Paying for (imported) blood products in Britain

Yesterday's post about paying for blood plasma in Canada reminded me of this story that The Guardian ran earlier in the year:
Blood money: is it wrong to pay donors?
"In some countries, people get paid for giving blood. And in the UK, we have to buy in plasma. But is safety compromised when money changes hands?"

"A recent black-and-white documentary, Blood, about a mobile blood collection unit in rural Russia, shows scenes familiar to many: dusty halls, anxious donors queuing to register, the occasional struggle to find a vein. Cups of tea, too, albeit just for the team.

Then there are the differences. Donors sit upright on uncomfortable, hard chairs. Some have just come off night shift; others have no money for food. Staff are concerned about how many units will test positive for blood-borne viruses. Potential donors worry about being accepted. A woman without an up-to-date residency certificate is turned away. A man insists he should be allowed to donate; he is broke and desperate for the 850 roubles (£8.85) payment. It is clear that most donors come for the money: for some, it is a lifeline.

Russia isn’t alone in paying donors – the US, China and Germany do, too. In Britain, however, we donate 2m units a year, with no payment – following the World Health Organisation recommendation that blood donation be voluntary. This is not only for altruistic reasons, but also for safety. “The safest blood donors are voluntary, non-remunerated donors from low-risk populations,” says the WHO.

...

"Nevertheless, thousands of NHS patients receive blood plasma from paid donors. This contains clotting factors and antibodies. Thousands of individual donations go into each dose of clotting factors – used to treat haemophiliacs who are bleeding – or immunoglobulins (antibodies) used to treat people with autoimmune diseases, severely damaged immune systems, or some serious infections.

After the outbreak of bovine spongiform encephalopathy (BSE), known as mad cow disease, some recipients of UK plasma products developed the fatal brain disease variant Creutzfeldt-Jakob-disease (vCJD). As there is as yet no adequate screening test for this, British plasma has not been used since 2002, when we began to import it from the US."

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HT Alex Nichifor

Bleeding for Canada: plasma exports from the US to Canada

In the HuffPo:, Peter Jaworski begins his rant about the blood supply with a good line about food:  Commodifying Blood Donation Could Solve Canada's Shortfall

"Many people think blood is special in a way that means it shouldn't be "commodified," or bought and sold on a market. It is a basic human need. It's not like the latest gadget or a pair of shoes; it is to be revered, not remunerated.

"I'm glad we don't think food is special in this way. If we did, imagine how many people would die of starvation, or would suffer from hunger.

This past December, the Ontario legislature preserved the sanctity of the exchange of blood through Bill 21, entitled the "Safeguarding Health Care Integrity Act." Schedule 1 included provisions from Bill 178, the Voluntary Blood Donations Act", which prohibits paying and receiving payment for blood, either directly or indirectly. With this bill, the legislature has made the giving and receiving of blood a sacrament.

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Of course Canadians don't have to pay other Canadians for blood plasma. If you look at the Harmonized Tariff Schedule (HTS) administered by the U.S. International Trade Commission (USITC), you find that HTS number 3002100210 stands for Human Blood Plasma, and in 2013 Canada had imports $29,274,584 worth from the U.S., where of course we compensate plasma donors.

HT: Josh Penrod

Everything for Sale? The Ethics and Economics of Compensation for Body Parts (Video of the panel discussion)

Here's the video of the panel discussion I participated in at Johns Hopkins on May 7, Everything for Sale? The Ethics and Economics of Compensation for Body Parts: the panelists were James Childress, Michele Goodwin, Alvin Roth and Debra Satz

The video, including introductions before and questions after, is an hour and 20 minutes. The introduction by Mario Macis starts around minute 6:40, and includes audience voting on questions of whether they would be in favor of regulated markets for kidneys, for hearts, for blood, for human eggs and sperm, and for breast milk. The panel discussion, moderated by Jeff Kahn, starts at minute 14, with each of the panelists, in alphabetical order, giving an 8 minute opening statement. (Mine begins at 33:20, and ends at 41:41, pretty close to the 8 minute guideline:) .)

