By Gina Shaw

Originally published by our sister publication, Pharmacy Practice News

Despite a recent critical blood shortage and an overall decline in plasma donations since the beginning of the COVID-19 pandemic, U.S. supplies of immune globulin (IG) products derived from plasma remain stable, market experts said. 

“This is the wrongest I’ve been in my career,” said Patrick M. Schmidt, the CEO of FFF Enterprises, a leading national wholesaler of plasma products, who had anticipated an IG supply shortage. “But one of the things we say internally is, ‘if we’re wrong about this, then patient care is still OK.’”

Earlier this month, the Red Cross said it has experienced a 10% decline in donations since the beginning of the pandemic, and has had to limit blood distributions to hospitals in recent weeks. 

“In fact, on certain days, some hospitals may not receive as much as one-quarter of the blood products requested,” the organization said in a media release.

Similarly, blood plasma donations at U.S. donation centers remain below 2019 donation levels, despite recovering somewhat in 2021 from their 2020 lows, said Matthew Hotchko, PhD, the president of the Marketing Research Bureau, which supplies market data and intelligence on the global blood and plasma industry. 

“For all of 2021, I would estimate that donations were down approximately 15% on a same-center basis compared to 2019. But the Mexican border centers have dropped much more, skewing the average [somewhat],” said Dr. Hotchko, who added that the omicron variant put a damper in what was expected to be a strong fourth quarter. “Donations were up compared to 2020, but that’s not a great achievement.”

However, Dr. Hotchko said he did not anticipate a reduction in the availability of IG in the United States, partly because it is the leading supplier and consumer of IG, and Americans pay by far the most for the products. “In fact, the challenge right now is boosting demand for IG in the U.S. market,” he said. 

People might be avoiding healthcare settings out of concern about COVID-19, and staffing shortages mean fewer procedures and treatments have been completed than before the pandemic, Dr. Hotchko noted. 

“We saw shrinking demand in the third quarter of 2021 and that didn’t really bounce back over the fourth quarter,” he said. “Overall, I would say there was a decline in sales between 2020 and 2021 in the low single digits, although I don’t have final numbers yet.”

Climbing Costs

The decline in plasma collections has raised the cost of doing business for plasma manufacturers and fractionators, Mr. Schmidt noted. 

“Those costs have been passed on in the form of price increases, which over the past two years have been in excess of what we were experiencing earlier,” he said. “It’s hard to pass on that cost because a lot of payors have adopted Medicare reimbursement rates, and there is a six-month lag time in adjusting those rates. As a result, many healthcare providers are upside down on IG, and there are very few products to choose from in both subcutaneous and intravenous IG that are profitable.”

Smaller suppliers might be having a difficult time, Mr. Schmidt said, because each infusion pharmacy makes its own decision on how much cost to pass on to buyers. “Unfortunately, I think what happens is that the big players get bigger because they potentially have more purchasing power.”

FFF Enterprises has increased its IG supply in anticipation of supply constraints, Mr. Schmidt said. “If they don’t materialize, yes, it has cost us money, but we’ve protected patients.”