For the past twelve years, William Jacques has visited CSL Plasma twice a week to donate his plasma. He brings in $460 a month, likening it to a part-time job. He’s not the only one. Across the United States, Americans are consistently frequenting plasma donation centers in exchange for a quick buck.
The number of these centers continues to rise. Currently, the United States has more plasma donation centers, at 1,247, than community colleges. The number of centers varies per state, largely due to differences in regulations. However, one thing is consistent– the presence of these centers in economically disadvantaged neighborhoods. The average plasma seller is low-income, under 35, unemployed, and lacking a college degree. Over two-thirds of donors are motivated to donate to pay for day-to-day essentials and emergencies.
The United States’ paid-donor plasma system supplies 75% of the world’s plasma, despite North America accounting for 44% of the demand. This is largely because the FDA allows individuals to donate plasma more frequently and at higher annual volumes than in any other country. In the United States, donors are remunerated $50-75 per donation. In 2025 alone, more than $4.7 billion was spent on donor compensation.
However, paid donations are not the only way. 64 countries have reached over 99% of their blood supply by unpaid donors, and 54 countries have reached over 50%. In fact, the World Health Organization has set a goal to achieve 100% voluntary non-renumerated donors by 2030. The World Health Organization advises countries against rumination, raising concerns about the harmful consequences of frequent donation.
This is especially concerning, considering the vulnerability of poor Americans who historically have worse health outcomes than their wealthier counterparts. There is a gap in knowledge about the effects of frequent plasma donation, raising serious ethical questions. Without this knowledge, how can an individual fully understand the risks of selling their plasma, and how can we determine the fair market value of plasma? One comparative study found that in countries with donor remuneration (causing more frequent donations), donor safety is at risk, and the infectious burden of donated plasma is higher, and plasma-derived medicinal product prices increased less in countries with a volunteer-based system.
It is imperative that we do not exploit the financial deprivation of poor Americans while also balancing the growing need for plasma donations. It is time for the FDA to reconsider the regulations regarding the frequency and remuneration of plasma donors. Some suggest regular audits of donation centers to monitor compliance with ethical standards and address possible exploitation. There must be research into the long-term health effects of frequent donation on vulnerable donors to ensure the long-term health and safety of donors and a sustainable blood and plasma supply for the United States and beyond.