Harvard celebrates Carmen Wang

One of the most interesting young market designers at Harvard these days is  Carmen Wang, a Ph.D. student in the Business Economics program. Here's an article about her work on blood donation registries, and her hope to combine market design with behavioral economics: The Real Price of Blood--How one GSAS student uses the tools of behavioral economics to increase blood donations

It begins this way:
"Love isn’t the only thing money can’t buy—blood is, too. And yet, though no money is exchanged, blood can find ways of getting to the people who need it, though not often in ways where demand and supply are aligned. In the days following the Boston Marathon bombing, people rushed to give blood in support of the victims, eager to donate one of the human body’s most precious resources to others, free of charge.

"While this altruistic impulse is certainly commendable, according to Carmen Wang, it is sometimes misguided. “In that instance, the American Red Cross had to issue an announcement thanking would-be donors and informing them that they already had an adequate supply of blood.” But at other times, for example when the flu or cold virus afflicts many regular donors, blood supply dips, and blood banks have trouble finding people willing to give."

Blood donation, in China

Here's a paper on incentivizing blood donation, with data from China.

Solving Shortage in a Priceless Market: Insights from Blood Donation
by Tianshu Sun, Susan Feng Lu, and Ginger Zhe Jin
November 2014

Abstract:

Blood shortage is common in many countries but it cannot be solved by price adjustment given the WHO recommendation for 100% unpaid voluntary donation. In this paper, we evaluate two non-price methods that blood banks often use to address shortage. The first method is informing existing donors of the current shortage via mobile message and encouraging them to donate voluntarily. The second method is asking the patient’s family or friends to donate in a family replacement program. Using 472,342 individual donation records from a large Chinese blood bank, we show that both methods are effective in addressing blood shortage in the short run but the two methods target different audiences and therefore have different implications for total blood supply. 

In the conclusion, the authors note that shortage messages reach existing donors, while family replacement programs primarily draw in new donors.

"Overall, the back-of-envelope calculation suggests that shortage message can be used in places

where the donor population is large and the shortage is small. In comparison, FR could be more

useful when the donor population is small and the shortage is severe. In this sense, our data suggests a more optimistic picture for FR than the WHO recommendation. However, in a society with a low donation rate (which could be the reason for severe shortage to begin with), most FR donors will be no-history FR donors and the FR treatment may discourage voluntary donation in

the long run by generating either distrust or crowd-out. Although a broader introduction of FR

can bring more blood supply in the short run, it may exacerbate shortage problem in the long run.

Like the WHO, we reach a cautionary conclusion for the FR program but for a reason different

from quality concerns. "

Some potentially repugnant markets

Jan Zilinsky writes with a selection of potentially repugnant markets:

 "I saw several pieces since late August, so I thought I would send along a few links:

-        Quebec is planning to cut in vitro fertilization insurance coverage and also “ban on in vitro fertilization for all women under the age of 18 and over the age of 42”

-        People protest rabbit meat in U.S. stores

o   Is the distinction between animals we eat and animals we love is entirely arbitrary?

o   Data: “producing six pounds of rabbit meat requires the same amount of food and water as it takes to produce one pound of cow meat”

-        Family judge warns pedophiles exploiting surrogacy laws

o   Legal situation: “Altruistic surrogacy is legal throughout Australia but commercial surrogacy is banned everywhere except in the Northern Territory, which has no surrogacy laws.”

o   Stated concern: “The Chief Judge warns that lack of regulation in many countries “creates a risk that children could be ‘commissioned’ specifically for trafficking or abuse purposes’’.”
*********

I don't think there's any repugnance involved in this last story, but it's still an interesting one, and where there's blood there may be repugnance...

-        Blood Industry Shrinks as Transfusions Decline

Banks for blood and sperm

At The Atlantic,  Rebecca Rosen writes about Banks of Blood and Sperm: How the idea of a "bank" shapes the way people think about storing and distributing body fluids, in an interview of  Kara Swanson, the author of Banking on the Body (which I blogged about here).

