2023-08-03 12:15:03
The blood system and the need for the sick do not go on vacation. However, there is a lack of plasma in Italy, “with serious consequences for patients who need life-saving drugs”. The alarm comes from Massimo Marra, president of the Italian association of dysimmune neuropathies patients (Cidp Italia aps), who warns: “Donations and collections are not sufficient to cover the national need for plasma and our country is still far from self-sufficiency, with heavy consequences for many patients who need plasma-derived drugs for their treatment, often life-saving. Short and long-term interventions are needed”.
Currently – reports Cidp Italia aps – Italy is only 70% self-sufficient; the remaining 30%, necessary to fully satisfy the need for plasma derivatives (albumin and immunoglobulins) and guarantee access to therapies for all patients, comes from the foreign market, in particular from the United States. This involves an international competition to win the little product available, as well as an increase in prices.
Plasma is the liquid component of blood, a limited resource by definition because it comes from voluntary donation and cannot be produced by chemical synthesis. For example, from plasma fractionation three classes of proteins are extracted that have therapeutic value for patients who need them: immunoglobulins, albumin and coagulation factors, which often have life-saving value for patients suffering from some rare pathologies. The current situation of plasma shortage, therefore, is seriously endangering the health of many patients. One example among many is that of patients suffering from dysimmune neuropathies, a group of rare pathologies of the peripheral nervous system, which are treated mainly with plasma derivatives, especially immunoglobulins.
“Immunoglobulin-based therapy – explains Marra – tends to reduce or eliminate symptoms that can be motor and/or sensory and affect both the legs and the hands, and is essential to allow patients to continue to carry out basic daily activities such as walking, and therefore being autonomous in movement, and grasping objects without them falling.When one does not have access to the drug, or its availability is not sufficient to best treat the pathology, there is an increase in disability and in some cases it can even lead to the loss of autonomy in personal hygiene”. The president of Cidp Italia aps then mentions the case of patients suffering from dysimmune neuropathies who need therapeutic continuity. “To obtain the drug necessary to cover the daily requirement of a patient with dysimmune neuropathies – he remarks – an average of two plasma donations are required, a truly significant number if compared to a year. For a patient weighing about 70 kg, for example , as many as 1000 plasma donations per year may be needed.”
“It is undeniable – acknowledges Marra – that the Italian system, as a whole, has demonstrated an enormous capacity to deal with the Covid emergency, resisting much better than other countries. But the pandemic is over and the quantity of drug currently available is lower than in the pre-Covid period.As a patient association, we collect reports from all over Italy which generally indicate dose reductions, increase in the interval between one administration and the next, transition to alternative therapies with less efficacy and greater side effects , or even an interruption of treatment. To solve the problem of plasma and plasma-derived shortages it is necessary to adopt concrete short- and long-term measures, starting with spreading a greater culture of donation, through awareness-raising activities throughout the national territory” . It is also necessary “to increase the available structural, human and economic resources. The equipment in the health facilities, the medical and nursing staff dedicated to transfusions and withdrawals, the collection centers and opening hours”.
“The major criticality that we see at the moment as an association – testifies the president of Cidp Italia aps – is that self-sufficiency is a national objective, but collection is a regional responsibility and unfortunately there are few regions that are really increasing it. In meanwhile, the Italian system is incapable of procuring the necessary quantities abroad”, concludes Marra who hopes “a strong national governance will soon be established so that all patients who need to be treated with plasma derivatives have equal opportunities to access these drugs, regardless of region of residence and from the center where they are being treated”.
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