Catherine Rolfes was between jobs and starting to think about how to make some extra cash to put toward her bills when her sibling suggested they visit a plasma donation center.<\/p>\n
At that point, \u201cI\u2019ve never donated plasma,\u201d recalls the 27-year-old, who lives near Columbus, Ohio. \u201cI donated blood back in high school twice, and both times I had a bad reaction. So I was like, I don\u2019t know. But then the bills started getting a little expensive. It\u2019s $125 [to donate]\u2014that\u2019ll come in handy. So I\u2019m like, we\u2019ll go.\u201d<\/p>\n
The U.S. is among only a handful of countries that allow donors to receive financial compensation for giving their plasma, the liquid part of blood<\/a>. Donors here can receive anywhere from $30 to upwards of $100 per visit,<\/a> and are permitted to donate plasma as frequently as twice a week, another rarity around the world. Regular donors can make hundreds of dollars a month.<\/p>\n Experts credit the compensation for making the U.S. one of the few countries that are self-sufficient in supplying plasma for their own patients\u2014and the single biggest contributor to the global plasma supply. Plasma from U.S. donors is used in life-saving treatments and therapies for people all over the world.<\/p>\n But the practice of paying donors has raised ethical questions for some: Critics say that it can be exploitative of people in need of money.\u00a0<\/p>\n \u201cIt\u2019s a really complex issue,\u201d says Emily Gallagher, an associate professor of finance at the University of Colorado Boulder who has studied compensation for plasma donation. \u201cGenerally speaking, the developed countries that allow [paid donation] are the only ones that are able to meet their own domestic plasma needs in terms of the medications that come out of this.\u201d<\/p>\n \u201cAnd the medication is life-saving\u2014there are many, many people around the world who would not survive without it,\u201d she continues. \u201cAt the same time, there are real reasons to be concerned about allowing for these compensated markets.\u201d<\/p>\n \u2018You\u2019ve given us our life\u2019<\/p>\n For years, Kelli Fairfax didn\u2019t know what was wrong. She was always sick, and it wasn\u2019t until she reached her 30s that she learned why: In 2001, she was diagnosed with Common Variable Immune Deficiency<\/a> (CVID), an immune system disorder that causes low levels of antibodies in the blood, which can make people with the condition more susceptible to infection.<\/p>\n \u201cWhen I got diagnosed, it really changed my life,\u201d says Fairfax, a 55-year-old who lives in San Antonio, Texas.<\/p>\n There\u2019s no cure for CVID, but there is a treatment. Replacement immunoglobulin therapy provides a patient with antibodies when their body can\u2019t make them on its own, enabling them to better fight off infection. People with CVID need to receive the treatment for the rest of their lives; Fairfax receives hers every week.<\/p>\n That therapy relies on an essential component: donated human plasma.<\/p>\n \u201cI\u2019m just so thankful,\u201d Fairfax says of plasma donors. \u201cI go to donor stations and I go and I thank them. You know, we call it liquid gold.\u201d<\/p>\n \u201cThese people don\u2019t have to do this,\u201d she continues. \u201cWe\u2019re thankful because you\u2019ve given us our life.\u201d<\/p>\n Plasma mainly consists of water, but it also contains important proteins such as gamma globulin\u2014which helps fight off infections\u2014and anti-hemophilic factor\u2014which helps the blood clot properly. Donated human plasma is used to create life-saving treatments for a variety of health conditions. Those include primary immunodeficiencies<\/a>, such as CVID, that impair the body\u2019s ability to fight off infections, as well as bleeding disorders like hemophilia and some types of cancer.<\/a> Plasma is also used for more everyday medicine, including for critical care patients who have experienced trauma or burns<\/a>.\u00a0<\/p>\n While such patients may only need that treatment for a certain period of time, others\u2014like Fairfax\u2014will need plasma-derived therapies for the rest of their lives. And the number of plasma donations needed to sustain a patient\u2019s treatment varies depending on their condition. Treating one person with hemophilia for a year, for instance, requires roughly 1,200 plasma donations, according to estimates<\/a> by the Plasma Protein Therapeutics Association (PPTA), a trade association representing more than 1,000 donation centers in North America and Europe, and manufacturers of plasma protein therapies. For patients with Alpha-1<\/a>, a genetic condition that can damage the lungs and liver, a year of treatment requires about 900 donations.<\/p>\n \u201cThere is such a need for donated plasma because for many of these patients, this is the therapy they rely on, but it is not a cure; it is something that they need for their lifetime to lead a healthy, productive life,\u201d says Anita Brikman, the president and CEO of the PPTA.<\/p>\n In 2022, 1.26 million people in the U.S. received a plasma-derived therapy at some point over the course of the year; around the world, the total was around 16.5 million, according to the Marketing Research Bureau<\/a>, which provides market data about the plasma industry.<\/p>\n \u201cYou look across the world, when we think about these patient populations\u2014you can see why the need is so significant,\u201d Brikman says.