Very interesting.  For example:

"What happened as the metaphor [of a bank] became more used in the 1950s and 1960s, was that a backlash developed against the market implications of the metaphor. The doctors and lay people who ran blood banks in the 1950s and 1960s, pushed the metaphor to its extremes—they told patients that each transfusion was a “loan” that needed to be repaid. Patients could repay in kind, or pay stiff replacements fees instead—fees that a bank could use to buy blood from a professional donor—always with the goal of keeping sufficient inventory.

The emphasis on buying and selling led blood banks into trouble in the courts—attorneys for patients injured from transfusions (which happened sometimes, if mismatched blood was given, or the blood contained a disease) argued that banked blood was a product. Product liability law was developing to find the manufacturer of a dangerous product liable even without negligence. Doctors, blood banks, and hospitals were horrified to have themselves considered product manufacturers. They began to backpedal from the banking metaphor by trying to make banked blood seem less like a product exchanged in markets.

What happened, with blood banks, and also with other kinds of banks, is that the banking metaphor and the backlash encouraged doctors, patients, and those of us who might be suppliers, to focus on one aspect—the supplier. Was the supplying body paid or unpaid? Paid suppliers, who were obviously entering into a market transaction, were treating their bodies as a source of private property, and were acting as though they were selling a product. Unpaid suppliers, were seen as giving gifts, out of altruism, and keeping themselves out of a market."
...
"In law, we thus divide body products into two categories: those which we legally mandate as gifts only—all organs—and everything else, which can be gifted or sold, at the discretion of the supplier. Organs is defined broadly—bone marrow, for example, is an “organ.” This means that bone marrow, which can now be extracted from the blood in a procedure similar to the way blood plasma is harvested, cannot be sold by anyone. (Blood plasma is routinely sold, by the way.)
...
"I argue in the book that the simple pay-suppliers/don’t-pay-suppliers approach to thinking about body products, which resulted from the banking metaphor, needs to be replaced with more nuanced thinking. Should we treat different types of organs (hearts v. bone marrow) differently? Can we think about compensation schemes that are not free markets, but are managed to support the public goals of increasing body-product supply? Can those schemes protect suppliers and recipients alike by keeping suppliers safe from exploitation, and recipients safe from diseased products? I use history to suggest that the answers can sometimes be yes. Body products used to be routinely paid for, and doctors thought about these potential problems and addressed them. Over time, we have forgotten this past, and come to assume that buying body products is always dangerous and bad.

I like to remind people that lots of altruistic gestures are compensated—the doctors, and nurses, and everyone who works on a transplant operation are all in caring professions. They are doing those jobs because they want to help people (at least we hope and assume so). But we wouldn’t suggest that they shouldn’t be paid because to offer payment for such efforts would be insulting or immoral or cause their altruistic tendencies to be replaced by mercenary concerns.

Yet that is how we treat organ supply—that offering money would do all those bad things. Why should the supplier of a body product be the only person in that life-saving supply chain who is not compensated? People might choose not to be compensated, but if they want to be, and if more folks will act as suppliers with that incentive, why not?

To give a more specific historical example, let’s think about mothers’ milk stations in the 1930s. At that time, in most cities, such a station existed. It was established and supervised by a doctor or doctors, and its daily operations were run by nurses. Lactating women came to the station to express their breast milk and were paid by the ounce. Payment was used to ensure an adequate supply. The supply was used for sick and/or premature infants who lack a maternal source of milk."

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In the meantime, here's a news article published around the same time, from the business side:
More blood banks merging to cut costs--Officials cite need for new model

"The proposed merger of Green Tree’s Institute for Transfusion Medicine with Florida-based OneBlood is the latest in a series of blood bank consolidations nationally, symptomatic of lean times for hospitals as they try to cut costs and reduce transfusions.

The deal, announced July 25, would create one of the largest blood banks in the country, with combined revenues of $480 million, if it goes through. The two firms jointly distribute nearly 2 million units of blood annually, serving 313 hospitals in eight states.

Only the American Red Cross would collect and distribute more blood."

Economic rewards to motivate blood donations, by Lacetera, Macis and Slonim

This just out in Science: Economic rewards to motivate blood donations. It suggests that old conclusions need to be revisited based on new evidence.

