Inspired by the analytical shift toward understanding altruism from an institutional perspective, this article presents an empirical analysis of the impact of institutionalized solidarity on attitudes toward payment for blood or plasma donations, in terms of both the level of welfare provision and confidence in the welfare system. Postulating that institutionalized solidarity is intertwined with group-based solidarity, this article offers a more refined understanding of the relationship between institutional context and attitudes toward paid donation by incorporating measures of social cohesion in the analysis. Based on Eurobarometer data from 2014, the results indicate that support for cash payment for donation is lower in European countries where social spending is higher. Similarly, aggregated levels of trust in the social security system are associated with less support for payment for donation. These findings point to the importance of institutionalized solidarity for the manifestation of support for non-remunerated blood and plasma donation.