Plasma proteins: Unique biopharmaceuticals – Unique economics

Abstract

Human plasma is used to prepare essential therapeutic products with unique features compared to traditional pharmaceutical products and other biopharmaceuticals. The raw material is inherently unique due to its human origin. The need to fulfill strict collection practices and testing, and the shrinking population of eligible donors, limit plasma availability and influence greatly the economics of the whole plasma industry. Consolidation in the industry has amplified and is making access to plasma, a highly valuable natural commodity, more difficult. In this industry, plasma has become the single most important factor of the cost of end-products. In addition, the fractionation of human plasma is a “cracking” process where manufacturing technologies must allow extracting an economically balanced portfolio of products with appropriate quality, safety, and recovery profiles. Over the years, although the size of production batches has generally increased (within limits accepted by regulatory authorities), the manufacturing costs of plasma products have increased as production methods have become more complex (in particular with the introduction of viral reduction treatments) and product recovery has been affected negatively (especially for coagulation factors). Therefore (a) ensuring the production of at least 3 to 4 products from each batch of plasma and (b) economies of scale have been leading to major consolidation in this industry to ensure appropriate allocation of plasma and manufacturing costs. Efforts need to be pursued to improve the efficiency of the fractionation process, improve proteins recovery, and expand the universe of ailments treatable by niche plasma products to enhance plasma utilization and cost-sharing potentials. Historically, the supply of plasma products has never met the global needs and has averaged a 20–80% deficiency. To date, the inherent economical requirement to ensure a production balance of at least 3 or 4 products from plasma implies that with current fractionation technologies and current reimbursement practices, shortage of market-leading products, like immunoglobulins or alpha 1-antitrypsin, will continue if not worsen.