America’s Paid Plasma Donors Carry the World’s Medicine Supply

U.S. plasma centers collected 62.5 million liters in 2025, about 68 percent of the world’s supply for medicines. About 216,000 paid donations now happen every day, and federal rules let a healthy adult give twice in seven days. That frequency, which most rich countries still refuse, is why American donors cover patients from Paris to Toronto.

Fifty-two percent of those liters treat American patients. The other 48 percent leave the country. The people in the recliners are not a side hustle. They are the supply chain.

America Now Has 1,247 Plasma Centers

Peter Jaworski, a Georgetown University ethics professor who runs the school’s Blood and Plasma Research Group, put the year-end count at 1,247 commercial centers, including four in Puerto Rico. That is more sites than U.S. community colleges, which number just over 1,000. Texas leads with 186, then Florida with 92 and California with 65.

The footprint barely grew. The industry added nine centers in 2025. Volume still rose from 57.6 million liters the year before, because new machines from Fresenius Kabi, Terumo, and Haemonetics pull 9 to 12 percent more plasma per donor. Jaworski’s annual tally records 62.5 million liters collected in 2025 from more than 75 million donations.

Those visits put $4.7 billion on prepaid debit cards, about $65 a donation on his average. That payout is larger than the federal Low Income Home Energy Assistance Program, budgeted at $4.1 billion. Texans took home $652 million. Utah, with 25 centers and 7.1 sites per million residents, took home $86 million.

CSL Limited, parent of one of the biggest U.S. collector networks, reported $15.6 billion in group revenue for the year ended June 30, 2025. Its Behring unit, which turns plasma into drugs, accounted for $11.2 billion. Jaworski groups CSL with Grifols, Takeda, Octapharma, and Kedrion as the five firms that run 90 percent of U.S. centers. Takeda operates BioLife Plasma Services.

America’s plasma contribution to the world, 2025 edition

The U.S. makes the most significant contribution to the global plasma supply, saving the lives of hundreds of thousands of patients

In 2025, that contribution got even bigger

(Link to report + details below)👇 pic.twitter.com/bTW8Yl92BW

— The Plasma Professor (@petermjaworski) January 2, 2026

HOW THE 2025 HARVEST SPLIT

Immunoglobulin demand, Jaworski notes, still grows 6 to 8 percent a year. Plasma cannot be mixed in a lab. It has to come out of a vein.

South Carolina Collects Enough Plasma for France

France met less than a third of its own need in 2024. Jaworski maps that 1.5 million liter hole onto about 29 U.S. centers, the number running in South Carolina. Spain’s 2023 shortfall of just over 1 million liters matches Iowa’s 20 centers. Italy’s 630,000 liter hole in 2024 matches Kansas and West Virginia together. Denmark’s 130,000 liter gap matches Wyoming’s three centers.

The European Union’s 8.7 million liter shortfall in 2025 equals about 175 U.S. centers, roughly California, Florida, and New Jersey combined. In an April 16, 2026 brief to Canada’s House of Commons health committee, Jaworski wrote that by July 2025 Canada was producing only 27 to 28 percent of the immunoglobulin it used, and that seven of ten donors are American for the patients who depend on that drug. Canada collected enough plasma for 3.1 million grams and imported 8.1 million grams from the United States.

WHICH STATES COVER WHICH COUNTRIES

• South Carolina: About 29 centers, enough to cover France’s 1.5 million liter hole.
• Iowa: About 20 centers, enough to cover Spain’s shortfall.
• Kansas and West Virginia: Thirteen centers together, enough to cover Italy’s 2024 gap.
• Wyoming: Three centers, enough to cover Denmark.
• Indiana: Thirty-seven centers, about the volume Canada was missing in 2025.

Countries that pay donors and let commercial centers operate, including Germany, Austria, Hungary, and the Czech Republic, collect enough for themselves. Countries that do not pay, including France, the United Kingdom, Australia, and most of Canada, buy the difference. The unpaid rule is kept. The liters still come from people who were paid.

Germany caps a donor at 60 visits a year. The U.S. cap is 104. That gap in the rulebook is the whole export machine.

Payday Loans Drop After a Center Opens

Emily Gallagher, an associate professor of finance at the University of Colorado Boulder, and John Dooley of Washington University in St. Louis tracked what happens in a zip code after a center opens. In The Review of Financial Studies in 2024, they found that payday loan demand falls by over 13% among borrowers under 35. Foot traffic at nearby stores rises by over 4 percent.

