Donor management: DOMAINE – the European perspective

Abstract

Background: In Europe, donor management faces several challenges, some of them with considerable political weight. 1. Migration: Migration throughout Europe has enormous effects on blood product supply and demand. Migrant populations show different disease patterns with different demands, while available data suggests that migrants tend not to be a blood donor in their new country. 2. Commercial activities: Commercial blood establishments now operate in 20% of the European countries. Commercial organizations are active in these countries that collect and process plasma. Non-remuneration of blood donors still is the written basic principle handled throughout Europe. However, in the plasma derived pharmaceutical business, paid donors do occur throughout the world, including the Americas and Europe. 3. Competition in the blood product supply chain: The debate on introducing competition in the field of blood supply for direct use in patients is growing throughout Europe. Pricing of blood components and access to donors are the major arguments for starting this debate. Competition and donor management: In case competition occurs, some aspects of donor management need special attention. Requested/potential donor base: The product range and market share of the blood establishment in question are the determinants for the qualitative and quantitative requirements of the donor base needed. For example, if a blood establishment decides to produce only apheresis plasma and only non-sub typed ABO-red cell and platelet concentrates for the lowest possible price, then the donor base will be essentially different from the donor base needed to produce the full range of blood products and blood components. Quality/Safety balance: Minimum quality and safety standards are laid down in European Directives and must be met by each blood establishment. However, a rise in quality assurance inevitably has its price. The precautionary principle confronts blood establishments with possibly large costs. Therefore, in straightened economic circumstances, the precautionary principle will, likely, be the first to be attacked with a subsequent potential rise in patient risk. Additional products and services: To remain attractive business partners for hospitals, a blood establishment could decide to offer additional services, such as 1. Additional and sub typed products: tissues, red cells and platelets; rare blood groups 2. Stem cells, including cord blood units 3. Product advice; consulting To remain attractive to donors, a blood establishment could offer them services, such as 4. Lifestyle advice 5. Periodic health check 6. Conditional sale (e.g. reduction in insurance premiums) Concluding remarks: 1. Migrational effects require adjusted recruitment/retention strategies throughout Europe. 2. Blood establishments must anticipate fluctuations in both their client base (shopping hospitals) and donor base (shopping donors) in case competition and commercialisation in the blood product supply chain emerges. 3. The introduction of competition in donor management may influence the supply of blood products qualitatively and quantitatively