The Decibel - Deaths raise concerns over selling plasma in Canada

Episode Date: May 25, 2026

Getting paid for plasma – the yellow-gold liquid part of blood – in Canada is still pretty new. It’s full of protein and antibodies and can be used to make medicine for immunodefficient people. But following the deaths of two plasma donors, the practice is facing criticism and concerns are being raised about its safety. Chris Hannay is a business of healthcare reporter for The Globe. He’s on the show today to discuss how plasma collection works in Canada, what he’s learned from his experience donating, and how the growing practice of paid plasma is regulated. Questions? Comments? Ideas? Email us at [e-mail] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Getting paid for plasma is a relatively new thing in Canada. Plasma is the fluid part of our blood. So it's kind of everything that's not blood cells. By itself, it's sort of yellow, golden color. It's full of proteins and antibodies. And it's used to help make a lot of life-saving medicine, particularly for people with immune deficiencies. The globe's Chris Hane has been doing a lot of reporting on the industry.

Canada is the third largest consumer per cancer. capita of drugs made from plasma in the world. So we're very high consumer of these drugs. There's a very big need for these drugs. And so Canadian Blood Services, which is the organization that kind of manages the supply of these drugs in Canada, has been wanting to collect more plasma so that more of the drugs used in Canada are made from donations in Canada.

The idea is that paying for plasma would create a bigger and more consistent pool of donors across the country. But the practice has recently come under scrutiny following two high-profile filed deaths. And it's led some to wonder how safe and ethical commercial collection in Canada really is. Today, Chris is going to walk us through how this all works in Canada, what we know about the people who have died, and what he's learned reporting on the private clinics involved. I'm Cheryl Sutherland, and this is the decibel from the Globe and Mail. Hi, Chris. Welcome back to the show. Hi, thanks for having me. So, Chris, I think many people are familiar with donating blood.

But I imagine that less people know about plasma donation. And actually, you became a donor yourself while reporting these stories about plasma donation. What was it like? Thanks. Yeah. I have, you know, written stories about this. And I thought, you know, to really understand, I got to do it myself. So I went to Canadian Blood Services location in Toronto to donate.

And so the beginning of the process is pretty similar to a blood donation. So you go in, you register, you fill out a health questionnaire. you talk to a nurse to make sure that you're healthy and that it's fine to use your blood. And you get, you know, all the great snacks and juice boxes and stuff you could want. And then they hook you up to plasma machine. So this is where it kind of differs from a blood donation. So with a typical blood donation, the, you know, the blood comes out of you and that's pretty much it. With plasma, there's a machine that takes the blood out of you.

And then there's a centrifuge that separates the different components. of that blood. So it separates like the red blood cells and then everything else. And that everything else is the plasma. It has like the proteins and the antibodies and stuff that are in your blood. The machine then mixes the red blood cells with anticoagulants so things don't clot and saline and inserts it back into your body. And that cycle actually happens a few times. So I think with mine, it happened three or four times over the course of about 45 minutes to an hour.

And eventually they extracted about, you know, for me, froze my first time. They extracted about 825 milliliters, so close to a liter. Is that a lot? Yeah, that's pretty much a full donation. I mean, the most that they usually take is a little under a liter. Okay. And do you see this happening? Like, can you feel it?

Like, what's it sense like? I didn't really feel anything too different than what a blood donation would be. But, I mean, you can see the fluids going in and out of your body, right? And the machine's kind of humming. It sort of looks like a medium-sized printer, I would say. So it is humming a bit. it's a little bit, maybe it's a little bit different, but it didn't, for me, it didn't feel too bad. You know, maybe felt a touch lightheaded afterwards as I have after a blood donation, but, you know,

you take it easy and eat some snacks and stuff and then you feel better after. Yeah, and as you mentioned, so I think people will be familiar with like this idea of blood coming out of your body, then it's, you know, taken away, usually used for, you know, people that need blood in hospitals, etc. But what exactly is plasma used for? So plasma, there's a very, maybe like 1% of the plasma that's collected in Canada is actually used for transfusion the way that whole blood is. Almost all of it is used to make pharmaceutical products.

Yeah, the main pharmaceutical product is one called immunoglobulin. That's used for people with immune deficiencies. Particularly the biggest demand is growing for people with what are called acquired immune deficiencies. So someone going through perhaps cancer treatment where the treatment for their cancer is also suppressing their immune system. And so they take this other drug. I'm going to use the acronym IG, so I don't have to say immunoglobulin again.

