The thing about selling plasma is how routine the whole thing has become, like morning coffee or birthday cake with the grandkids.
Three collection centers have opened in the Pittsburgh area in recent years and more are on the way as the push and pull of everyday economics overcomes the ick factor of blood and needles.
CSL Plasma Inc. in McKeesport is a regular stop for Dan Wickler after dropping off his kids at school. He works the night shift at an Etna machine shop.
At the collection center, Mr. Wickler, 40, a Lawrenceville resident and single father of two, relaxes in a comfortable chair while a technician tightens a tourniquet around his upper arm. A needle is inserted into an arm vein, followed by a plastic catheter attached to clear tubing.
Blood flows into a spinning centrifuge that separates the straw-colored plasma from red blood cells. The red blood cells are returned to his vein through the tubing in a repeating cycle that lasts about an hour.
When it’s over, after about a quart of liquid has been collected, he’ll drive home to sleep.
Other competitive threats include ongoing research into gene therapy for hemophilia A and B, with virtual cures that could be commercially available in the early 2020s. For now, though, human plasma is driving global sales in the industry — from $5 billion in 2000 to $21 billion in 2017, an increase exceeding 300%.
Riding on a rising tide of plasma collections, CSL Plasma profits rose 32% to $1.7 billion, while revenue was up 44% to $7.9 billion over the five years between 2013 and 2018, according to the company’s financial reports.
Barcelona, Spain-based Grifols, which operates a collection center on the North Side in addition to Penn Hills, also has growth plans — including increasing the number of centers from 249 to 325 by 2023, a 31% increase, according to the company. The sites were not disclosed.
“We are continuously discussing potential locations,” Grifols spokesman Mr. Seal said.
The word “plasma” doesn’t appear in the U.S. Tax Code, but preparers, including Mountain View, Calif.-based Intuit Inc., makers of TurboTax, advise that the estimated $400 a month in potential earnings from selling plasma is taxable.
The money may not be much, but it can be just enough to spackle a budget hole for people living paycheck to paycheck.
“We really think it’s become a financial coping mechanism for families to meet essential expenses,” said H. Luke Shaefer, associate professor at the University of Michigan School of Social Work, who has studied the plasma industry. “They’re trying to package together a low-wage job, two low-wage jobs, but they’re still not quite able to pay rent.”
Growth in demand for plasma coincided with the Great Recession and an economic rebound that hasn’t reached everyone. Pittsburgh Foundation senior vice president Jeanne Pearlman said the economic strain that drives people to sell their plasma is found in pockets in certain communities.
“We were supposed to be seeing signs of recovery and, anecdotally, we think some people have done better,” said Ms. Pearlman, whose organization is studying poverty in the Pittsburgh metropolitan area. “We’re talking about people who are one car repair, one broken water heater away from disaster.”
Forty percent of Americans say they could not cover an emergency $400 expense, according to an annual survey by the Federal Reserve Board.
McKeesport, a threadbare Pittsburgh suburb still smarting from the collapse of heavy industry decades ago, was chosen by CSL Plasma for a collection center. Plasma clinics also open near universities where there are lots of first-generation students who are likely to be short of cash, Mr. Shaefer said.
Less than three miles from CSL Plasma’s McKeesport clinic is Penn State University Greater Allegheny campus, where 43% of students are the first in their families to attend college.
“There’s a lot of people living on that margin,” Mr. Shaefer said. “They don’t have any safety net to catch them when they fall.”
And the money increases with more trips to the collection center — a key to mainstreaming the business of selling human tissue, which relies on regular clinic visits and a weekly routine. Mr. Gutierrez-Faust, for example, squeezes in a regular Sunday morning trip to Grifols in Penn Hills before driving home to McKeesport for Mass at Corpus Christi parish.
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For people who need a ride, Pittsburgh’s plasma centers are conveniently located on public transit routes.
In December, Grifols’ Penn Hills center paid first-time donors $25, then $40 for a second donation plus a weekly bonus of $15, making $420 the total that donors could receive if they gave plasma the maximum eight times during the month.
Studies haven’t found long-term health problems associated with selling plasma, but the World Health Organization recommends that plasma and blood be accepted only from volunteer, unpaid donors.
The policy stems from the experience of thousands of people worldwide who were infected with hepatitis, HIV and other diseases after receiving infusions of tainted blood and plasma in the late 1970s and mid-1980s.
Disease testing then was in its infancy.
Donors aren’t paid for their plasma in Great Britain and many parts of Canada.
