OBJECTIVES: Human polyvalent immunoglobulins (Igs) are plasma derivatives that treat primary immunodeficiencies for which there are no alternatives. Unlike small molecule pharmaceutical products, the cost of plasma derivatives increases with the volume manufactured. Increasing demand for Igs results in high collection and fractionation costs and reduces the viability for manufacturers to increase production volumes. This research aims to explore the cost evolution of plasma in Europe and to demonstrate how the increasing Ig demand has driven costs.

METHODS: Data on Ig demand were collected from International Blood/Plasma News. Cost of plasma collection was analyzed through the increase of the price per liter of plasma between 2016 and 2021 in the EU and US¹. The last liter economy concept was used to explain the increased production costs.

RESULTS: Ig demand in Europe is estimated to increase from 60 metric tons in 2019 to a projected 83 metric tons by 2027². The average price increase from 2016 to 2021 per liter of plasma was +26% for EU (€110 to €139) and +27% for US ($156 to $198)¹. One contributor to increased cost is known as last liter economics. This refers to the fact that demand for different PDMPs varies significantly in volume with Ig having by far the largest demand. With continued strong demand for Ig, the plasma industry needs to collect increasing plasma volumes at higher costs where there’s only Ig to be sold out of those incremental liters^3,4.

CONCLUSIONS: As Ig demand continues to rise, patients with these rare conditions could potentially risk treatment disruption if manufacturing of these essential therapies becomes unviable due to the rising costs. A unique policy to reflect the price of Igs in line with the rising demand and associated costs could allow for increased patient access to essential and often life-saving therapies.