"The position and guidelines of the World Health Organization (WHO) and several national blood collection agencies for nearly 40 years have been based on the view that offering economic incentives to blood donors is detrimental to the quantity and safety of the blood supply (1). The guidelines suggest that blood should be obtained from unpaid volunteers only (2). However, whether economic incentives positively or negatively affect blood donations (and other prosocial activities) has remained the subject of debate since the positions were established (2–8).

"Evidence consistent with the WHO position came originally from uncontrolled studies using nonrandom samples and, subsequently, from surveys and laboratory studies indicating that economic incentives can “crowd out” (decrease) intrinsic motivations to donate and can attract “worse” donors (9). This evidence arguably affected policies, such as bans on compensation for blood and organ donations in many countries.
...
"With a few early exceptions based on small, nonrepresentative samples (12), field trial evidence on how economic incentives affect blood donations has been absent. But field-based evidence from large, representative samples has recently emerged. The results are clear and, on important questions, opposite to the uncontrolled studies, surveys, and laboratory evidence preceding them."
...
"Conclusion

"In light of the recent evidence, it is time to re-examine policy guidelines for increasing and smoothing blood supply, including whether incentives can play a role. There are efforts under way from different parts of society toward using rewards to increase donations. The U.S. 9th Circuit Court of Appeals' 2012 ruling legalizing compensation for bone marrow donations through apheresis was initiated by private individuals (32). A company prompted a 2010 European Court of Justice ruling that allowed importation of blood products obtained from compensated donors (33). Researchers and clinicians have noted that some WHO guidelines (e.g., emphasis on exclusive use of nonremunerated donors and centralizing blood collection organizations) are unintentionally adversely affecting blood collection in sub-Saharan Africa (34).

"In addition to economic incentives, policy-makers should consider nonpecuniary rewards (e.g., symbolic and with social recognition) and various appeals. Debates on ethical issues around giving rewards for donations (35) should be encouraged. But there should be little debate that the most relevant empirical evidence shows positive effects of offering economic rewards on donations."

Incentives for blood donation (and seminar by Bob Slonim today at Stanford)

Bob Slonim is visiting at Stanford this quarter, and will be giving a seminar today: here's the announcement.

Mon, Oct 8, 3:30PM - 5:00PM

Bob Slonim Sydney (visiting Stanford)

Blood Donation Registry: A lab and natural field experiment

GSB E-103

There's no paper to link to yet...
****************

Over at MR, Alex Tabarrok wrote a little while ago about the earlier work of Bob and his colleagues on blood donation:

"Mario Macis, Nicola Lacetera, and Bob Slonim, the authors of the most important work on this subject (references below), write to me with the details:

The decision to donate blood involves complex motivations including altruism, civic duty and moral responsibility. As a result, we agree with Buttonwood that in theory incentives could reduce the supply of blood. In fact, this claim is often advanced in the popular press as well as in academic publications, and as a consequence, more and more often it is taken for granted.

But what is the effect of incentives when studied in the real world with real donors andactual blood donations?

We are unaware of a single study of real blood donations that shows that offering an incentive reduces the overall quantity or quality of blood donations. From our two studies, both in the United States covering several hundred thousand people, and studies by Goette and Stutzer (Switzerland) and Lacetera and Macis (Italy), a total of 17 distinct incentive items have been studied for the effects on actual blood donations. Incentives have included both small items and gift cards as well as larger items such as jackets and a paid-day off of work.  In 16 of the 17 items examined, blood donations significantly increased (and there was no effect for the one other item), and in 16 of the 17 items studied no significant increase in deferrals or disqualifications were found.  No study has ever looked at paying cash for actual blood donations, but several of the 17 items in the above studies involve gift cards with clear monetary value.

...

Goette, L., and Stutzer, A., 2011: “Blood Donation and Incentives: Evidence from a Field Experiment,” Working Paper.

Lacetera, N., and Macis, M. 2012. Time for Blood: The Effect of Paid Leave Legislation on Altruistic Behavior. Journal of Law, Economics and Organization, forthcoming.

Lacetera N, Macis M, Slonim R 2012 Will there be Blood? Incentives and Displacement Effects in Pro-Social Behavior. American Economic Journal: Economic Policy 4: 186-223.

