Help Is in Your Blood—Incentive to “Double Altruism” Resolves the Plasma Donation Paradox

Abstract

Blood donation is considered as one of the purest forms of altruism. Plasma donation, in contrast, despite being a similar process, is mostly a paid activity in which donors are compensated for their contribution to the production of therapeutic preparations. This creates a so-called “plasma paradox:” If remuneration is promised for a socially useful effort, volunteers with altruistic motives might be deterred. At the same time, regular plasma donors who pursue the monetary benefits of donation might drop out if remuneration stops. The same controversy can be caught in the messages of most plasma donation companies as well: They promise a monetary reward (MR), and at the same time, highlight the altruistic component of donation. In this study, we tested the assumption that emphasizing the social significance enhances the willingness to donate blood plasma more effectively than either MR or the combination of these two incentives. This had to be rejected since there was no significant difference between the three scenarios. Furthermore, we also hypothesized that individuals might be more motivated to donate plasma if there is a possibility of offering an MR toward other socially beneficial aims. We found an increased willingness to donate in scenarios enabling “double altruism”, that is, when donating plasma for therapeutic use and transferring their remuneration to nongovernmental organizations, is an option. We propose relying on double altruism to resolve the plasma paradox, and suggest that it could serve as a starting point for the development of more optimized means for donor recruitment.

Plasmapheresis and Plasma Donation: Challenges in the Blood/Plasma Supply Chain

“…Altruistic blood donation indicates respect for the need of others and the importance of life, which in turn engenders a sense of social responsibility and benefits the whole community. 39,40 It also helps protect the poorest sector of society from exploitation, and may help ensure the safety of blood supplies, since payments could incentivize some people to hide relevant medical information such as infectious diseases. 39,40 However, with regard to product safety, in the USA, where remuneration is allowed, there have been no reported cases of infectious diseases transmitted from plasma donors since the modifications of the Code of Federal Regulations requirements and adoption of the Plasma Protein Therapeutics Association IQPP standards.…”

“…In this scenario, payments are made for plasma donations, but people are offered the opportunity to transfer the payment to a charity/nongovernmental organization, thus encouraging donors who may wish to keep the payment as well as those who would prefer to donate the money. 40 A recent study found an increased willingness to donate plasma when "double altruism" was an option. 40 It is also worth noting that incentives need not be cash payments.…”

“…39,40 It also helps protect the poorest sector of society from exploitation, and may help ensure the safety of blood supplies, since payments could incentivize some people to hide relevant medical information such as infectious diseases. 39,40 However, with regard to product safety, in the USA, where remuneration is allowed, there have been no reported cases of infectious diseases transmitted from plasma donors since the modifications of the Code of Federal Regulations requirements and adoption of the Plasma Protein Therapeutics Association IQPP standards. 41 Requirements for mandatory second donation, serology and nucleic acid testing for each donation, and the fractionation process used (which involves solvent detergent, nanofiltration and other processes), ensure plasma products are very safe, which helps to minimize any possible negative effect associated with paying donors.…”

“…Among individuals who have a strong altruistic drive, or those who are motivated by gaining public recognition through being a donor, monetary reward can be perceived to reduce the status of donating, and thus can "crowd out" some potential donors. 40 There is evidence of a difference in attitude between the sexes, at least among whole-blood donors. A study in Sweden (where donations are not remunerated) found that introducing remuneration decreased the willingness of women to continue donating, but not men; however, when offered the option of donating the money to charity, women became more willing to donate again.…”

“…40 A recent study found an increased willingness to donate plasma when "double altruism" was an option. 40 It is also worth noting that incentives need not be cash payments. 51 A common alternative is getting paid time off work.…”