GAO report on National Cord Blood Inventory


As a condition of their renewed funding for public cord blood banking, Congress required the U.S. Government Accountability Office (GAO) to conduct a study on the economic viability of the national cord blood program. The report is titled "Practices for Increasing Availability for Transplants and Related Challenges". (download the 39 page pdf file)

Here are some interesting facts in the report:

The organizations NMDP and CIBMTR forecasted that, by the year 2015, there should be over 10,000 patients per year having stem cell transplants from unrelated donors. (Reference: Talk on "Unmet Needs" presented to the HRSA Advisory Council Nov. 2011)

Instead of rising, in recent years the rate at which the NMDP has been releasing cord blood transplants has been nearly flat, even though the cost per cord blood unit has remained constant at $30K during this time frame. (Reference: GAO pdf file p.26) A wider review suggests that there are multiple factors impacting patient access to transplants.

NMDP sales of cord blood units for transplants:
2005-2006 sales increased 13.6 %
2006-2007 sales increased 38.4 %
2007-2008 sales increased 00.2 %
2008-2009 sales increased 10.4 %
2009-2010 sales increased 00.4 %

The NMDP is considering raising the minimum threshold for storing donations from 90 million to 1.25 billion TNC (TNC = Total Nucleated Cells). A review of their inventory shows that the largest units are the most likely to be released for transplant.  Hence if they only bank the largest units, they will only be spending money on the ones that are most likely to yield a return on investment.

However, only the biggest babies and the best cord blood collections have this many cells. It is estimated that raising the threshold to 1.25 billion TNC would result in only 10% of cord blood donations being accepted.  Also, it would be detrimental to HRSA's goal of increasing the genetic diversity of the donor pool, because African American collections tend to have smaller volumes and lower stem cell counts than Caucasians.

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