Cost effectiveness of Iran national plasma contract fractionation program

Although blood as a very precious human resource has been used for direct transfusion for centuries it has recently become increasingly important to separate the manufacturing aspect of blood as a source of pharmaceutical “raw material”. The process of separating blood into its components will result to plasma as a rich source of human proteins for further manufacturing of plasma derived medicines (PDM). Fractionation of plasma could provide a wide range of medicines essential for management of patients with bleeding and immunological disorders. Coagulating factors including factor VIII (FVIII), factor IX (FIX), von willebrand factor, fibrinogen, fibrin sealants, prothrombin complex concentrate, albumin and immunoglobulins (IG) are among the most used PDM around the world. Some of these medicines including coagulation factors concentrates and IG are on the WHO Model List of Essential Medicine emphasizing their clinical importance. Primary immune deficiencies (PID) and bleeding disorders such as haemophilia are among the most important disease require PDM for their management. The majority of patients with haemophilia or PID are currently not receiving adequate treatment, and the numbers of these patients being diagnosed are increasing.Global need for PDM have been increasing almost geometrically over the last decade and based on evidences for new indications of this medicines it seems that administration of PDM will increase for years to come [1]. Despite introduction of biotechnology for production of some of these medicines including clotting factors VIII and IX availability of others such as normal and hyperimmune IG and even albumin is limited only by the availability of plasma as their raw material for fractionation. It is estimated that every year about 30 million liters of plasma fractionated worldwide [2]. However, there are considerable discrepancies among countries in production and fractionation capacities for human plasma. Currently most plasma collectio