Lacetera N, Macis M, Slonim R.: Rewarding Altruism: A natural Field Experiment, NBER working paper.

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Black Market for Blood

According to this AP article, Bulgaria is experiencing first-hand the concept of repugnant transactions:

"It's a grim reality for patients and families in Bulgaria, a struggling EU nation where donors are troublingly scarce, hospitals are strapped for funds and blood traders — mainly Gypsy, or Roma, men — are thriving...

..once a deal is struck, a donor hanging out nearby — or at most a phone call away — is summoned, and turns up at the blood clinic masquerading as a relative. He gets a proof of donation certificate and sells it to the desperate family. The blood heads off to be checked, and if it is found to be disease-free it goes toward filling the clinic's reserves."

It seems the Bulgarian legal apparatus is largely tolerant of the black market, most likely as it believes it to be a critical driver of blood supply. But one must wonder to what degree the presence of a black market crowds out altruistic donors ("voluntary blood donation has been gradually shrinking here over the past two decades..."). At the same time, a black market is less efficient (from a social standpoint) than a publicly operated market for blood; the middlemen are presumably taking much of the rents. So while the jury is still out on whether enforcement of the ban of blood sales or a public embrace is best, this interior solution cannot be optimal.

So why can't Bulgaria get more people to go under the needle? Repugnance has put the Bulgarians in a prickly (groan) spot.

Selling blood plasma as a part time job

In the Chronicle, Lawrence Biemiller writes, At Central Michigan U., It’s a Matter of Money

“For a lot of college students, it’s just a little extra spending money,” Mr. Canze said when I asked about the plasma trade. “I probably know nine to a dozen people who will go regularly. They screen you, hook you up, pump you, and get you on your way.” Each visit to the local BioLife Plasma Services facility takes about an hour, during which you can read, listen to music, or get on Facebook through the company’s Wifi network. The facility even offers day care.

“Donating” is a euphemism the company uses. The frequently-asked-questions section of the company’s Web site includes the question: “Why do plasma donors receive money for donating?” The answer: “Plasma donors spend up to two hours, as often as twice a week, in our centers to help save someone’s life or improve the quality of it. We merely offer compensation to our donors for their commitment to the program. For more compensation information, contact your local center directly.”

You make $20 per BioLife visit, Mr. Canze told me. You can go as often as twice a week, and if you go at least once a week for a month, you get a $20 bonus. The math is easy enough—you can make $180 a month. That’s real money, especially for college students, especially in Michigan.

WHO: blood donation insufficient in developing countries

The World Health Organization reports

• "65% of all blood donations are made in developed countries, home to just 25% of the world's population.

• In 73 countries, donation rates are still less than 1% of the population (the minimum needed to meet basic needs in a country). Of these, 71 are either developing or transitional countries.
• 42 countries collected less than 25% of their blood supplies from voluntary unpaid blood donors, which is the safest source.
• 31 countries still reported collecting paid donations in 2007, more than 1 million donations in total.
• 41 countries were not able to screen all blood donations for one or more of the following transfusion-transmissible infections (TTIs)–HIV, hepatitis B, hepatitis C and syphilis."

They recommend programs of voluntary blood donation:
"Safe blood donors are the cornerstone of a safe and adequate supply of blood and blood products. The safest blood donors are voluntary, non-remunerated blood donors from low-risk populations. Despite this, family/replacement and paid donors, which are associated with a significantly higher prevalence of transfusion-transmissible infections (TTIs) including HIV, hepatitis B, hepatitis C, syphilis and Chagas disease, still provide more than 50% of the blood collected in developing countries. WHO advocates and recommends to its Member States to develop national blood transfusion services based on voluntary non-remunerated regular blood donation in accordance with World Health Assembly resolution 28.72, which was adopted in 1975. "

Today is (also) National Donor Day

Happy Valentine's Day! Isn't it good to love and be loved?

Food for thought: Today is also National Donor Day.