<\/p>\n Donating to help people\u2014and pay the bills<\/p>\n Bethany Beinlich donated plasma for the first time over the summer. The 22-year-old, who lives in Austin, Texas, heard about donating from her brother-in-law, who did it in college. When she first decided to donate, she was waiting to start her new job, and she wanted some extra \u201cfun money.\u201d And she wanted to help people.<\/p>\n \u201cAs a radiation therapist, I am working with cancer patients and I understand how there are different treatments for cancer that are being discovered right now that are using plasma,\u201d she says. So as well as helping her earn some cash, donating is also rewarding for her, knowing that patients could be helped by it.<\/p>\n At first, Beinlich went twice a week. She doesn\u2019t go as frequently now, but she visits a center when she can.<\/p>\n Estimates for the number of plasma donations in the U.S. each year vary, but Brikman says the PPTA pegs it at roughly 45 million. Plasma donation involves blood being drawn from a donor, the plasma being separated out, and other components of the blood\u2014such as red blood cells and platelets\u2014being cycled back into the donor. The process is widely considered to be safe<\/a>, and, for many donors, it\u2019s smooth and simple. Some people may experience mild reactions, such as lightheadedness, but health experts say<\/a> that can often be avoided by drinking water and eating a healthy meal. <\/p>\n Overall, Beinlich\u2019s experience has been positive; she\u2019s never had a bad reaction. If anything, she wishes she had done it in college to help pay some of her bills.<\/p>\n For Rolfes, it wasn\u2019t the most pleasant experience at first. She visited a plasma donation center for the first time in mid-October. But after she was hooked up to the machine and the donation process began, she started feeling ill.<\/p>\n \u201cI felt like I was sweating profusely,\u201d she says. \u201cI was hot and then I was cold, and I was literally physically shaking and I was seconds away from passing out.\u201d<\/p>\n \u201cI was very scared,\u201d she says. \u201cIt was like this impending doom.\u201d<\/p>\n She told a staff member that she wasn\u2019t feeling well, and they gave her an ice pack and gatorade and stopped the donation process. The issue, a staff member told her afterward, was that she didn\u2019t eat or drink enough before donating, so her blood pressure dropped. After Rolfes rested for a while, staffers asked her if she wanted to continue, and she said yes. For the rest of the donation, she felt fine. And she left with $125 on a debit card, which she used to pay her gas bill and buy some food.<\/p>\n That experience didn\u2019t deter Rolfes from returning later that month to donate again. This time, she drank a lot of water and ate a good, full meal beforehand, and the process went much more smoothly. She left the appointment with another $125, which she used to pay her electric bill and buy groceries.\u00a0<\/p>\n Rolfes posted a couple TikToks about her first time donating, and received responses from people who said they relied on plasma-derived therapies and thanked her for donating. That was eye-opening, she says. She plans to continue donating, maybe once or twice a month.<\/p>\n \u201cIt\u2019s a good little extra money, and for a good cause too,\u201d she says.<\/p>\n The compensation debate<\/p>\n There are only five countries that collect enough plasma donations domestically to meet the needs of their own patients: the U.S., Germany, Austria, Hungary, and the Czech Republic, according to Peter Jaworski, a professor of strategy, ethics, economics, and public policy at Georgetown University\u2019s McDonough School of Business who has studied the ethics and economics of plasma donation. All of those countries allow plasma donation centers to compensate donors.<\/p>\n The U.S., though, is by far the biggest contributor to the world\u2019s plasma supply\u2014plasma collected in the U.S. accounts for nearly 70% of all the plasma collected globally for the manufacturing of plasma-derived therapies, Jaworski says. Many countries that can\u2019t collect enough plasma domestically have to import medicine made from plasma donated in the U.S.<\/p>\n \u201cNot compensating donors would very likely result in a shortage,\u201d says Mario Macis, a professor at Johns Hopkins Carey Business School who has studied compensation for blood and plasma donations. \u201cMost other countries around the world are not self-sufficient when it comes to plasma donation. So compensating donors is very important to ensure an adequate supply\u2014to make sure that patients who need plasma-derived therapies get it.\u201d<\/p>\n But some critics have objected to paying plasma donors, raising an ethical concern: What if the money places undue pressure on vulnerable people to donate? Does the promise of compensation exploit people who are struggling financially?<\/p>\n According to surveys that Gallagher\u2014the University of Colorado Boulder professor\u2014helped conduct, plasma donors are more likely to be under the age of 35, Black, and male, compared to non-donors. Researchers also found that donors are less likely to be fully employed, are more likely to have incomes of less than $20,000, and are more likely to have poor credit scores.<\/p>\n About 64% of the people surveyed said they donated plasma to pay for essential goods and emergencies, such as making their rent payments on time. Only 19% of the people surveyed said they did it to make some extra cash.<\/p>\n