Plasma Donations Pay Bills, Sustain Global Therapies

The United States is among a small group of countries that permit financial compensation for plasma donation, and it remains the largest global supplier of plasma-derived medicines. For donors facing tight budgets, compensation becomes a practical way to cover bills while helping people who rely on plasma-based therapies. Catherine Rolfes, 27, who lives near Columbus, Ohio, was between jobs when a sibling suggested she try donating. "I've never donated plasma," recalls the 27-year-old. "It's $125 [to donate]—that'll come in handy. So I'm like, we'll go."

Donors can receive roughly $30 to $100 per visit and may donate plasma as often as twice per week. Regular donors can make hundreds of dollars a month. Experts say the compensation helps the U.S. meet demand for plasma-derived therapies, which are used to treat conditions from immune deficiencies to bleeding disorders. Emily Gallagher, associate professor of finance at the University of Colorado Boulder, calls the topic "a really complex issue." "Generally 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." The United States, however, is by far the biggest contributor to the world’s plasma supply, accounting for nearly 70% of all plasma collected globally, according to Peter Jaworski, a Georgetown University professor who has studied the ethics and economics of plasma donation.

Kelli Fairfax didn’t know what was wrong for years. She was diagnosed with Common Variable Immunodeficiency (CVID) in 2001, an immune system disorder that causes low levels of antibodies in the blood. There’s no cure, but replacement immunoglobulin therapy provides antibodies when the body cannot make them on its own, enabling patients to fight infections. Fairfax, now 55, receives therapy weekly. She says plasma donors have given her life back. "I’m just so thankful," Fairfax says of the donors. "I go to donor stations and I go and I thank them. You know, we call it liquid gold." She adds, "These people don’t have to do this. We’re thankful because you’ve given us our life." Plasma mainly consists of water but includes proteins such as gamma globulin and anti-hemophilic factor, which help the body fight infections and clot blood. Donated plasma is used to create life-saving treatments for a variety of conditions, including primary immunodeficiencies like CVID, bleeding disorders such as hemophilia, and some cancers. It is also used for critical-care patients who have suffered trauma or burns. While some patients need treatment only temporarily, others—like Fairfax—rely on plasma-derived therapies for life.

Treating one person with hemophilia for a year, for instance, requires roughly 1,200 plasma donations, according to the Plasma Protein Therapeutics Association (PPTA), a trade association representing donation centers and manufacturers of plasma-derived therapies. For Alpha-1, a genetic condition that can damage the lungs and liver, a year of treatment requires about 900 donations. Anita Brikman, president and chief executive of the PPTA, notes that the need for donated plasma is high because for many patients this is not a cure but a lifelong therapy. In 2022, about 1.26 million people in the U.S. received a plasma-derived therapy at some point during the year; worldwide, the total was about 16.5 million, according to the Marketing Research Bureau.

Bethany Beinlich donated plasma for the first time over the summer. The 22-year-old, who lives in Austin, Texas, learned about donation from her brother-in-law. She was between jobs and wanted some extra cash, but she also wanted to help people. "As 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," she says. Beinlich started donating twice a week at first and continues to visit when she can. Overall, Beinlich has had a largely positive experience; she’s never had a major reaction and wishes she had donated in college to help pay bills.

The donation process involves drawing blood, separating plasma, and returning the rest of the blood components to the donor. The procedure is widely regarded as safe; most donors experience only mild reactions, which can be mitigated by staying hydrated and eating beforehand. A typical visit can last about an hour and a half, and donors are compensated for their time with a prepaid card or similar method. For some, the payoff is immediate cash that can cover essentials such as gas, groceries, or bills, as happened for Rolfes. She returned later in the month after adjusting how she prepared for a donation, and she left with another $125. She has posted about her experience on social media and says the responses have underscored the real-world impact of plasma-derived therapies on patients.

The ethics of paid plasma donation remain hotly debated. Five countries — the United States, Germany, Austria, Hungary, and the Czech Republic — allow compensation and rely on such donations to meet domestic needs. Across those nations, the United States accounts for the largest share of plasma collection, nearing 70% of the global total. Some researchers argue that paying donors is essential to prevent shortages that would leave patients without life-saving medicines. Mario Macis, a Johns Hopkins economist who has studied compensated donation, says that not compensating donors would very likely lead to shortages because many others cannot meet their domestic needs without such a system. "Not compensating donors would very likely result in a shortage," Macis says, noting that most other countries depend on U.S.-donated plasma for therapies.

Still, critics warn that compensation can press vulnerable people to donate, potentially exploiting those in financial distress. Surveys helped by Emily Gallagher indicate that plasmadonors are more likely to be under 35, Black, and male, and to have lower incomes and less stable employment. About 64% of respondents said they donated to pay for essentials or emergencies, such as rent, rather than simply as a source of extra cash. In a study published last year, Gallagher and a colleague found that the chance a young person would take out a payday loan decreases after a plasma-donation center opens nearby, by about 18% within three years. Gallagher emphasizes that the debate about plasma touches on broader questions about whether society should commercialize parts of the human body, especially when basic needs like housing and health costs are at stake. Brikman counters that centers are spread across communities and that donors are not targeted toward any single group.

Jana Mattheu, whose son Caden has CVID, highlights the human stakes. Caden receives weekly plasma-derived therapy that has allowed him to work and live independently. "It’s as important as oxygen," she says. If compensation encourages more people to donate, she says, there is nothing inherently wrong with paying for their time. Yet she adds that she would hope the decision could be made without monetary incentives in a perfect world. The central question remains: can a system that pays donors both sustain necessary products for patients and protect vulnerable donors from coercive financial pressures? For now, patients and donors alike rely on plasma-derived therapies, while policymakers, researchers, and industry groups continue to weigh the ethics, economics, and health implications of compensated plasma donation.