The head of Canadian Blood Services (CBS) says the agency plans to open dozens more collection facilities in the coming years amid signs it is losing volunteer donors to a for-profit clinic that pays people to give plasma.
Canadian Plasma Resources, a private operator that gives gift cards to plasma donors, opened a collection facility in Saskatoon in February.
Although the national blood agency said in April that paying donors for plasma was an option, it has now ruled that out. (Plasma is the straw-coloured portion of the vital fluid that is processed into pharmaceutical products for patients.)
"We've begun to see some early impacts of having this private, for-profit enterprise operate in our jurisdiction," Sher said. "It is early evidence, but it's certainly consistent with what other countries are seeing when you see large-scale ramp-up of the paid plasma industry side by side with the blood industry.
"We in Canada are at risk, if we don't collect more of our own plasma, that we're not going to be able to access the global supply of these plasma drugs," he said.
"We have to collect more plasma, control it, and keep it in Canada for Canadian patients, which the private industry is not obligated to do. They will sell to the highest bidder."
Demand for pharmaceuticals derived from plasma is increasing by up to 10 per cent a year in Canada, he said. There's similar growth in the U.S., Australia and Europe, and it's anticipated China and India will clamour for more, too.
Neurological and immunological conditions that are now recognized and treated with plasma pharmaceuticals are driving up demand, Sher said.
Currently, CBS collects about 200,000 litres per year of plasma from donors who freely donate blood containing red blood cells, platelets and plasma.
The plan is to increase plasma collections another 500,000 to 600,000 litres per year, by opening 30 to 40 collection facilities of various sizes across Canada in the next seven years, Sher said.
Michael Decter was an adviser to the Krever Commission into the tainted blood scandal, and is a former deputy health minister in Ontario.
"As an economist I'm not surprised that once you allow paid plasma donation in, it's going to undercut the volunteer sector," Decter said. He's delighted with the change in direction at CBS.
"It's a Christmas gift that they've come to their senses and they're going to try to collect more blood on a voluntary basis from Canadians."
Kat Lanteigne, executive director of Blood Watch, an advocacy group that represents tainted blood victims across Canada, also welcomed the move — with some reservations.
Sells sovereignty of donors
"Right now what's happening is that the private companies are actually putting Saskatchewan at a deficit supply," Lanteigne said. "They're not helping us become more self-sufficient. And so we're very happy that Canadian Blood Services is speaking out, but the government of Saskatchewan and our federal government have to listen."
Lanteigne worries about the implications of Saskatchewan's approval of for-profit plasma collection, saying a domestic blood strategy "is the only way to secure the integrity and safety of our national blood system."
"We're not having an argument about the final drugs and the safety of those medications. We're talking about the system as a whole, and how you're procuring and who gets to procure that plasma. In our country, Canadian Blood Services has the sole responsibility to do that. And there's no legitimate reason why we should we selling the sovereignty of our donors away to a private company to make profit off the sale of plasma."
Lanteigne called on federal Health Minister Jane Philpott to revoke the licence for the Saskatoon facility.
British Columbia and Nova Scotia are also exploring the possibility of opening such clinics. Lanteigne would also like to see a moratorium on approving more paid plasma clinics. Quebec and Ontario outlaw such payments.
CBS is also lobbying for a moratorium.
"At the Canadian Blood Services Annual General Meeting … we asked governments to take a pause in support for commercial activity," until the agency's plan for plasma self-sufficiency is ready early in 2017, a spokesman said in an email.
Saskatchewan's government said it looks forward to receiving the plan.
"Saskatchewan supports the involvement of the public and private sectors in the collection of plasma to meet this patient need," a spokesman for the province's health ministry said.
Similarly, "the New Brunswick Department of Health sees no reason, nor does it intend, to introduce any legislative or regulatory measures that would prohibit private paid plasma collection within the province," a spokeswoman said in an email.
Lanteigne hopes CBS will strive to obtain 70 to 80 per cent of Canada's plasma pharmaceuticals from domestic, voluntary plasma collections, instead of its 50 per cent goal.
Barzin Bahardoust, CEO of Canadian Plasma Resources, said it hopes to open a paid collection centre in Moncton, N.B., in March, pending approval from Health Canada. The company's goal is to open 10 clinics by 2020.
Bahardoust said his company is pleased CBS is expanding, saying the agency's 50 per cent goal leaves half for his company to fill.