Sep 29, 2017
We describe the existing public cord blood bank system, assess current trends and economic relationships of key stakeholders, and provide recommendations to improve the economic sustainability of the system. We propose changes to the federal program to buttress banks' financial stability. We found a system valuable to society and worthy of public investment, especially to improve the genetic diversity and quality of the national inventory.
Hematopoietic stem cells (HSCs) — from bone marrow, peripheral blood, or umbilical cord blood — are used to treat patients with cancers such as leukemia or lymphoma, disorders of the blood and immune systems, severe aplastic anemia, sickle cell disease, and certain inherited metabolic diseases. In addition to cord blood's direct therapeutic value to patients, it is also used for basic research on blood, blood stem cells, and immune cells.
In recent years, the U.S. government (through the Health Resources and Services Administration) has endeavored to increase the overall national inventory — which currently contains over 200,000 units — as well as the number of high-quality units and the number of units from racial/ethnic minorities. Despite the important clinical and research roles of cord blood products and a clear public health need for increasing and diversifying our national inventory, little is systematically known about the economics of the industry, including what banks' costs and revenues are, cost structures and determinants of financial health, successful collection efforts for cord blood banks (CBBs), whether the market is competitive or similar to a public goods market, and the role of the government in the market.
In this report, we aim to fill these knowledge gaps by (1) describing the existing public CBB system, (2) assessing current trends and economic relationships from the perspective of key stakeholders in the public CBB system, and (3) providing recommendations to improve the economic sustainability of the public CBB system.
Overview of the U.S. Cord Blood System
Trends Affecting Public Cord Blood System Sustainability
Trends in Public Cord Blood Banking and Shipping
Economics of Cord Blood
Cord Blood Bank Financial Sustainability
Factors Shaping the Public Cord Blood Sector's Future
Government Intervention in the Public Cord Blood System
Themes, Recommendations, and Conclusion
Donor Race/Ethnicity Matches