They take the IG to help bolster their immune system. Okay. So it sounds like plasma is very important for many people that are dealing with various illnesses, including cancer here. So for your situation, when you did your donation, you did this at Canadian Blood Services or CBS, and you volunteered, right? But there are now clinics in Canada where you can be paid for your plasma. Can you tell me about that? Yeah, so Canadian blood services have been around for about 30 years. They were found in the late 90s to control the blood system.

What's been a new phenomenon in Canada is private companies who will pay people for their plasma to them be used as an ingredient for these drugs. So this is relatively new in Canada. There's one clinic that's been in Winnipeg since the 80s, but for a very long time it was the only one. It was making a very specialized kind of drug. About 10 years ago, there was another private company called Canadian. plasma resources that sprung up and opened a few clinics here or there around the country. But then in 2022, during the pandemic, the Canadian Blood Services announced that it had signed this partnership with a multinational company based in Spain called Griffles.

And the idea was that Griffles bought up the Canadian Plasma Resources Centers. It bought up the clinic in Winnipeg and then opened a bunch more of its own clinics to collect plasma. and it's also currently building a factory in Montreal where it hopes to make these drugs eventually. At the moment, it has about 17 locations across the country, and all of them pay people for their plasma donations. Okay, 17 locations. Is Griffiths kind of like the only player here in Canada when it comes to paid donations? Pretty much right now, yeah. Okay.

And what's the reasoning behind paying people? Like, what is the issue they're trying to solve? The issue is that if you need to get people to come into your client, clinic and do something as, I don't know how else to put it, like they're giving their bodily fluids, right? You can do one of two things. So if you're Canadian blood services or your other government funded nonprofits, like there are all over the world, what you do is you have to spend a lot on marketing and donor retention efforts and really try to emphasize to people how important their donations are, how important it is that they come in, volunteer their time, volunteer their body to help other people who are sick and who need it. On the flip side, the private companies, the business model there, is that it's essentially instead of spending all that money on marketing and other efforts, you just pay people.

You just say, here's money to come in and give us your plasma. And there was a Health Canada expert panel that reported in 2018 that it is, you know, if you look at the two different models, it is generally cheaper around the world to just pay people directly. That's really interesting, yeah. So it's like instead of doing this marketing campaign, it's like, why don't you just give the money directly to the people who want to donate. Exactly.

Okay. How much money are people getting paid for their plasma donations in Canada? It's kind of complicated. So if you go to the Griffle's website, they have a page where they have a whole chart that shows you how much it is. And so the amount depends. So they always pay the most, I mean, Griffles or any company operating in different countries, they always pay the most for your first donation.

So in Canada right now, Griffles offers $100 per donation for the first four donation. And then it goes down a bit from there. The amount that is paid depends on the frequency of donation. So if somebody comes in twice a week versus once a week, as well as the volume of the donation, so someone who donates, say, 650 milliliters, will not earn quite as much as someone who donates 950 milliliters. And then, again, the whole reason for doing this really is to get people to come back regularly. And so they also pay bonuses. So if you donate 10 times within six weeks, they'll get a bonus. If you donate 100 times within a year, which would be essentially two times every week for a whole year, you would get a bonus.

So what it sounds like to me is that they are trying to encourage people to come back more often. Why is that? Why do they want people to come more often? Canadian Blood Services tries to get people to come in about once a week for plasma, or at least that's the maximum. With griffles, they really want people to come back twice a week. And the reason is that it's easier to just have like a stable base of people who are coming really often rather than always having to find new donors who are coming in less frequently. And so the question is then, is it safe to do that? So my understanding from talking to medical professionals is there's a bit of a, there's not really been a whole lot of research about what it means for a donor to come in twice a week for really long term.

So there was a, in 2024, there was a systematic review that was done on high frequency plasma donations. And they found that there could be long term declines in antibodies or the protein that helps people keep iron in their body. I talked to a physician in Denmark who helped write the study. And his big thing was just it's from what we know so far there's the potential that it could have not be great for somebody long term to donate twice a week. But that it's honestly, it's not clear right now. There's not really been enough medical research, and he's really hoping that there's going to be more. The information there is still kind of unclear. Okay.

So, Chris, you actually spoke to some people while reporting on your stories about plasma. What did you learn about the people choosing to sell their plasma? Traditionally, what the industry is trying to target is really people who are middle class. So they're in one stable location. They're going to keep returning to one center, and they're going to do it often. But they're people who maybe need just a little bit more. more every month. Maybe they have unexpected expenses. They have families. Maybe they're people who lost their jobs. Some of the folks I spoke to had unfortunately lost their jobs and they were

looking for a new, you know, a source of income while they were looking for something new. I talked to one woman who is a stay-at-home mom who does different things on the side while her kids are in school and this was sort of like one more kind of side gig she could try as a way to earn money. Where do these clinics tend to be? The research, So this has been studied in the U.S. And it's a lot easier in the U.S. because the U.S. is kind of like where this industry really lives. There are thousands of plasma donation centers in the U.S.

