Plasma collection in Italy reached all-time highs in 2023, but self-sufficiency of this blood component is still a long way off due to increased demand for immunoglobulin. This is what emerged from the second edition of "The Supply of Plasma-derived Medicinal Products in the Future of Europe," an international plasma conference that brought together experts and policymakers, donor and patient associations, as well as Italian, European, and international organizations. According to data given at the conference, Italy achieved 62% immunoglobulin self-sufficiency in 2023, two percentage points lower than the previous year. The paradoxical aspect is illustrated by the data from the 2023 collection, which, with its 880 thousand kilograms of plasma - the result of generous donations from about 1.5 million donors - has reached the greatest levels ever seen in Italy. The nation deviated from its strategic objective of attaining autonomy in the domain of plasma derivatives due to a substantial surge in the need for immunoglobulins, which escalated from approximately 104 grams per thousand inhabitants in 2022 to 108 in 2023, representing an increase of 3.8%. Italy, which is self-sufficient in red blood cell collection, must thus rely on the international market to supply the demand for plasma derivatives and supplement medicines, which are also employed in life-saving therapy and are made from plasma collected through voluntary, anonymous, and unpaid contributions. The national health system's inability to produce plasma-derived medications on its own continues to be a strategic issue.