Donors

The business of blood plasma collection

The first step in the manufacture of Factor VIII / Factor IX concentrate products begins with Plasma (this is the liquid part of blood that remains once the red cells and cellular components have been removed) and the companies that produced Factor would need lots of it.

In the United States and some other countries that Britain imported products from the donors were paid cash for their donation. It had long been understood that paying a person for their donation was a bad idea, a payment presented a clear and strong motive for a donor to lie about their health status, particularly IV drug abusers.

Image Source: Bad Blood 1985

Image Source: Bad Blood 1985

Plasma collectors would often set-up their collection centres in poor "skid-row" locations where profits could be maximised, preying upon those who were more likely to carry viral infections such as IV Drug Abusers and Prostitutes. Pay-for-Plasma operations were even setup in Prisons where higher viral-risk activity, such as homosexuality and needle sharing was common place.

Plasma Pooling

Mixing blood plasma together, amplifying infection risk

Image Source: BBC Panorama 2017

Image Source: BBC Panorama 2017

Once plasma had been collected, the next step was to "pool" or "mix" it together. The practice of pooling carried yet a further clear and present danger, by mixing all of these plasma donations together it meant that if even one of the donations carried a virus, then now the entire batch did.

In effect, the manufacturers were taking the relatively minuscule risk one may have of contracting a virus from a single donor (as was the case in for example Blood Transfusion), but then magnifying that risk by, literally, 60,000+ times over for Factor VIII.

This critical difference is the reason why the very low Hepatitis exposure risk via traditional Blood Transfusion from a single donor was somewhere in the order of 0.1%, it was closer to 100% for Factor VIII. Concentrates. The bigger the pool, the bigger the risk. Blood was not pooled, Plasma was.

from plasma to profits

Image Source: Bad Blood 1985

Image Source: Bad Blood 1985

the penultimate factor

Once the Plasma had been pooled, it would be "Fractionated", this is the name of the process that is used to separate out the various "Fractions" of plasma, such as Factor VIII & Factor IX.

Image Source: Bad Blood 1985

Image Source: Bad Blood 1985

Factor For Sale

From Prison to Patient

Following fractionation and processing the products would be packaged and ready for sale. There was no mention to patients of the high viral risk donors, the pay-for-plasma programs, the prisons or mass-pooling. It was after all, a profitable business.