Canada’s publicly funded healthcare system faces a daunting fiscal reality. It spends nearly $1 billion per year on drugs that use blood plasma. Canadian Blood Services (CBS) is at the heart of this investment. They manage blood collection and distribution throughout Canada, except in Quebec. In fiscal year 2024-25, CBS surpassed an astounding 317,000 liters of plasma collected. This critical public resource provides indispensable care for a range of complex medical needs, including substance use disorders.
This straw-colored and protein-rich liquid portion of the blood is the basis for more than 20 life-saving and life-enhancing therapeutic products. Today, you can get plasma through traditional whole blood donations. Otherwise, specialized machines made for direct plasma donations are able to do so. The collected plasma is then separated into its components in a process called fractionation. At this stage, it becomes a slurry before being sent back to Canada as completed items.
Immunoglobulin (IG) therapy continues to cause the greatest demand for plasma products. This therapy is life-saving for patients with immune deficiencies and certain neurological conditions. Depending on the product, IG can be as expensive as $60,000 to $100,000 per patient per year. This increasing cost is a major fiscal strain on our healthcare system.
In 2022, CBS entered a long-term partnership with Grifols. This for-profit global healthcare company runs the largest network of for-profit pay-for-plasma collection centers in Canada. This collaboration aims to enhance the collection and processing of plasma to meet the growing demand for IG and other plasma-derived products. Grifols has committed itself to deepening Canada’s supply chain for pharmaceutical products derived from human plasma. This latest move underscores the company’s ongoing dedication to Canadian patients.
The increasing financial burden of IG utilization has alarmed physicians and policymakers alike. Thirteen hematologists have made a set of twelve recommendations to help decrease reliance on IG therapy. Our first three recommendations should be viewed through the lens of reducing unnecessary IG use to create fiscal space.
Readers will remember Graham Sher, CEO of Canadian Blood Services, telling us how important their one and only product was the primary product.
“The main product that we focus on all the time is immunoglobulin,” – Graham Sher
Changes in the medical landscape have led to increased dependence on IG therapy. Breakthroughs such as CAR-T cell therapy and other pioneering cancer therapies are ushering in the new era. Peter Jaworski, a leading researcher on the topic, shined a light on this paradox.
“One of the biggest drivers of immunoglobulin use is a good news story, CAR-T cell treatment and other new cancer treatments,” – Peter Jaworski
The National Health Service (NHS) in Great Britain has adopted draconian guidelines for doctors. These guidelines stipulate when IG should and should not be used, distinguishing them from practices within Canada. This structured approach has resulted in IG usage that is one-third of that in Canada, suggesting a potential area for improvement within Canada’s healthcare system.
Mohammad Rafaei, a healthcare analyst at Altarum, pointed out the healthcare cost burdens associated with excessive IG use.
“We recognize this has a big financial impact on our healthcare system,” – Mohammad Rafaei
With this investment we have seen Canadian Blood Services and Grifols form a powerful partnership. Together, they work to ensure a safe and adequate plasma supply and address the increasing costs of immunoglobulin therapies. Every day, healthcare professionals advocate for a lesser reliance on these products. At the same time, stewardship of plasma resources going forward is an increasingly urgent concern.
