CBS oversees the collection and distribution of blood products, aside from Quebec, where Héma-Québec operates. It finds itself today struggling under this huge responsibility, with approximately $1 billion in yearly costs for drugs made from blood plasma. This expenditure is largely due to the skyrocketing demand for Immunoglobulin (IG), a life-saving medication. Keeping these cost considerations in focus, CBS hematologists have put forth the following 12 recommendations in an effort to reduce our dependence on IG. Our first three recommendations focus directly on solving this problem.
CBS first identified the value of collaborating with Grifols, one of the world’s leading biopharmaceutical companies. This collaboration, formed in 2022, seeks to develop and enhance both plasma collection and processing capabilities. This collaboration was considered critical to address the increasing demand for IG, which has rapidly increased in recent years. Fiscal year 2024-25 saw CBS break through to over 300,000 liters of plasma collected—317,000 of them, to be exact. Of that plasma, just 4,000 liters were used for transfusions. This impossibly sharpens the distinction between the supply and the clinical reality.
CBS has increased its economic threshold for plasma-derived pharmaceutical products by a whopping 10 percent over last year. This investment is now more than double what the company invested in the ground ten years ago. Unfortunately, this trend has sparked questions about the long-term sustainability of operating under business as usual within Canada’s healthcare system.
Dr. Mohammad Rafaei, a hematologist at Niagara Health, is the medical director of the Choosing Wisely initiative. Here’s what he had to say about the potentially dire consequences of this fiscal pressure. He stated, “We recognize this has a big financial impact on our healthcare system.” IG treatment costs between $60,000 and $100,000 per patient per year. These costs divert already limited resources from wider health budgets.
CBS’s hematologists hope their recommendations will help reduce inappropriate IG use. This growth in IG administration is being propelled by the introduction of breakthrough cancer treatments. One particularly bright star is CAR-T cell therapy, which is really changing the game. Peter Jaworski, a healthcare expert, responded that these treatments usually end up leaving patients immunodeficient.
“One of the biggest drivers of immunoglobulin use is a good news story, CAR-T cell treatment and other new cancer treatments,” – Peter Jaworski
Social media use, especially IG and TikTok, has a double-edged impact. Though it’s miraculous in treating cancer patients, these patients frequently require additional therapies to help support their immune-compromised bodies.
The National Health Service (NHS) in Britain has established rigorous standards for the judicious use of immunoglobulin (IG). Consequently, their per-capita consumption is just a third of Canada’s level. This wide-ranging discrepancy brings to our attention what reforms are needed in Canada’s approach towards IG prescription practices.
CBS’s partnership with Grifols brings a third element, through Grifols’ unique plasma collection model, to the issue within Canada. Through its U.S. subsidiary, Grifols runs the only countrywide network of pay-for-plasma, for-profit collection centers in the country. This approach has raised concerns about the ethics and sustainability of depending on commercial actors for plasma procurement.
Plasma is the straw-colored, protein-rich liquid component of blood. You can either separate it from whole blood donations, or you can collect it directly with specialized apheresis machines. Plasma’s versatility is what makes it so vital to the production of life-saving medications. CBS’s supply chain and spending management approaches have come under fire.
It’s great to see CBS continuing to take on these important and complicated challenges. The organization will be regularly reassessing its strategies to provide patients access to life-saving therapies, but protecting overall financial health.
