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KCE Reports 120 Plasma 5
1 INTRODUCTION
1.1 CONTEXT
Blood transports elements that are essential to life in individuals, but it can also be used
to produce derivatives that are used in the treatment of specific disorders in others
such as immunodeficiency and haemophilia. These derivates are produced by a process
called plasma fractionation. Plasma is the transparent yellowish liquid part of the blood,
composed of 90% water and the rest of immunoglobulins (a part of this report is
devoted to their consumption), albumin, coagulation factors and lipoproteins. This
plasma is obtained either by separation of the red blod cells following a whole blood
donation, or by plasmapheresis, a process used to isolate the plasma from the blood of
a donor, which retains the red blood cells.
In Belgium, all of the blood and plasma is collected by the Red Cross and a few
independent centres. The donors are not paid, in accordance with the rules in force in
the European Union. The collected plasma is sold to a company in Belgium, which
performs the fractionation.
The majority of European countries consume a greater quantity of derivatives than can
be extracted from the blood and plasma collected from their citizens. They must
therefore obtain other supplies from fractionation companies that buy plasma abroad. If
this foreign plasma should one day be in short supply or only be available at exorbitant
prices, importing countries may find themselves in difficulty. This difficulty is
exacerbated by the fact that plasma derivatives are vital for the treatment certain
serious illnesses, hence the question posed to the KCE of self-sufficiency for Belgium in
plasma and plasma derivatives and the precautions to be taken to reduce as far as
possible the risk of a shortfall in supplies.
1.2 RESEARCH QUESTIONS
To clarify the issue, we intend to answer the following questions:
Concerning supply:
• How and in what quantities is plasma collected in Belgium and in other
countries? What trends have been observed? What subsidies are
provided to ensure that enough is collected?
• How are derivative products manufactured from the plasma collected in
Belgium? What are the quantities produced? How is it financed?
Concerning demand:
• Which medical indications are treated with plasma stable derivatives ?
Which amounts are required to treat these conditions and which
amounts are consumed in Belgium? Which trends can we expect over
the coming years?
Concerning security of coverage of demand:
• What it meant by security of coverage in general? What level of coverage
do we seek to achieve in Belgium and in other countries?
• What different approaches could be used to achieve optimally the desired
level of coverage?