Canadian Blood Services reducing reliance on U.S. for life-changing plasma drugs

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TORONTO — For years, Stephane Cliche was a healthy avid athlete, but he kept getting sinus and respiratory infections and doctors couldn’t figure out why.

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It wasn’t until he was diagnosed with non-Hodgkin lymphoma in 2016 that it became clear his immune system didn’t work properly.

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Cliche got immunoglobulin — a cocktail of antibodies from donor blood plasma — as a standard treatment taken alongside chemotherapy, which often knocks down patients’ immune systems.

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Months after he stopped both the chemo and the immunoglobulin infusions, his health-care team did a followup blood test and found he had very few of his own antibodies — and would need to continue regular immunoglobulin injections to function as his immune system.

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Now 51, the Ottawa college instructor credits those weekly doses with allowing him to live a normal, active life.

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“If I would not be on the immunoglobulin, I probably could not work full time,” Cliche said, noting that it would be dangerous for him to be exposed to students without immunity to fight off viruses and bacteria.

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“I would start getting infections repetitively.”

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Cliche is just one of thousands of Canadians who rely on immunoglobulin made from plasma — the pale yellow liquid part of your blood that’s left over after red blood cells are separated out. According to Canadian Blood Services, the demand for immunoglobulin is rising every year, but 70 per cent of Canada’s supply comes from international sources — mostly the U.S.

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Although there is no current shortage of immunoglobulin in Canada, the current political climate of protectionism in the U.S., coupled with the “dramatic” demand projected to increase about 10 per cent each year, could put the supply at risk, said Dr. Graham Sher, CEO of Canadian Blood Services.

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“It is critically important that Canada become more domestically self-reliant in making immunoglobulins in this country,” he said.

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The need for more immunoglobulin production is driven by several factors, he said, including more cancer patients getting the antibody treatment while their immune systems are suppressed through chemotherapy, as well as a growing and aging population adding to the number of immune system-related diagnoses, including autoimmune disorders.

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Meeting more of that demand means driving up donation rates to get the raw plasma needed, then manufacturing the end product of immunoglobulin drugs here in Canada, Sher said, creating “truly a domestic end-to-end supply chain.”

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Right now, about 30 per cent of the plasma for immunoglobulin production comes from donors in Canada, then is sent to manufacturing facilities in the U.S. and Europe. Those manufacturers return the finished product to Canada. Much of the rest of the immunoglobulin is made from plasma collected from American donors.

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“Our long-term strategic goal is to achieve a minimum of 50 per cent domestic self-reliance — meaning of all the immunoglobulin used by Canadian patients, at least 50 per cent will be collected from Canadian donors and manufactured in Canada for Canadian patients,” Sher said.