Assessing the financial resources required to establish convalescent plasma collection programmes across Europe in response to a pandemic

Background: During the COVID-19 pandemic, convalescent plasma (CP) was investigated as a potential treatment. We assess the financial resources required to implement a COVID-19 CP (CCP) programme and provide recommendations on how best to prepare for collection and use of CP in future pandemics. Study Design and Methods: We mapped pathways for collecting and manufacturing CCP using a UK blood establishment as a test case, and identified the resources required at each stage to provide high-titre (HT) CCP units. A top-down micro-costing approach and an economic model were used to establish the cost per HT CCP unit. Data collection questionnaires were later prepared to acquire data from 21 countries across Europe, facilitate comparisons and estimate costs per HT CCP unit using a top-down gross-costing approach. Costs are reported in Euros adjusted for cost-of-living differences. Results: The key cost driver for England was the cost of CCP collection. Nine countries responded, four with existing infrastructure for apheresis plasma collection at the start of the pandemic and five without. Four countries provided sufficient data to estimate the cost per HT CCP unit, which varied between €198-€265 for countries with pre-existing apheresis plasma collection, and €807-€1,749 for those without. Discussion: Countries had marked differences in the scale of CCP collection, and methods of selecting and measuring HT CCP, which contributed to the variation in expenditure observed. Costs were significantly lower in countries with existing infrastructure for apheresis plasma collection and where donors were tested for anti-SARS-CoV-2 antibody titre before attending plasma collection.