The Evidence Base

Informing Policy in Health, Economics & Well-Being
A collaboration with
USC Dornsife Center for economic and social research

On the Value of Public Investment in Cord Blood Banking

Transplanted stem cells from umbilical cord blood can offer a lifeline to patients with certain disorders like leukemia, severe aplastic anemia and sickle cell disease. On average, approximately 43 percent of all cord blood transplants benefit pediatric patients. Cord blood provides a unique source of stem cells that are typically less differentiated than stem cells from other sources (bone marrow and peripheral blood), which allows less stringent donor-recipient matching and thus increases survival chances of those most at risk of not finding a suitable stem cell source.

Last week, the plan to reauthorize the C.W. Bill Young Cell Transplantation Program and the National Cord Blood Inventory was submitted by the Congressional Caucus to Cure Blood Cancers and Other Blood Disorders (introduced as H.R. 4764, the Timely ReAuthorization of Necessary Stem-cell Programs Lends Access to Needed Therapies [TRANSPLANT] Act).

The TRANSPLANT Act would allow for existing annual spending of $30,000,000 to continue between fiscal years 2021 through 2025 and would also encourage “collections of high quality”. This is positive news, given the results of our earlier work assessing the sustainability of the U.S. public cord blood system, led by Kandice Kapinos.

Our 2017 analysis found that the average annual value of having a national public bank system for cord blood ranges from $883 million to $1.7 billion, far outweighing the aggregate industry operational costs of $60 million to $70 million to maintain the current system (this includes other funding sources). We warned that the relatively low quality of cord blood units collected presented a challenge for both public and private cord blood banks as only units with a high total nucleated cell count are suitable for donations, and those represent only about 15 percent of units in public banks’ inventories. Another challenge we identified was the limited genetic diversity of cord blood units available in public banks.

In our report, we provide recommendations on how to make the system more efficient and sustainable, including specific ways to increase the diversity and quality of units collected, improvements to consistency in contract funding, and preparation of contingency plans should market conditions for cord blood banking deteriorate in the future. To learn more, see our Research BriefOur full report can be found here.

This research was sponsored by the U.S. Department of Health and Human Services, Office of the Assistant Secretary of Health.