Blood donation is valuable, so why not pay donors?

Need more blood donors? Economists have a suggestion: Pay them.

For nearly 40 years, efforts to compensate people for donating blood have been discouraged by the World Health Organization. In the United States, the American Red Cross says “all blood collected for transfusion in the United States must be from volunteer donors.”

But the authors of an essay published in Friday’s edition of Science challenge the rationale for such policies, which presume that the highest-quality blood comes from altruistic donors. The types of people who would donate blood only if offered compensation (i.e. intravenous drug users) are more likely to be people with bloodborne infectious diseases (i.e. HIV or hepatitis) — or so the thinking goes.

Such concerns are unfounded, write Nicola Lacetera, Mario Macis and Robert Slonim. Among the reasons:

* Donated blood can be screened to make sure it’s safe to use for transfusions.

* By offering incentives to those who show up for a blood drive rather than those who actually donate, there’s little incentive for would-be donors to lie about their health history.

* A field trial in Argentina that offered supermarket vouchers worth roughly $11.50 or $19.20 (in U.S. dollars) boosted blood supply without having any effect on safety.

As the Argentina trial showed, financial incentives work. The economists reviewed 19 cases of “incentive items” being offered to encourage people to donate blood, including coupons, T-shirts, lottery tickets and an extra vacation day. In 18 of those 19 cases, the enticements worked — and the more the reward was worth, the more blood donation increased. The only “incentive” that was a dud was a free cholesterol test.

The economists also noted that donors of blood stem cells can be paid thanks to a 2011 federal appeals court ruling.

It may not be feasible to offer financial incentives to blood donors all the time, but the evidence clearly shows that they can be put to good use when the need is great.

“Rewards can successfully address temporary shortages,” the authors wrote. “It is time to reexamine policy guidelines for increasing and smoothing blood supply, including whether incentives can play a role.”

You can read a summary of the Policy Forum essay online here.

Return to Science Now.