blood supply, except in Quebec, where it's HémaQuébec's role.

Ontario, B.C. and Quebec don't allow payments to blood and plasma donors, through each province's Vol‐ untary Blood Donations Act.

CBS is exempted from the act.

"The agreement [with Gri‐ fols] also complies with On‐ tario's Voluntary Blood Dona‐ tions Act, which has always contained an exemption for Canadian Blood Services with implicit consideration of our agents, given our role as the national blood operator and supplier of blood pro‐ ducts in Canada," Canadian

Blood Services said.

"Through our agreement, Grifols will operate under the act as an agent of Canadian

Blood Services."

In Ontario, the act passed unanimously in the Legis‐ lature in 2014.

Alana Cattapan is Canada Research Chair in the politics of reproduction and an assis‐ tant professor in political sci‐ ence at the University of Wa‐ terloo

Cattapan said that at the time the exemption to CBS was under debate in the Leg‐ islature, several MPPs feared it would allow private forprofit buying of plasma and eventually violate the spirit of the act.

A spokesperson for Ontar‐ io's Ministry of Health said CBS's network of blood and plasma donor centres re‐ mains voluntary.

"Our government will con‐ tinue to monitor the deci‐ sions of Canadian Blood Ser‐ vices to ensure it delivers a secure supply of plasma pro‐ tein products to Ontarians," the spokesperson said.

Blood agency aims for better plasma goals in Canada

CBS currently relies on plasma donations to meet national demand and collects about 15 per cent of what's needed, according to its web‐ site. The remaining 85 per cent is purchased from the global market.

Peter Jaworski, a Canadi‐ an scholar, is associate pro‐ fessor at Georgetown Univer‐ sity in Washington D.C. and an adjunct professor at Vir‐ ginia School of Law.

He said paid clinics could help Canada become more self-sufficient.

Jaworski said the U.S. sup‐ plies 65 to 68 per cent of the plasma used to manufacture therapies globally.

"Canada has been around 80 per cent dependent on plasma collected in the U.S. since at least 2012," he said.

"We've depended on peo‐ ple who donate plasma in the U.S. to companies like Grifols, where they are paid for their plasma donation."

CBS said its partnership with Grifols will help them reach a target of 50 per cent in getting plasma in this country in shorter time.