"February 14 is the 10th National Donor Day -- a day to give the gift of life.
Fill out an organ and tissue donation card, register with your State Donor Registry and make sure your family knows you want to be a donor.
Join the National Registry of potential volunteer marrow and blood stem cell donors.
Learn how you can donate your baby's umbilical cord blood stem cells at birth.
Donate blood.
Why be a Donor?
The need is great and growing.
Almost 95,000 people are in need of an organ for transplant.
Approximately 35,000 children and adults in our country have life-threatening blood diseases that could be treated by a marrow/blood stem cell or cord blood transplant.
Every two seconds someone in America needs blood, more than 39,000 units each day, according to the American Red Cross.
Why do it Today?
Valentine's Day is the day of love and donation is the gift of life. Can you think of a more loving gesture than making February 14 the day you join thousands of Americans in making the donation decision?

National Donor Day was started in 1998 by the Saturn Corporation and its United Auto Workers partners with the support of the U.S. Department of Health and Human Services and many nonprofit health organizations. "

Law and economics of repugnant markets

Kimberly Krawiec at The Faculty Lounge, some time ago followed up on one of my posts with an interesting one of her own: Selecting for Sex: US entrepreneurship in the baby market

She is a professor at Duke Law, and a scholar of repugnant markets, often analysing them with respect to rent seeking behavior. See e.g.

Altruism and Intermediation in the Market for Babies, 66 WASH. & LEE L. REV. 203 (2009).
Abstract: Central to every legal system is the principle that certain items are off-limits to commercial exchange. In theory, babies are one such sacred object. This supposed ban on baby selling has been lamented by those who view commercial markets as the most efficient means of allocating resources, and defended by those who contend that commercial markets in parental rights commodify human beings, compromise individual dignity, or jeopardize fundamental values. However, the supposed and much-discussed baby selling ban does not, and is not intended to, eliminate commercial transactions in children. Instead, it is an asymmetric legal restriction that limits the ability of baby market suppliers to share in the full profits generated by their reproductive labor, insisting instead that they derive a large portion of their compensation from the utility associated with altruistic donation. Meanwhile, a wide range of baby market intermediaries profit handsomely in the baby market, without similar restrictions on their market activities. Baby selling "bans" thus have more in common with the rent-seeking by powerful marketplace actors seen in other commercial markets than with normative statements about the sanctity of human life. The author concludes with a call for the removal of the last vestiges of the "ban" against baby selling and other laws that diminish the capacity of baby market suppliers to access the marketplace.

Price and Pretense in the Baby Market, in BABY MARKETS: MONEY, MORALS, AND THE NEOPOLITICS OF CHOICE (Cambridge University Press, forthcoming 2009).

Show Me the Money: Making Markets in Forbidden Exchange, 72 LAW & CONTEMP. PROBS. (2009).

Sunny Samaritans and Egomaniacs: Price-Fixing in the Gamete Market, 72 LAW & CONTEMP. PROBS._ (2009).
Abstract: This Article considers the market structure of the human egg (or “oocyte”) donation business, particularly the presence of anti-competitive behavior by the fertility industry, including horizontal price-fixing of the type long considered per se illegal in other industries. The Article explores why this attempted collusion has failed to generate the same public and regulatory concern prompted by similar behavior in other industries, arguing that the persistent dialogue of gift-giving and altruistic donation obscures both the highly commercial nature of egg “donation” and the benefits to the fertility industry of controlling the price of a necessary input into many fertility services – namely, eggs. A comparison to the egg market’s closest cousin – the sperm market – does not reveal similar collusive attempts to depress the price of sperm. A further analysis of the industry explores potential reasons for this difference.

The last two articles appear in an edited online journal volume by Professor Krawiec, called Show Me the Money: Making Markets in Forbidden Exchange, which has articles on the sale of blood, organs, eggs and sperm, labor, and surrogate wombs: here's her blog post summarizing them.

The market for blood plasma

Is Money Tainting the Plasma Supply?

