Americans Can’t Afford Not to Sell Their Plasma

A young influencer throws on a moto jacket and a tote bag, getting ready to show off her new “favorite rich girl habit.” B-roll plays of her filling out a questionnaire and having her blood pressure taken, as she explains in a voice-over how viewers can get up to $700 in just one month.

“It’s honestly the perfect way to make a real impact while earning extra money for whatever you need,” she says in her sponsored content post.

The influencer, who did not respond to a request for comment, partnered with BioLife Plasma Services to show part of the “plasma donation process.” People, often cash-strapped, are paid, usually via prepaid debit cards, to sit for an hour or two as a machine harvests a pale, yellow liquid from their blood.

The U.S. is one of a handful of countries that allow people to be compensated for the time they spend donating plasma. And business is booming: Plasma, which is used to make life-saving drugs for people with cancer, chronic diseases or immune deficiencies, is a multibillion-dollar business and a major U.S. export.

Across the country’s 1,214 active plasma collection centers, it’s estimated that more than 200,000 people donate their plasma each day, a figure that’s increased in recent years. These centers have long been strip-mall fixtures in impoverished neighborhoods, but they are increasingly popping up in middle-class suburbs.

Affordability debates are dominating U.S. politics, yet when it comes to the plasma industry — where some struggling Americans turn for emergency cash — Congress is shirking responsibility.

“I have been sort of puzzled by why nobody in Congress seems to talk about it. It never seems to come up in any sort of political context,” said Emily Gallagher, an economist who’s researched the connection between plasma centers and poverty in America.

“We asked people why they’re donating, and 64% said the primary reason was to pay for essential goods and emergencies. So basically, they’re late on their rent, their electricity has been turned off,” Gallagher said of one study she conducted. “We didn’t see a lot of evidence that people were doing it purely for altruistic reasons.”

The industry and its paid partners tend to frame the transaction as an opportunity to earn extra money for fun expenses — like gifts for family members — rather than as a way to pay for necessities like bills and groceries. That obfuscates harsh realities in America: Some low-income people have come to rely on plasma centers to make ends meet, and the industry has an inverse relationship with the health of the economy.

“Americans are selling their plasma to pay the bills at the same time Trump is trying to spend their tax dollars on his new ballroom,” said Sen. Elizabeth Warren (D-Massachusetts) in a statement to NOTUS. She said her party is working to ensure “no family is forced to sell their plasma to make ends meet.”

Congressional attention, though, is limited to rhetoric: The legislative body has not introduced any bills that specifically address donation frequencies or offer new donor protections.

In the U.S., people can give 104 times a year, or twice a week, a limit that has existed since at least 2000. Elsewhere, the standard is typically around twice a month, and even the more permissive paid donation systems allow it only about once a week.

There is a stunning lack of research around the safety of long-term, frequent donations, and recent research suggests that giving plasma as frequently as the U.S. allows could deplete donors’ blood proteins faster than they can regenerate.

CSL Plasma, a subsidiary of an Australian company that operates more than 300 U.S. plasma centers, warns about protein depletion on its website. “This can lower the ability to fight off infections, so check in with your healthcare provider to monitor your immunoglobulin levels if you donate plasma often,” the site says.

The Food and Drug Administration requires plasma collection centers to report adverse events and fatalities, a spokesperson for the Department of Health and Human Services said.

“FDA continues to review the safety of plasmapheresis procedures,” the spokesperson said in a statement to NOTUS. “FDA also keeps abreast of scientific literature on the safety of plasma donations.”

The high cap for plasma donations was met with surprise on Capitol Hill.

“Are people giving plasma over a 104 times a year?!” said an email from one shocked aide for Democrats on the House Energy and Commerce Committee, home to the chamber’s main health subcommittee. No other health committee responded to questions about what work they’ve done to oversee the industry.

Rep. Greg Murphy (R-North Carolina), a physician, said he’d want to review research on how many people give plasma that often.

“Good boy, that’s a lot. That’s like, every three days. Who are the people that are doing it? Are they high-risk individuals?” Murphy said. “The bottom line is, you would always want to make sure it does not pose a safety risk to the donor.”

A spokesperson for the Plasma Protein Therapeutics Association, an advocacy group representing plasma-collection companies and plasma-derived drug manufacturers, emphasized that plasma is used to make drugs that save many patients’ lives, and that the collection process in the U.S. is “safe, long-standing and strictly regulated.”

“Many patients around the world are able to access their therapies due to higher donation frequency in the U.S., which currently supplies approximately 48% of plasma to the rest of the world,” the PPTA spokesperson said in a statement. “If more countries were to update plasma donation policies and modernize regulations based on current scientific knowledge, there would be less reliance on the U.S. to meet growing global clinical need for plasma.”

Meanwhile, the World Health Organization has urged its member countries as recently as this month to develop incentives to build self-sufficient, voluntary plasma supplies.

Congress regularly involves itself in trivial regulatory matters, from showerhead water pressure to the availability of whole milk in public schools. Still, several members told NOTUS they knew little about the commercial plasma industry.

When asked about it, Rep. Rich McCormick (R-Georgia), a physician, immediately offered a free-market argument.

“If you don’t want to give blood or plasma, guess what? Nobody put a gun to your head. If you want to donate, make some extra dollars, yeah, good for me, good for you. That’s capitalism at its best,” McCormick said. “Until I see people dying of it, or seeing people harmed by it, which I haven’t yet seen … until I see the detriment, why would I make more regulations?”

He said Congress hasn’t gotten involved because the industry works fine: “If it ain’t broke, don’t fix it.”

Rep. Maxine Dexter (D-Oregon), who’s also a physician, said any new rules or regulations should be left up to federal health agencies.

“That is an unfortunate reality that some people have to use that as a mechanism for survival right now, literally, to pay the bills,” Dexter said. “I think that we should not be in the business of telling medicine what they should or shouldn’t do.”

“We’re too slow and clunky here, and we’re not scientists or doctors for the most part,” Dexter continued. “I, of course, am, but I recognize that means nothing in a legislative branch role.”

Art Caplan, a bioethicist at New York University Grossman School of Medicine who formerly served as chair of the Advisory Committee on Blood Safety and Availability at HHS, said it’s been decades since Congress gave the industry serious thought.

“I can’t even remember the last time there was a hearing on this whole subject,” Caplan said. “Many people in Congress believe that a market is the best way to distribute any resource, and that there is nothing wrong with a market that depends upon poor people to provide the supply.”

That doesn’t mean the industry isn’t present in Washington. The PPTA, which counts several commercial plasma companies among its members, reported spending $160,000 on lobbying during this year’s first quarter, in part to talk to congressional offices about “plasma protein therapies and the rare disease patients that use them, and the need for continued Source plasma donations,” according to its disclosure documents.

“I like the fact that people can participate as they wish and actually get paid for it, but maybe the question that is underneath what that industry does is, are there ethics and morals? And are we taking advantage of vulnerable people?” Rep. Mike Kennedy (R-Utah), a physician, told NOTUS. “That’s a whole set of questions, considering the massive nature of the industry that probably needs to be considered, evaluated.”

Still, Congress is busy.

As Kennedy put it: “Considering all the things I got to think about, it’s not on the top of my list for consideration.”