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Cost-effectiveness of Private Umbilical Cord Blood Banking

Kaimal, Anjali J. MD, MAS; Smith, Catherine C. MD; Laros, Russell K. Jr MD; Caughey, Aaron B. MD, PhD; Cheng, Yvonne W. MD, MPH

doi: 10.1097/AOG.0b013e3181b8fc0d
Original Research

OBJECTIVE: To investigate the cost-effectiveness of private umbilical cord blood banking.

METHODS: A decision-analytic model was designed comparing private umbilical cord blood banking with no umbilical cord blood banking. Baseline assumptions included a cost of $3,620 for umbilical cord blood banking and storage for 20 years, a 0.04% chance of requiring an autologous stem cell transplant, a 0.07% chance of a sibling requiring an allogenic stem cell transplant, and a 50% reduction in risk of graft-versus-host disease if a sibling uses banked umbilical cord blood.

RESULTS: Private cord blood banking is not cost-effective because it cost an additional $1,374,246 per life-year gained. In sensitivity analysis, if the cost of umbilical cord blood banking is less than $262 or the likelihood of a child needing a stem cell transplant is greater than 1 in 110, private umbilical cord blood banking becomes cost-effective.

CONCLUSION: Currently, private umbilical cord blood banking is cost-effective only for children with a very high likelihood of needing a stem cell transplant. Patients considering private blood banking should be informed of the remote likelihood that a unit will be used for a child or another family member.

LEVEL OF EVIDENCE: III

Given the current limited indications for umbilical cord blood stem cell transplant, private umbilical cord blood banking is not cost-effective.

From the 1University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences and 2Department of Medicine, Hematology/Oncology Division, San Francisco, California.

Dr. Caughey is supported in part by a grant under the Robert Wood Johnson Foundation Physician Faculty Scholars Program.

Presented as Abstract #332, Poster Session II, at the 29th annual meeting of the Society for Maternal-Fetal Medicine, January 26–31, 2009, San Diego, California.

Corresponding author: Anjali Kaimal, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 505 Parnassus Avenue, Box 0132, San Francisco, CA; e-mail: ajkaimal@gmail.com.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.