Transfusion Medicine | ORIGINAL ARTICLE Community attitudes to remunerated blood donation in Australia: results from a national telephone survey Hilary Bambrick 1,2 & Gisselle Gallego 1,3 1 Centre for Health Research, School of Medicine, University of Western Sydney, 2 National Centre for Epidemiology and Population Health, The Australian National University, and 3 Faculty of Health Sciences, The University of Sydney, Sydney, Australia Received 21 August 2012; accepted for publication 17 June 2013 SUMMARY Background: Blood in Australia is sourced through voluntary, non-remunerated donations. With periodic shortages in supply, increasing demand for blood products and a donor base that is perceived to be unsustainable, remuneration has been proposed as a means to improve donation rates. Objective: To examine community attitudes to remunerated blood donation in Australia. Method: A national random telephone survey of Australian adults age 18–70 was conducted (n = 1024). Associations were tested using a chi-square (χ 2 ) test for linear distribution. Results: Reimbursement for the cost of travel to donate blood was supported by more respondents (46%) than reimbursement for time (19%). Non-donors were more likely to support a payment compared to donors (P = 0·002). Twelve per cent of respondents thought they would be more likely to donate if remunerated while 10% thought they would be less likely. The majority (76%) thought that a payment would not change whether or not they would donate, while 85% thought that it would make other people more likely to donate. The average amount considered to be reasonable reimbursement was AU$30. Conclusion: Despite the common perception that other people would be motivated to donate blood with the introduction of a financial incentive, remuneration may provide minimal incentive in Australia and is unlikely to increase donor participation for the time being. Key words: Australia, blood donation, community attitudes, remuneration, survey. In Australia, blood is obtained from non-remunerated volunteer donors by the Australian Red Blood Cross Service (ARBCS) Correspondence: Gisselle Gallego, BPharm, PhD, Centre for Health Research, School of Medicine, Building 3, Campbelltown Campus, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia. Tel.: +61 2 4620 3949; fax: +61 2 4620 3891; e-mail: g.gallego@uws.edu.au (Australian Red Cross Blood Service, 2012). Voluntary, non-remunerated donation is strongly advocated by the World Health Organization (WHO) as providing the most stable supply with the lowest risk of transfusion-transmissible disease (World Health Organization, 2012). Despite alignment with the WHO’s ideals, the sustainability of voluntary blood donation as it stands in Australia is uncertain. Australia has one of the lowest rates of blood donation in the developed world with only 3% of the eligible donor population giving blood in a given year (Reid & Wood, 2008). Seasonal shortages are common, for example due to influenza and even outbreaks of mosquito-borne disease (Bambrick et al., 2009b). Furthermore the exclusion criteria to minimise the transmission risk of the variant Creutzfeldt-Jakob disease has reduced the donor pool by around 5% by disallowing donations from people who spent 6 months or more in the UK between 1980 and 1996 (Correll et al., 2001). Blood donors are derived from a volunteer population aged between 16 and 70 who must meet a number of stringent criteria (Australian Red Cross Blood Service, 2012). People aged 50 – 59 are the group most likely to donate (Flood et al., 2006). The demand for blood products is increasing while capacity for supply to meet growing demand is threatened. Novel therapies, and new applications of current therapies, is putting increasing demand on blood products (Bambrick et al., 2006), pressure that is augmented by the growing needs of Australia’s ageing population and an increasing prevalence of chronic disease. In tandem with this, age and ill health will, over time, disqualify a proportion of current donors unless there is a proportional increase in new volunteers. The Review of Australia’s Plasma Fractionation Arrangements (The Flood Review) drew attention to the shortfalls in Australia’s current system to deal with future demand and a decline in donor rates and suggested that ‘reimbursement or compensation for direct expenses related to blood donation’ (p. 141) could boost blood donation (Flood et al., 2006). Remuneration for blood donation in Australia is not an entirely a new idea (Whyte, 2003) but the debate on the shape a financial incentive might take and its potential effectiveness has been limited. Types of remuneration range from an in-kind item (for example, a token gift such as a cap or bag is offered in Norway) (Misje et al., 2005), to reimbursement for lost time and/or for travel expenses First published online 22 July 2013  2013 The Authors doi: 10.1111/tme.12062 Transfusion Medicine  2013 British Blood Transfusion Society