Canadian Blood Services is asking the provinces for approximately $100-million over six years to dramatically increase the amount of plasma it collects to make medications, a move that comes as a private company that compensates plasma donors prepares to open a second location in New Brunswick.
Canadian Blood Services (CBS), which manages the country's blood supply outside Quebec, sent a business plan to provincial governments late last week laying out its vision for opening as many as 40 new plasma collection centres across the country and attracting upward of 144,000 new voluntary donors.
The goal of the proposal is to have unpaid Canadian volunteers provide the raw material for half of the intravenous immune globulin – an antibody medication made from plasma and used to treat and prevent a variety of diseases – needed in this country by 2024.
It is an ambitious target, considering CBS only collects enough plasma to meet 17 per cent of the growing demand right now.
"If we don't collect any more plasma in this country, within a few years we'll be at 10 per cent or less, meaning we'll be 90 per cent dependent on the U.S. market," said Graham Sher, chief executive officer of CBS.
CBS declined to release a copy of the plasma business plan, but Dr. Sher confirmed that he told a public meeting of CBS's board in December that it would cost roughly $100-million over six years to build and staff the new plasma collection facilities, some of which will be located inside existing blood-donor clinics.
CBS already buys the vast majority of its plasma protein products, including immune globulin, from the United States, where most donors are paid.
For supporters of a volunteer-only plasma system in Canada, the hope is that CBS's proposal will help forestall the rise of a homegrown for-profit plasma industry reliant on paid donors.
They worry that compensating donors could undermine the voluntary system, something Dr. Sher said has already begun to happen in Saskatoon, where a paid plasma clinic opened last year.
"It's corrosive to have private collection," said Michael Decter, a former deputy minister of health in Ontario and an adviser to the Krever Commission that probed the tainted blood scandal.
"The two largest provinces [Ontario and Quebec] have agreed and passed legislation. There's still some debate about the question, but I think that the CBS has chosen to settle it by coming forward with their own plan."
Canadian Plasma Resources (CPR), the company that owns the Saskatoon clinic, pays people in reloadable Visa gift cards for giving plasma, the straw-coloured liquid that surrounds the cells and platelets in blood.
CPR shifted to Saskatoon after the Ontario government in 2014 joined Quebec in banning payments for blood and blood products, thwarting the company's plan to open paid plasma collection centres in Toronto and Hamilton.
The company is now poised to open a second clinic in Moncton. Barzin Bahardoust, chief executive officer of Canadian Plasma Resources, said he is hopeful that Health Canada will grant the clinic a licence by the end of February.
"Even if CBS reaches its target, there's still a 50-per-cent demand that has to be met by private industry," Mr. Bahardoust said. "There's large room for Canadian companies and Canadian industry to participate and we should allow Canadian companies to be competing with the U.S. pharmaceutical or international pharmaceutical [companies] that are supplying CBS at the moment."
But it's not clear that the Moncton clinic will get the go-ahead.
Health Minister Jane Philpott, who has in the past expressed cautious support for paid plasma, said in a statement Tuesday that she has asked Health Canada to "carefully assess" Dr. Sher's concerns about the Saskatoon clinic's effect on the voluntary blood-collection system.
"CBS has, for the first time, expressed concern that more of these operations could make it harder to collect volunteer plasma donations," Dr. Philpott said in an e-mail to The Globe and Mail. "This is a significant change, and one we take very seriously, which is why I have asked Health Canada to carefully assess these concerns and to consult with our provincial and territorial partners in order to inform next steps."
Dr. Philpott and Dr. Sher both stressed that plasma protein products made from paid plasma are safe.
In an interview Tuesday, Dr. Sher reiterated concerns he first raised in December that the CPR clinic in Saskatchewan is drawing donors away from the public system.
"We are seeing some early data out of our Saskatoon blood collection facility that would suggest there is the beginning of an impact," he said. "This is something we need to be very vigilant [about.]"
Mr. Bahardoust said he asked CBS for evidence to back up that assertion, but it provided none.
"Unfortunately, I think [Mr. Sher's] statements were provided with insufficient, or a complete lack, of evidence," he said.