Gallagher has said the same number of people sell plasma as use payday loans, and that a center is often a last-minute bridge, $100 short on rent. A typical two-week payday loan carries a 400 percent APR, and 80 percent of those loans are rolled over at least once, according to Consumer Financial Protection Bureau figures the researchers cite. They estimate U.S. households avoid $180 million to $227 million a year in payday and installment borrowing costs because the centers exist.

THE $4.7 BILLION PAYOUT

• Donor fees: $4.7 billion in 2025, about $65 a visit on Jaworski’s average, across more than 75 million donations.
• Jobs on site: Each center employs about 50 to 60 people, or 62,000 to 74,000 jobs across the 1,247 sites.
• Who sells: Donors tend to be 35 or younger, low-income, and short on ordinary credit, Gallagher found, and they are more likely to be men and to identify as Black.
• Why they go: More than two-thirds of donors in a 2018-2019 national survey said they needed money for day-to-day bills and emergencies.

“This is one of the highest hourly wages you can earn without any experience. You’re making $50 in a 90-minute period. That’s a really high wage for somebody who makes $15,000 a year,” Gallagher said. Repeat visits do the economic work. In the researchers’ sample, a fifth of donors came only once, 29 percent gave more than 10 times in six months, and 10 percent gave 40 times or more in that window.

What Twice-a-Week Donation Pays

The advertised number is the new-donor bundle. BioLife Plasma Services tells first-timers that new donors get up to $800, based on center location, with terms attached. The asterisk is doing a lot of work. Hitting that figure means coming back again and again in the opening weeks. After the promo, the card loads far less.

Quentin Watts, 32, learned that the hard way in southwest Minneapolis. He had been a seasonal UPS driver six days a week. In January 2026 he was not moved to a permanent job. Rent, insurance, and utilities piled up, then the house went. A former colleague had mentioned plasma. Search ads found him first. He picked the closest center so someone could fetch him if a needle went wrong. He is afraid of needles. Some mornings he sat in the parking lot for 45 minutes.

The new-donor rate paid him $100 a visit for the first month, then $40. He started lining up at 7 a.m. Compensation sometimes falls into the $40 to $50 range, and donors often learn the day’s rate only at the desk. At some centers, heavier donors are paid more because the machine can take more volume. You have to be at least 18 and weigh at least 110 pounds, and you have to pass protein and hematocrit checks each visit.

Frey Chu, a 31-year-old in Long Beach, California, built Discover Plasma, a crowdsourced pay tracker, after his sister and friends started donating in college. He has counted nearly 7,000 subscribers. The database exists because the posted rate and the loaded rate are not the same thing, and the loaded rate moves.

The Super-Donors Who Hit the Ceiling

Of the people who walk in each day, fewer than 1 percent donate at the legal maximum. The average donor comes 14 to 17 times a year. The rest of the volume still depends on a thinner group that treats the 48-hour gap as a schedule.

Watts is in that group. He looked up the risks, talked to regulars, then stopped looking. “You kind of go, ‘Oh, I don’t need to know that,’” he said. “I need this, so I’ll put the serious complications on the back burner.” A shared industry database, the Cross Donation Management System, flags anyone who tries to give more than twice a week or hop from BioLife to CSL the next morning.

Jose Covarrubias, a 37-year-old youth counselor in Orange County, California, donates twice a week and wants more money for it, because the material is valuable. Brad, a 31-year-old truck driver in Sand Springs, Oklahoma, has been paid $60 a visit and called that scraps. Kevin, 41, in Las Vegas, says he has earned nearly $30,000 over several years at two visits a week. He also describes bungled needle sticks, scars that nurses now mistake for drug marks, and one session that lost him one to one-and-a-half units of blood when a machine was hooked up wrong. He now has fatigue he did not have before.

Russ Darbon, 61, a steel mill worker in St. Louis, has had no trouble and likes the blood-pressure and iron checks. Plasma volume usually returns within 48 hours if you drink water. A patient with hemophilia can need 1,200 plasma donations for a year’s medicine. Watts’s own grandmother survived blood cancer on donated plasma about a decade ago. He still tells almost no one he goes.

Frequent Donation Still Lacks a Long Study

Federal rules for automated collection say the procedure shall not occur less than 2 days apart or more frequently than twice in a 7-day period. That is the 104-visit year. Centers run questionnaires and finger-stick tests on the way in. They do not follow donors out the door.