So when they've done studies about this in the U.S., they have found that centers tend to be located in areas where people have lower income. The typical donor in the U.S. is lower income, tends to be younger, tends to have a worse credit score. And one of the other interesting thing they found is that actually some of these people were less likely to take on payday loans if they were donating plasma. So that kind of gets into the sort of the complicated feelings some people have in the industry. You know, there are some people who don't like the industry who say, well, this is kind

of exploitive. You're targeting people who don't have a lot of other means to make money other than, you know, selling something from their body. And there are other people who say, well, this is still a better option than taking out payday loans. And, you know, there's one, you know, outspoken professor on this in the U.S. who characterizes this as a shadow safety net, so a way that people can earn extra money

and maybe not fall into other kind of financial traps. So you're talking about the U.S. here. Did you learn anything about locations in Canada? Yeah, so we tried to replicate the study. So my colleague, Dexter McMillan, did most of the work on this. It was a little bit trick here in Canada just because there's only, as we mentioned, like 17 private centers in Canada. So with that caveat, this is not quite as statistically significant

as the study in the U.S., But from what we identified, the clinics that are in Canada tend to be in neighborhoods that have lower income than average. We'll be right back. So, Chris, these paid clinics we've been talking about are all run by Griffles, as you mentioned. And they've drawn some controversy because two people have recently died after making plasma donations. Can you tell us what we know? Sure. And I'll just to preface this by saying there are things we know and things we don't know.

So these are still subject to some investigation, and I'll walk through that. So there's one woman, a young woman who was a 22-year-old student at the University of Winnipeg who died in October following a donation. With her case, her family allowed us to actually view the autopsy. And what the autopsy says is that this young woman was 45 minutes into a donation. So towards the end of one, probably, her heart rhythm started to deteriorate. And unfortunately, efforts to resuscitate her were not successful. And she was, you know, rushed to hospital and pronounced dead shortly after arriving at the hospital. Her official cause of death was sudden cardiac death.

And it also noticed that she had a heart condition. She had an enlarged heart. So there's some question about whether or not the plasma donation she was experiencing at the time contributed to her death. So the chief medical examiner in Winnipeg has said that he believes it did not contribute to her death and that event could have happened in any number of activities that she was doing. but the family believes that because her heart problems happen during the plasma donation, that there's a link and that there should be more investigation done into identifying exactly what happened during her death. The second death happened in January, also in Winnipeg, but at a different Griffle Center.

There are two centers in Winnipeg. The death in January, we don't know very much about. What we do know is that someone donated on the afternoon of January 29th, I went home at some point and by early the next morning was experiencing symptoms. We actually don't know what symptoms are. The documents we've seen from the government are heavily redacted, but this person began to experience some kind of symptoms were taken to hospital and passed away. Unfortunately, we don't know the identity or much else about that person yet. Is it rare for incidents like these to happen?

Yeah, it is quite rare to have deaths connected to plasma donation. So according to Health Canada, there's only been three deaths. in Canada that have some connection to a plasma donation, three deaths in the past 10 years. The two that I just talked about, and then a third also in Winnipeg in 2018. They have not released any details about what happened in 2018. Certainly some people have wondered why it's all happening in Winnipeg. Lots of questions remain there. We don't really know.

Griffles itself says that plasma donation is low risk and that generally the only kind of health complications that might happen, the most common ones, are any. kind of like bruising or swelling on the arm where someone's had the needle inserted. But Griffles has not provided any data really on whether there were more severe reactions. I did talk to one donor who unfortunately had to go to a hospital after one donation. And Health Canada as well has not really provided good data about sort of reactions that are that are less severe than someone dying. On these two recent deaths, has Griffiths said anything about what happened? Driffles has tended to defer to Health Canada.

So Health Canada has said that its investigation so far has not identified a link, a causal link, I should say, between the plasma donation and the deaths and believes they are just coincident. They happen to happen around the same time. And Griffles has tended to defer to Health Canada on that. And Health Canada regulates these clinics, right? That's right. Yeah. So any place in Canada, whether it's a hospital, whether it's Canadian Blood Services, whether it's Griffles, In order to collect blood or plasma, they need a license from Health Canada to do that.

And so Health Canada issues that license. And they may do inspections of those facilities as well or a different kind of check that it calls a compliance verification. After the deaths were reported each time, Health Canada inspectors went to these locations to do what it calls a compliance verification. We obtained a report from after those visits. And Health Canada inspectors did notice some what it called deficiencies at the operations. operations and asked Griffles to make some corrections on there. So things like it identified some gaps in staff training, some concerns that staff at the center didn't always know what to do when alarms began to sound on the machines.

