Plasma protein and related products program
Meet Dr. Sylvain Grenier, director of our plasma protein and related products program
Sylvain has spent most of his life in service to others. Now, he’s using his experience as a clinical pharmacist to reshape our program and ensure all patients have access to the medication they need, when they need it.
As a leader in clinical pharmacy, Sylvain not only brings his wealth of experience and knowledge to Canadian Blood Services but also compassion and empathy.
“We always hear that medicine is an art, while pharmacy is a science. I’m very science-oriented on one hand, but at the same time I really like to have that contact with patients. Pharmacy brings the two together,” Sylvain says. “Patients understand better than anyone what it’s like to live with their conditions, so how they feel is important, and this must be seriously considered in our decision-making.”
In addition to his full-time role as the director of our plasma protein and related products program, he is an adjunct professor with the University of Ottawa’s faculty of medicine, a part-time pharmacist and a member of the Canadian Armed Forces Reserves. This follows a 28-year military career where he served overseas in Bosnia and Afghanistan and retired as national practice leader for pharmacy. As part of this role, he was responsible for the Canadian Armed Forces’ national drug program.
Prior to COVID-19, Sylvain also worked as a clinical pharmacist behind the counter at a small independent pharmacy in Gatineau once a week. There he would connect with people in the community, dispensing their prescriptions and offering health education and advice they can trust. Although the pandemic has put a temporary halt on his work at the pharmacy, Sylvain continues to bring his patient-first mentality to his role at Canadian Blood Services.
“This is the part that I like the most, to be able to help patients,” he says. “Often, pharmacists are the first line of health-care providers where patients can ask questions about anything regarding their health. We are easily accessible to the public.”
An intricate balancing act
Canadian Blood Services is responsible for ensuring a safe and secure domestic supply of plasma, and for minimizing potential risks and impacts of the growing global demand for plasma-derived medications, particularly immunoglobulins. As part of the program, Canadian Blood Services manages a national formulary of approximately 50 plasma protein and related products, which includes bulk-purchasing these medications on behalf of health systems to provide them to more than 700 hospitals and clinics in Canada. Funded by the provincial and territorial ministries of health, the sustainability of this program is vitally important to patient care.
The variety of plasma protein and related products available has significantly increased in the last decade, as has the list of illnesses that can be treated with these products — many being chronic conditions requiring lifelong treatment.
Managing this national program has become an intricate balancing act but it’s guiding purpose remains unchanged. Canadian Blood Services’ priority is to ensure patients continue to have access to consistent, effective and appropriate medications for their care while having a sustainable program for the provincial and territorial ministries of health.
A holistic approach
Since joining Canadian Blood Services’ team in 2019, Sylvain has brought more patient consultation into the product selection process for the national formulary. Representatives of patient groups are included at the table alongside physicians, health-care leaders and Canadian Blood Services’ medical, financial and supply chain experts, as products are considered.
“I think it makes quite a bit of difference when you approach the program as a clinician with the needs of patients in mind rather than just focusing on the products. We recognize that,” he says. “This is why Canadian Blood Services hired a pharmacist to lead the program — to make sure we consider the medical, scientific, economic and social aspects in a more holistic way.
“Ultimately, we select products for the national formulary based on the value they bring to patients in terms of efficacy and safety. Helping people, helping patients, this is our main goal.”
Equitable access across the country
Plasma protein and related products currently on Canadian Blood Services’ formulary are available to clinicians and their patients across Canada (except Quebec) with approved national criteria and/or recommended best practices for use. This means regardless of where a patient lives in Canada, or if they move within the country, Canadian Blood Services provides access to these medications.
Demand for plasma protein and related products is increasing, treatment options are expanding, and patients’ needs are changing. As the environment evolves, so do we. Most recently, we added expertise in clinical pharmacy to our program team.
We also know decisions affecting patients can’t be made in isolation. We consult with health ministries, clinicians, hospital blood banks, patient advocacy groups and experts nationally and internationally to ensure our program offers sustainable, effective and safe product choices that continue to improve patients’ quality of life.
National buying power
Plasma protein and related products are expensive when compared to other therapies. Buying products through a pan-Canadian approach gives provincial and territorial health systems bulk-buying power. This means we have opportunity to negotiate a lower price per product for Canadians. Over the years, our contract negotiations with manufacturers have totalled approximately $1 billion in savings and cost avoidance based on annual national demand forecasts.
Accountable supply chain
As the national blood operator, we have one country-wide network that can be leveraged in multiple ways. This means we can use our supply chain infrastructure for transfusable blood products to safely and efficiently provide plasma protein and related products to hospitals and health-care centres coast to coast at no additional cost to health-care systems or patients.
As use of these products grows worldwide, manufacturers are under increasing pressure to keep up with demand. Because it takes many months to make these products, they can temporarily fall into limited supply. If this were to happen, we would leverage our national inventory and supply chain and work together with health-care systems, clinicians, hospitals and clinics, patient groups and others to ensure the patients we serve receive necessary treatments.
From the donor bed to a patient’s bedside, we are involved every step of the way. As the national blood operator, we collect plasma from volunteer donors. We work with manufacturers with the goal of ensuring safe and effective plasma protein and related products are consistently available for patient care in Canada.
We collaborate with clinicians and hospital blood banks to share best practices and to understand how products are performing for patients. We are world leaders in blood research, and we monitor medical advancements and industry trends. All of this helps safeguard the national formulary for health-care systems and the patients we serve.
We are ready for today, and we are always planning for tomorrow. As the national blood authority, it is our job to ensure patients in Canada have access to the blood products they need in a manner that is fiscally responsible and sustainable. This includes understanding the needs of patients and trends in the use of plasma protein and related products in Canada and around the world. We also work collaboratively with health-care partners to improve patient outcomes and develop best practices for use by clinicians, and we are working to increase the amount of plasma we collect in Canada to continue meeting the demand for plasma protein products today and in the future.
By the numbers
241, 000 L of plasma
We collect plasma from volunteer blood and plasma donors across the country. Some of this plasma is transfused directly to patients, but most is used to make plasma protein products. Each year, we ship thousands of litres of plasma to manufacturers in the U.S. and Europe to make medications exclusively for use in Canada.
There are a variety of plasma protein and related products available through our national program. We work to ensure the right mix of products is available for patients at affordable prices for health-care systems.