Michelle Fransen and colleagues surveyed 5,608 source-plasma donors at 14 U.S. centers for the journal Transfusion in 2023. After they grouped people by how often they had given in the prior year, self-reported quality-of-life scores did not differ from new donors. Cough, cold, fatigue, and sore throat were the common complaints, with no clean pattern by frequency. The same team found that most people who stopped cited convenience, not health. People who feel worse also tend to quit, Gallagher notes, which leaves a healthier group in the data.

CSL Plasma’s own FAQ warns that frequent donation may deplete immunoglobulin and weaken the ability to fight infection. Grifols has said plasmapheresis may temporarily affect the immune system but does not pose significant long-term health risks. Veronica Hoad, a public health specialist at Australian Red Cross Lifeblood, has said there is not conclusive evidence on bone health or immune change after decades, because the long studies were never done.

WHAT WE KNOW

• The cap: Automated collection may not run more often than twice in seven days, with at least two days between visits.
• The short file: In the 5,608-donor survey, high-frequency donors did not report worse day-to-day health than new donors.
• The average: Most donors come 14 to 17 times a year, a pace Jaworski calls one nobody will tell you is unsafe.

WHAT IS UNCONFIRMED

• Twenty years on: No high-grade study tracks people who donate at the cap for decades.
• IgG drops: Lower antibody levels show up in some work; whether that becomes more infections over time is still open.
• The right price: Without a long health cost, Gallagher argues, donors cannot tell if today’s fee is too low.

Health Canada suspended Grifols’s licence at its Taylor Avenue site in Winnipeg on September 23, 2026, the first time it had suspended a blood establishment licence, after inspectors said the quality system was still not in place. Rodiyat Alabede, a 22-year-old university student, died of sudden cardiac death on October 25, 2025, during a paid donation there. An autopsy found an enlarged heart. A second Winnipeg donor died in January 2026 after a visit at another clinic. In April 2026 the department said it had established no linkage between the deaths and the donation process. Grifols said donor and patient safety had not been compromised and that it was already working on a reopening plan. Alabede’s family has disputed the finding. The fight is over how a paid clinic is run, not over the U.S. twice-a-week rule, but it is the kind of case the missing 20-year file makes harder to close.

Nobody actually knows what the longer-term health costs of doing this twice per week might be. People who come into these plasma centers may assume that it has been determined that two times per week is based on clear scientific study and therefore it must be safe, otherwise the government would not allow that frequency.

Emily Gallagher, associate professor of finance, University of Colorado Boulder

The World Health Organization has long advised countries not to pay for plasma, citing harm from donations that come too often. The U.S. did not take that advice, and the rest of the medicine cabinet now depends on that refusal.

A Liter of Plasma Sells for About $190

Independent centers sell a liter for about $190, give or take $10, Jaworski estimates. Donors receive 30 to 40 percent of that, around $70, though a single visit usually yields 850 to 880 milliliters, so the $65 average fee and the $70-per-liter cut are not the same number. Staff, kits, testing, and rent take most of what remains. The center keeps about 8 to 12 percent, around $15 a liter. Raising donor pay, he argues, would raise the price of immunoglobulin, already among the costliest drugs on earth. “It’s about the patient,” he said.

Donors who live on the fee do not experience it that way. Chu built a pay tracker because the posted promo and the Tuesday-morning load are different numbers. Watts used the card for gas. In March 2026 he found part-time bakery work and moved out of his car into a spare room. He is still looking for a better job. He still lines up at 7 a.m. twice a week, the one appointment that does not bounce.

Jaworski wants foreign blood services to thank the American donor in public. They thank their own unpaid volunteers. They do not issue a release for the person who filled the other 48 percent. Until those countries collect for themselves, or until someone funds a 20-year health study, the global medicine supply will keep clearing through the same recliners, on the same 48-hour clock.

Disclaimer: This article is news reporting and analysis of plasma collection, donor pay, and published health research. It is informational only and is not medical advice, a recommendation to donate or to stop donating, or guidance on personal finances. Readers who are considering plasma donation, or who have had symptoms after donating, should talk with a licensed physician and follow the screening rules at the center they visit. Pay rates, center licences, and clinical findings reflect the documents and interviews cited here and can change as regulators, companies, and researchers update their records.