Blood Veins for Hire: Understanding the Implications of Plasma Donation As an Economic Coping Strategy

Background and Purpose: Blood plasma is the raw material for plasma protein therapies (PPT), medicines that treat a range of disorders such as hemophilia. As therapeutic uses of blood plasma have expanded, the demand for PPT has skyrocketed. Today, 70% of the world’s blood plasma is collected at for-profit plasma donation centers throughout the U.S. where people get paid for giving plasma, and where 48.8 million plasma collections were made in 2021. These centers are overrepresented in high poverty areas where racial and ethnic minorities are more likely to reside. These findings, along with journalistic accounts describing how people are motivated to give plasma to earn cash, suggest that plasma donation has become an economic coping strategy in the US.

To garner an understanding of the role plasma donation plays in the lives of donors within the context of income inequality, racial inequality, and a changing labor market, this study asks: how do people interpret their roles as plasma donors given the transactional nature of the interaction? I hypothesize that this work will highlight how poverty and inequality push people to become plasma donors.

Methods: Forty semi-structured interviews will be conducted with people who have experience giving plasma in southeast Michigan. Southeast Michigan has been severely impacted by the collapse of the manufacturing industry, while concurrently experiencing the expansion of blood plasma centers—making it the ideal setting to explore the implications of plasma donation as an economic coping strategy in response to labor structure changes. The intent of this analysis is to (1) explore donor rationale for giving plasma, (2) interrogate the extent to which giving plasma is tied to an unstable labor market and access to government transfers, (3) explore how earnings from plasma donation are spent, and (6) consider whether those giving plasma deem the transaction to be a donation or a form of labor.

Results: Preliminary analysis of pilot interviews suggest that people primarily give plasma for the money. The frequency with which people give plasma is associated to their level of need at a given time as well as their connection (or lack thereof) to the labor market and access to government transfers. When respondents deem they have sufficient income from other sources, they stop giving plasma. Moreover, respondents often reported side effects related to giving plasma, including fainting, fatigue, muscle cramping, etc. Plasma donors perceived themselves to be selling their plasma rather than donating, and expressed that they would not continue to give plasma if the procedure was not paid.

Conclusion and Implications: Poverty drives people’s decision to sell their plasma. Without an adequate safety net, people must find alternative ways to generate cash and plasma donation is one of them. Given the potential health risks associated with this transaction, as well evidence suggesting that the poor and people of color are overrepresented as donors, this phenomenon deserves further attention. Policymakers must consider whether current poverty alleviation policies and regulations surrounding plasma donation are sufficient to safeguard the health and well-being of plasma donors.