Cord blood transplantation, a cost-effective alternative: a health-economic analysis of the National Swedish Cord Blood Bank

New IHE publication on annual costs and revenues associated with the National Swedish Cord Blood Bank (NS-CBB)

Hematopoietic stem cells (HSC) can be used to treat life-threatening conditions such as severe immune deficiencies in children and to treat leukemia or other severe blood diseases or malignancies in both children and adults.

Since 2006 umbilical cord blood has been collected in Sweden and stored at the Sahlgrenska University Hospital in Gothenburg in the National Swedish Cord Blood Bank (NS-CBB). The NS-CBB is altruistic and publicly funded.

The aim of the analysis was to investigate costs and revenues associated with the NS-CBB and to estimate whether the NS-CBB could be considered cost-effective concerning the costs in relation to survival and health-related quality of life (HRQoL) of those patients who receive cord blood as source of hematopoietic stem cells.

The results are presented as an illustrative example with calculations based on information available from authorities, interviews with the NS-CBB staff and scientific publications. Costs are presented as Euro at 2015 price level.

The annual costs and revenues of the NS-CBB is about EUR 1.3 million. Additional direct and indirect costs for each stem cell transplantation are estimated at between EUR 186 000 and EUR 277 000 depending on patient age. Between 5 and 10 patients are treated annually with stem cells from the NS-CBB.

The cost-effectiveness ratio could be estimated at approximately EUR 14 000 per QALY (quality adjusted life year) if 10 patients per year would be treated.

For patients treated with stem cells from the NS-CBB, there is often no other available treatment alternative. An altruistic cord bank with the possibility to collect stem cells from donors of different ethnicity is important from a perspective of equality.