Cost of umbilical cord blood units released for transplantation

BACKGROUND: A large number of institutions have started programs banking um bilical cord blood (UCB) for allogeneic unrelated-donor and related-donor t ransplantation. However, limited information is available on the financial issues surrounding these activities. STUDY DESIGN AND METHODS: The aim of this study was to determine the fee pe r UCB unit released for transplantation that would allow cost recovery afte r 10 years. Three organizational models were considered suitable to provide units for five UCB transplants per 1 million population per year, a figure that would translate into an annual need for 280 units in Italy. Models A, B, and C included, respectively, seven networked banks, each with an inven tory of 1,500 units; two networked banks, each with an inventory of 5,000 u nits; and one bank with an inventory of 10,000 units. It was estimated that it would take 3 years to develop the cryopreserved inventory and that appr oximately 3 percent of the inventory could be released and replaced each ye ar during the 7-year interval between the fourth and tenth years of activit y. The data on the costs of labor, reagents and diagnostics, disposables, d epreciation and maintenance, laboratory tests, and overhead, as well as the operational data used in the analysis were collected at the Milano Cord Bl ood Bank in 1996. RESULTS: Fees of US $15,061, $12,666, and $11,602 per unit released during the fourth through the tenth years of activity allow full cost recovery (pr inciple and interest) under Models A, B, and C, respectively. CONCLUSION: Although UCB procurement costs compare favorably with those of other hematopoietic cell sources, these results and the current fee of US $ 15,300 used in some institutions show that UCB is an expensive resource. Th erefore, judicious planning of banking programs with high quality standards is necessary to prevent economic tosses. The advantages of lower fees asso ciated with the centralized banking approach of Model C should be balanced with the more flexible collection offered by Model A.