It suggested there was high turnover that 14 out of 20 staff involved in collections had been hired within the last nine months or so up to that death. So it sort of told Griffles that it should take care of this stuff. Griffle says that it has submitted plans to Health Canada to address those gaps. However, another thing that's in the Health Canada documents is it also does say that they have been noticing some of these same issues recurring since 2022 over and over. And so it does, you know, raise some questions about how effective Griffell's responses to the concerns have been and how effective Health Canada has been at trying to get some of these issues fixed. Okay. So Health Canada has been flagging issues at some Griffles clinics since 2022, which is when their partnership with the CBS started. Chris, how has this looked outside of Winnipeg? Health Canada has inspected

Griffle's locations around the country. So Health Canada inspected a center in Calgary and one in Regina in recent months and found both to be noncompliant. One of the issues in Regina, I believe that was flagged, was a donor visiting too often, more often than they should have been under the under the rules. As well, because of these different inspections piling up, Health Canada also conducted an investigation of the Griffle's Head Office, which is in Oakville, Ontario. Griffles doesn't collect blood or plasma at the head office, but what Health Canada was looking for was sort of like the overall processes of how the company works, how they keep track

of records, things like that. Health Canada has said that it found things that were concerning and that it identified recurring systemic deficiencies, that's their term, at the centers. And so it added terms and conditions under Griffle's licenses. And so those terms and conditions say that Griffles has to improve the records it collects and has to do things like take fewer donors per hour than they were before. And Health Canada says that, you know, if those conditions aren't followed, it may take further action in the future.

Chris, I'm curious, has this had any impact on paid plasma collections in Canada? Yeah, paid plasma has always been an issue that's really invited strong and I think honestly held opinions on both sides. So there are people who argue that commercial collection paying people for donations can be exploitative, can maybe bring people to donate who should not be donating, providing incentive or providing incentive to donate more often than should be good for their health. So there are some people who believe that. You know, for example, there's the Canadian Health Coalition. Some provinces actually banned the practice. Oh. So Ontario actually banned paying people for their plasma in 2014.

Alberta and BC both did that as well. Quebec has had a longstanding ban. But kind of what happened is that those bans came in during the 2010s, and some got kind of rolled back around the time Canadian Blood Services struck this agreement with Griffles. So Alberta banned paying for donations while the NDP. was in power, and then when they lost in the United Conservative Party came into power, they repealed that ban. In Ontario, there is an exemption that allows Canadian blood services to pay people if it wants to.

Canadian blood services doesn't, but what's kind of happened is that Canadian blood services has argued that its arrangement with Griffles means that Griffles is acting as its agent, and the Ontario government has agreed with that. It's a loophole there. Yeah, so that's how Griffles operates in Ontario, although there is a law on the books banning paying donors. Okay. Chris, how do the donors that you spoke to feel about what happened with these two deaths? A lot of the donors, I mean, to be honest, there's a bunch of donors I talked to who had no idea this was going on.

Okay. But, you know, those who did or after I told them about it, if they didn't know, say that they're aware of risks. It is a, you know, it's generally safe, but it is a medical procedure. There's always some kind of risk when someone donates, Griffles informs them of possible risks that can happen. And, you know, the people I talk to say that, you know, even with that awareness of risk, they're happy to keep doing it. They feel safe.

They've had good experiences. And, you know, the extra income every month really helps them out. I mean, you know, broad picture here. You know, this all sounds pretty complicated, right? There is this tension. We want to make sure people have bodily autonomy. economy, right? But there's also a need to make sure vulnerable people are protected. And at the same time, Canada does need plasma. So where does that leave us? Yeah, I'm sorry to say I don't know that I have the perfect answer right now.

It's a big question. So, you know, there's some people who say, you know, it's not ethical to pay people for their plasma donations. And there's other people who say that it's not ethical to not pay people for their plasma donations. And so I think it's, you know, I think at the end of the day, I think the important thing is the, you know, safety of donors. And so, you know, I think the thing that seems to be broadly agreed is just making sure the practice is safe and well regulated. Chris, thank you for coming on the show. Really appreciate it. Thanks for having me.

That was Chris Hane, the Globe's Business of Health Reporter. That's it for today. I'm Cheryl Sutherland. Ali Graham produced this episode. Our associate producer and intern is Cynthia Jimenez. Our producers are Madeline White, Rachel Levy McLaughlin and Mahal Stein. Our editor is David Crosby.

Adrian Chung is our senior producer, and Angela Pichenza is our executive editor. Thanks so much for listening.