EXPLAINER: Donated Blood Is Free—So Why Do Patients Still Pay for It?

Blood donors give voluntarily and without payment. So why do patients and their families sometimes still have to pay when they receive blood?

The Philippine Red Cross (PRC)-Kalinga Chapter says the answer is simple: patients are not paying for the donated blood itself. They are paying for the services required to make the blood safe, properly processed, stored, and ready for transfusion.

PRC-Kalinga Chapter Administrator Raymund Mario Chan explained that while blood is collected from donors free of charge, blood service facilities incur costs for testing, processing, storage, equipment, personnel, and other procedures before a blood unit can be released to a patient.

The blood is donated. The processing is not free.

In an interview with Guru Press Cordillera, Chan cited Department of Health regulations allowing blood service facilities to collect reasonable service fees for blood and blood products, subject to DOH-prescribed maximum fees.

He explained that the fees cover the work that happens after donation.

“Technically, under Department of Health Admin Memo 2006-0003, that is already our policy wherein you're going to pay. Meron po tayong binabayaran na blood testing fee. So yun po yung mga coverage po ng pagbayad ng blood testing which is the TDIs or tinatawag natin na testing infection. Libre po yung dugo, technically kinuha po natin free, hindi naman po binayaran yung donor,” Chan said.

What does the fee cover?

According to Chan, the processing costs cover several steps involved in preparing blood for transfusion.

These include laboratory screening for transfusion-transmissible infections, blood processing, use of specialized equipment and facilities, proper storage, professional services, supplies, and logistics.

“We're going to pay for the testing, we're going to pay for the facility, we're going to pay for the agents, we're going to pay for our manpower—kasi hindi naman pwedeng hindi MedTech ang maghahawak,” he said.

Blood also cannot simply be placed in an ordinary refrigerator.

Proper blood storage requires specialized equipment and controlled conditions. The WHO notes that maintaining the correct “cold chain”—from collection and transportation to storage and transfusion—is essential because improper temperatures can affect blood components and increase the risk of bacterial growth and other safety problems.

How much do patients pay?

Chan said the fees cited by the PRC-Kalinga Chapter are:

₱2,100 — Whole blood

₱2,300 — Packed red blood cells (RBC)

₱1,500 — Platelets

These should be understood as processing/testing-related charges rather than the purchase price of the donated blood, according to Chan.

Actual charges may vary depending on the facility, blood component, applicable exemptions, and other services involved. For example, DOH facilities publish their own blood-service schedules, including fees for whole blood, packed RBCs, platelets, and crossmatching.

Why does blood need so much testing?

Blood donated by a volunteer cannot simply be handed directly to another person.

WHO recommends that donated blood be screened for transfusion-transmissible infections before it is used. This includes screening for infections such as HIV, hepatitis B, hepatitis C, and syphilis.

Chan said the process may also involve further validation when a test result is reactive.

“We need to validate and until such time na positive yung sakit niya and then we will coordinate with the government for the counseling, for the result. Hindi po talaga natatapos sa testing lang. Hindi po natatapos sa donation lang, until such time that you're going to be counseled,” he said.

This means the work does not necessarily end once a blood bag has been collected. Testing, validation, documentation, handling, and proper disposition of blood products are all part of maintaining a safe blood supply.

Why are platelets especially difficult to keep in stock?

Platelets require special handling and have a much shorter shelf life than many other blood components.

The WHO says platelet concentrates may generally be stored for up to five days, depending on the storage system and applicable requirements. They must also be kept under controlled conditions and continuously agitated to preserve their function.

This short shelf life makes regular donations particularly important, especially during periods when hospitals experience increased demand for platelets, such as during dengue outbreaks.

Kalinga’s blood demand remains high

The explanation comes as PRC-Kalinga continues to serve patients across the province.

As of the interview, the chapter had collected 1,745 blood units and assisted 653 patients, including 336 indigent patients. It had also served 1,581 blood bags.

The figures illustrate why maintaining a steady pool of blood donors remains important.

Blood cannot be manufactured, and because blood components have limited shelf lives, health systems need a continuing supply of voluntary donors.

What should patients bring when requesting blood?

Chan reminded patients and their families to bring the necessary documentation when requesting blood.

The request should indicate the:

Doctor’s signature

Required blood type

Number of units needed

Hospital where the patient is confined

Families should coordinate with their hospital and the blood service facility regarding any additional requirements.

What if the patient cannot afford the fee?

Chan said indigent patients who cannot afford the processing costs may seek assistance through government and social welfare programs.

He cited the Lumin-Awa Blood Samaritan Fund of the Provincial Government of Kalinga, headed by Governor James S. Edduba, which had provided 449 blood bags free of charge to indigent patients as of the interview.

Other partners, including the Office of the Governor and TAMPCO, also provide assistance to indigent patients, according to Chan.

Patients and families who need help are encouraged to coordinate with their hospital social workers or appropriate government welfare offices to determine whether they qualify for assistance.

The bottom line

The blood is donated. The safety process costs money.

When a volunteer gives blood, the donor is not paid for the blood. But before that donation can safely reach a patient, it must undergo screening, processing, storage, handling, documentation, and other procedures that require trained personnel, equipment, facilities, supplies, and electricity.

Understanding this distinction can help explain why a patient may still see a charge even when the blood itself came from a voluntary donor.

At the same time, the PRC-Kalinga Chapter continues to encourage eligible residents to become regular blood donors.

Because behind every blood bag is not simply a medical product—it is a voluntary gift that can give another person a chance to live.