Paying for Canadian Plasma

I’m a signatory (along with a number of economists and ethicists) to this letter to the Expert Panel on Immune Globulin Product Supply and Related Impacts in Canada. The letter argues that Canada, which imports most of its plasma from the United States (which, in turn, collects plasma from paid donors), should not ban compensation to plasma donors.

The genesis of the letter is that the Provinces of Québec, Ontario, and Alberta prohibit compensation for plasma donations for purposes of further processing into plasma-derived medicinal products (PDMPs). Currently, Nova Scotia and British Columbia are contemplating similar bans. The detailed letter, for which Peter Jaworski deserves primary credit, addresses, among other issues, wrongful exploitation, commodification, and crowding out.  But the most interesting issue, in my view, is the purported safety rationale behind the ban.

Many opponents of compensating Canadian plasma donors raise safety issues. This really makes no sense to me (or the other signatories) for a number of reasons.  First, some opponents conflate blood donors for transfusion purposes with plasma donors for PDMPs. As we explain in the letter, these are two very separate issues. Second, the scientific consensus is that compensating donors does not compromise the safety of PDMPs. As stated by Dr. Graham Sher, the CEO of Canadian Blood Services:

“It is categorically untrue to say, in 2015 or 2016, that plasma-protein products from paid donors are less safe or unsafe. They are not. They are as safe as the products that are manufactured from our unremunerated or unpaid donors.”

Finally, and perhaps most importantly, Canada imports PDMPs from the United States, where donors are compensated. There is no reason to believe that PDMPs made from compensated Canadian donors would be any less safe than PDMPs made from compensated United States donors. Instead, the opponents’ position seems to reflect a type of NIMBYism that fellow letter signatories Nico Lacetera (Rotman School of Management, University of Toronto) and Mario Macis (Johns Hopkins, Carey Business School) discuss in an article forthcoming in a Law & Contemporary Problems volume, Altruism, Community, and Markets, edited by me, Julia Mahoney (UVA), and Sally Satel (AEI). A draft doesn’t appear to be available online yet, but I’ll blog more about it when it is.

Fellow signatories Al Roth and Alex Tabarrok also blog about the letter here and here, respectively. The letter is very informative and can be read in full here.

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