Presentation (CTI)

OBJECTIVES: Demand for immunoglobulins (Ig) in Canada is rapidly growing. However, domestic plasma collection remains insufficient to meet self-sufficiency targets established at 42% by 2027, resulting in sustained dependence on foreign supply. This study evaluates whether Canada can achieve Ig self-sufficiency through supply-side plasma collection and assesses the contribution of demand-side strategies, including substitution toward alternative therapies for selected indications.
METHODS: An economic model was developed to analyze Canadian Ig demand and domestic plasma collection using data from national blood agencies, public reports, and international market sources. Supply-side requirements were estimated in terms of additional plasma volumes and number of new collection centers needed to achieve the 42% self-sufficiency target by 2027. Demand-side scenarios examined partial substitution of Ig use in myasthenia gravis (MG) and chronic inflammatory demyelinating polyneuropathy (CIDP), indications with approved non-Ig alternatives. Incremental system costs were estimated from a healthcare payer perspective, including plasma collection and Ig administration costs.
RESULTS: Ig demand is projected to increase from 9.7 million grams in 2023-2024 to 11.4-13.0 million grams by 2027-2028. Achieving 42% self-sufficiency would require an additional 489,000-622,000 litres of plasma annually, equivalent to opening 13-28 plasma collection centers per year, substantially exceeding historical deployment rates. The incremental annual cost of a supply-only strategy was estimated at CAD 201-255 million. In contrast, diverting 50% of MG and CIDP patients to alternative therapies reduced required plasma volumes by up to 30%, lowering needs to 9-20 new centers per year and offsetting additional system costs.
CONCLUSIONS: Achieving Ig self-sufficiency in Canada through expanded plasma collection alone is operationally and financially implausible within the foreseeable future. An integrated strategy combining moderate supply expansion with demand-side interventions offers a more feasible and cost-effective pathway to improving supply security, system sustainability, and patient access to essential Ig therapies.