"Hundreds, probably thousands, of Mexicans like Ms. Delgado come to the United States to trade their plasma for dollars. Eagle Pass, a town of 27,000 that bills itself as the place “where yee-hah meets olé,” has two such plasma collection centers. There are about 15 others in border cities from Brownsville, Tex., to Yuma, Ariz.
The centers are run by pharmaceutical companies that transform the plasma into life-saving but expensive medicines for diseases like immune deficiencies and hemophilia.
Some border centers are new while others have been around for many years. They account for only a small percentage of the plasma collected by the industry, with the rest coming from collection centers throughout the United States.
But they have stirred debate in recent years because they illustrate the workings of the $12 billion plasma products business, a fast-growing industry that has depended on the blood of people hard up for cash. Based on typical industry yields and prevailing prices, it appears that a single plasma donation, for which a donor might be paid $30, results in pharmaceutical products worth at least $300.

Away from the border as well, many plasma collection centers have historically been located in areas of extreme poverty, some with high drug abuse. That troubles some people, who say it might contaminate the plasma supply or the health of people who sell their plasma.
“Why in the United States do we have to depend on people who are down and out to donate?” says Dr. Roger Kobayashi, an immunologist in Omaha who uses plasma products to treat many patients. “You are taking advantage of economically disadvantaged individuals, and I don’t think you are that worried about their health.” "
...
"But the plasma companies and federal regulators say the practice is legal, ethical and safe. There have been no known cases of an infectious disease being transmitted through plasma products for more than a decade. And since the body quickly renews its plasma, the process is considered safe for donors if properly monitored.
“It’s not like giving up a kidney,” says Dr. Jay Epstein, director of blood research at the Food and Drug Administration, which regulates the collection centers and the plasma products."
...
"The United States is one of the few countries that allows plasma donors to be paid. (And even here the plasma industry says it pays donors for their time, not for the plasma itself.)
But many of the countries that prohibit compensation do not collect enough plasma. So they rely on plasma or plasma products made from the blood of people who donate in the United States, which supplies more than half the world’s plasma.
“The U.S. is the OPEC of plasma,” says Jim MacPherson, chief executive of America’s Blood Centers, a network of blood banks.
FOR the plasma industry, times have been good. Growth has averaged 8 percent a year over the last two decades. "
...
"To satisfy demand for plasma-based medicines, the industry has increased the number of collection centers to 408, from 299 in 2005, according to the Plasma Protein Therapeutics Association, the industry trade group. Paid donations in the United States rose to 18.8 million in 2008 from 10.4 million in 2005. "

"There are even a few signs that in areas hardest hit by the economic downturn, people who once donated blood without compensation to organizations like the Red Cross are selling plasma instead. “I know of five or six people who are multi-gallon donors who have switched to plasma,” said Doug Klynstra, recruitment manager for Michigan Blood, a nonprofit blood bank. He said the bank’s donations are down 10 percent this year. "

"The blood banks generally collect whole blood, which is separated into red cells, platelets and plasma and often used for transfusions. They almost never pay for donations because that might induce donors to cover up health problems that could make the blood unsafe.
The plasma companies, which collect only plasma, say that is less of a concern for them because their manufacturing process can kill many viruses and because they have more time to screen donors. "

Compensating blood donors

Robert Slonim, Mario Macis, and Nicola Lacetera report on the effect of (non-cash) incentives on whole blood donation: Will There Be Blood? Incentives and Substitution Effects in Pro-social Behavior

Abstract: " We examine how economic incentives affect pro-social behavior through the analysis of a unique dataset with information on more than 14,000 American Red Cross blood drives. Our findings are consistent with blood donors responding to incentives in a “standard” way; offering donors economic incentives significantly increases turnout and blood units collected, and more so the greater the incentive’s monetary value. In addition, there is no disproportionate increase in donors who come to a drive but are ineligible to donate when incentives are offered. Further evidence from a small-scale field experiment corroborates these findings and confirms that donors are motivated by the economic value of the items offered. We also find that a substantial fraction of the increase in donations due to incentives may be explained by donors substituting away from neighboring drives toward drives where rewards are offered, and the likelihood of this substitution is higher the higher the monetary value of the incentive offered and if neighboring drives do not offer incentives. Thus, extrinsic incentives motivate pro-social behavior, but unless substitution effects are also considered, the effect of incentives may be overestimated."