Transfusion. 2025 Nov 14.
OBJECTIVES: Public banking of umbilical cord blood (UCB) remains important as a source of donor cells for hematopoietic cell transplantation (HCT). Given reductions in global cord blood transplant activity, the economic value of UCB banking may be questioned. We performed a scoping review to gain a full and current understanding of economic evaluations of public UCB banking.
METHODS: We conducted a systematic search to June 2024 in Medline, Embase, Cochrane Central, Health Technology Assessment, Econlit, Scopus, and cumulative index to nursing and allied health literature (CINAHL) databases.
RESULTS: Our search identified 13 studies published between 1999 and 2019, predominantly from the United States and Europe. Of these, five are classified as full economic evaluations, with two employing cost-effectiveness analysis, one applying cost-utility analysis and two applying cost-benefit analysis. Key findings reveal a shift from evaluating the optimal inventory size and costs associated with establishing cord banks, to the evaluation of strategies that increase usage and reduce costs of bank operations. Only two studies considered the societal gain from transplant survivors, noting many cord blood transplant recipients are pediatric with significant gain in quality-adjusted life years that offset the high costs of operating public cord banks. Studies addressing the needs of underrepresented populations were lacking.
CONCLUSIONS: Our analysis highlights the evolving landscape of public UCB banking economic evaluations. Updated full economic studies are needed to understand the current landscape given potential usage by specific sub-groups of the population, reduced global usage for HCT, and the emergence of novel uses of cord blood.
Keywords: allogeneic; analysis; cost; economic; hematopoietic cell transplantation; public banking; umbilical cord blood; value