Donating plasma and donating blood are essentially the same process: the entry questionnaire, getting hooked up to a machine, the cookie afterward. But in the US there’s a key difference: one is an act of charity, and the other an act of commerce. So why is it that you get paid to donate plasma, but not blood?

It’s a common misconception that the Food and Drug Administration bans paying for blood. In fact, it only says blood from paid donors has to be labeled that way. But hospitals won’t use it. In practice, nobody really pays for blood, said Mario Macis, an economist at the Johns Hopkins Carey Business School who has studied incentives for blood donation. “Even though it’s legal, it’s still considered not totally moral or ethical to pay cash to blood donors.”

Aside from the ickiness of handing out literal blood money, the FDA worries that paying donors would jeopardize the safety of the blood supply. No one with a blood-borne illness is eligible to donate, but the agency worries that if money were on the line, donors might lie about their health or their risk behaviors.


The science there is far from settled. But the World Health Organization finds it convincing enough that they discourage countries from paying blood donors. “Evidence shows significantly lower prevalence of transfusion-transmissible infections among voluntary nonremunerated donors than among other types of donors,” their commentary in 2013 read.

Donated blood is tested for diseases, anyway, but the FDA says it intends those steps to be redundant security measures, “like layers of an onion.”

Plasma donation — in which blood is drawn, plasma separated out, and then blood cells and other components put back into you — is often compensated. The FDA doesn’t require paid plasma donations to be labeled. The reason is that plasma collected this way never goes straight into another person. It’s broken into many different protein products that will become pharmaceuticals. Along the way, these components are processed to remove or kill any virus stowaways. “The risk of infection is inherently much lower,” said Dr. Christopher Stowell, who recently chaired the FDA’s Blood Products Advisory Committee. Whole red blood cells are too fragile to undergo the same kind of processing as plasma.

And there’s some evidence that paying for plasma does, indeed, lead more people to conceal their disease status or risk behaviors. For instance, the Government Accountability Office looked at California’s blood versus plasma supply back in the 1990s and found that the plasma had much higher rates of HIV. There are reports of desperate donors lying about illnesses to donate for cash.

However, the type of compensation matters. In a 2013 Science paper, Macis and others found that rewards such as gift cards, coupons, and T-shirts almost always boosted donations, and they didn’t find any effects on blood safety. (The FDA doesn’t count rewards like this as payment, as long as they can’t be easily turned into cash.) “Nonmonetary incentives do work,” Macis said. He thinks using more of these motivators could help the United States manage seasonal blood shortages.

Were you hoping for more than a T-shirt? Don’t even think about selling a kidney. The National Organ Transplant Act of 1984 made it illegal to pay for organs. But in the 2011 case Flynn v. Holder, the US Court of Appeals for the Ninth Circuit ruled that a certain method of bone marrow donation could be compensated.

Traditionally, bone marrow was collected in a surgical procedure, with a hollow needle stuck straight into the pelvis. But in a more common method called peripheral blood stem cell apheresis, donors take drugs that release the stem cells from their marrow into their blood. Then they donate the cells through a needle in the arm and an apheresis machine — just like a plasma donation.

Centers that collect such cells pay up to $800, but they haven’t seen that much interest, the AP recently wrote. And the cells can’t be processed like plasma, so it’s unclear what the risk might be from paying donors in this nascent market.

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  • I have always been a blood donor. Saving three lives is heartwarming for me. I began giving plasma when I lost my job in November. I personally gave plasma so that my two children could have a wonderful Christmas as they always have! I have been a single mother for 17 years and times have been tough. This is the first time I have had to ever turn to something as this, but ya know what, it’s once again, makes my heart happy and every penny helps my family! It’s a temporary fix but even after going back to work, donating plasma is a great way to save! Just keep yourself healthy during the process💜

  • My sister has a rare blood type A – and she usually donates her blood, but now she is in financial need, but calling around all I’ve found is companies that take plasma. Where can she go to sell a rare blood type?

    • Are you crazy? Theres a reason we dont pay people. Because desperate people use the money for all kinds of things including drugs and contract hits.

  • When you are being compensated for something, why would it be called a “donation”? It’s as if there are opposite meanings for the word “donate” when it is blood that is being donated (given for free) and blood plasma that is being donated (sold). Why isn’t one called “donating blood” and the other “selling blood plasma”?

  • So people will lie about having HIV. Okay i get it but couldnt you just test the patient before? Or is that too smart? Plus when has money making been moral? This country was created because of slavery…

    • The blood IS tested. But if the donor admits being sick or admits risky behaviors, no need to perform the tests. They do cost too! And someone qualified has to run these tests and be paid.

  • Agreed. Our medical market is a vicious system and once again those with something in demand get screwed. If they don’t have to pay for it, then they shouldn’t be able to charge for it. Especially since they testing is considered redundant. That’s a scary thought right there.

  • How come you don’t get paid for your blood but hospitals can charge upwards of four thousand dollars for a blood transfusion?

    • Because there is more to transfusion than the blood itself. Blood must be properly collected by someone who knows what they’re doing into bags that are made of material that allows for gas exchange and that contain anticoagulant and other substances that cost money. Blood must be processed by qualified personnel using appropriate precautions in a manner that avoids contamination and mislabeling. It must be tested for presence of pathogens, typed for blood antigens, then matched with the patient in need by a certified technologist, prepared for transfusion and administered in a proper way by someone who knows what they are doing.

    • I completely agree with this. I have done both donated my blood and sold my plasma on numerous occasions. The one thing that I started feeling was angry about how much I would be charged for blood at a hospital if I ever needed it, even though I used to regularly give it away. How much the patients are charged for an act of charity. I understand staff need to get paid, but when you are donating for free they have professionals handling the blood and they are still getting paid. Something seems fishy with the current system.

  • This is outrageous. People can starve but you need to sell your blood for food. This could ONLY happen in the the United States. You would be better off going to prison to get food but you will probably end up with AIDS with your dinner.

  • Also if you are in financial troubles surely there’s other places you can go to and there’s plenty of people you can see about that .

    • Kylie if people had an alternative why don’t you think they are are using it? Maybe the charities in their neighborhoods are all tapped out or maybe there are too many conditions attached to the charitable donations. I’ve heard of people going to prison in the U.S. just so they can get medicines. How low can the U.S sink before it destroys itself?

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