Along with the U.S., China and Russia are among the countries that ignore the WHO recommendation.
Men in their peak earning years of 55 to 64 deliver more plasma than women or any other age group, according to a trade group. The connection suggests that for some men, aging and financial insecurity may be linked — and selling plasma can offer some relief.
Forrest Iddings, 60, of McKeesport, said his plasma money supplements a small pension from General Electric, where he worked in Connecticut. He has a place to live now, he said, after being homeless for about six months, and depends on plasma money for “what I need: clothes, food.”
Plasma proteins are used to make medicines to treat hemophilia — a disease that prevents blood clotting — immune system deficiencies and other diseases and the medicines require a lot of plasma: Treating one person for hemophilia for a year, for example, requires 1,200 plasma units. In the U.S. alone, the American Red Cross estimates 10,000 units of plasma are needed daily.
By comparison, 13.6 million units of whole blood and red blood cells are collected each year, according to the Red Cross.
The need is growing internationally. Only about one-quarter of people with hemophilia receive adequate treatment globally, according to the World Federation of Hemophilia, while uses for plasma are expanding as new applications are discovered.
Plasma contains 2,000 proteins, but just 15 to 20 of them have been commercialized — leaving scientists and entrepreneurs with plenty of blue sky, according to Orange, Conn.-based Marketing Research Bureau, which tracks the industry. Chronic diseases, including heart disease and stroke, are among the new uses being explored for today’s plasma medicines.
People who sell their plasma say they like the idea of helping people, though most have never met anyone who benefited — people like Andrea Witlin who lives in Pine, about 15 miles north of Pittsburgh.
Dr. Witlin, a 65-year-old retired physician who specialized in high-risk pregnancies, remembers growing up in a family that simply denied the possibility of sickness. Her parents, both secondary school educators, “didn’t believe in being sick, so I just kind of motored through it all,” she said. “I’ve basically been sick all my life, colds, bronchitis, infection stuff.”
She suffered more infections than other people and the bouts lasted longer. She was hospitalized for pneumonia when she was 10.
The first inkling that something bigger might be wrong came in her early 30s when her primary care doctor ordered testing for the proteins in her blood that fight bacteria, viruses and toxins: all of them were borderline low.
Finally, when she was just shy of 45 years old, Dr. Witlin was diagnosed with common variable immune deficiency — an impairment that increases susceptibility to bacterial, viral and fungal infections.
“My body doesn’t make antibodies,” she said.
Intravenous immunoglobulin, a plasma-derived medicine first used in the 1950s to supplement the body’s defense network, was prescribed for her. It worked.
Six years ago, Dr. Witlin was hospitalized for about a week with sepsis, a life-threatening blood infection. She said she probably wouldn’t have survived without immunoglobulin.
She’s careful to avoid people with colds and other contagious illnesses, but it has been about a year since she’s had a serious infection and she cherishes the freedom. Dr. Witlin doesn’t know anyone who sells their plasma, but she knows what she’d like to say to them.
“I’m eternally grateful to them,” she said. “I don’t know how much they know about the people they’re helping.”
At the core of the commercial plasma industry is a warm clinic and friendly staff to welcome people back again and again.
Technicians use first names to greet return visitors and at some centers, frequent donors are recognized by having their names appear on a big screen. Newcomers undergoing that first venous puncture are comforted by staff.
Posters of grateful patients decorate collection center walls, reminders of those who are being helped and of the bigger cause served by people selling their tissue.
“They make you feel comfortable, like a big family,” said Elizabeth resident Ashley Spencer, 30, who sells plasma so she can work fewer hours as a residential aide and spend more time with her 6-year-old daughter. “You’re doing something good and you’re benefiting.”
McKeesport may be a sinkhole of the Western Pennsylvania economy, with one-third of the population impoverished — more than twice the national rate. But the lobby floor at CSL Plasma nearly sparkles amid Olympia Shopping Center’s shuttered supermarket, senior day center, and quick loan and furniture rental storefronts.
Perhaps more than anything else, the commercial plasma industry values return clients, people for whom selling human tissue is fully integrated into a way of life. People like Mr. Gutierrez-Faust, who faithfully stick to a regular donation schedule, are heroes.
Once, he said, there was a delay in getting checked into the Grifols center in Penn Hills for one of his regular appointments, a lapse he said he hardly noticed.
For his trouble, the center gave him a $10 bonus.
“I didn’t even know they missed me,” he said.
Kris B. Mamula: firstname.lastname@example.org or 412-263-1699