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论脐带血供应的价值。

On the Value of the Umbilical Cord Blood Supply.

机构信息

RAND Corporation, Arlington, VA, USA.

RAND Corporation, Arlington, VA, USA.

出版信息

Value Health. 2018 Sep;21(9):1077-1082. doi: 10.1016/j.jval.2018.03.003. Epub 2018 Apr 12.

Abstract

BACKGROUND

Several public cord blood banks are struggling financially, and the question remains as to whether additional allocations of funds to them are justified.

OBJECTIVES

To estimate the social benefits of public cord blood bank inventory net of cord blood banks' operational costs.

METHODS

We used publicly available data from the Health Resources and Service Administration on the number of annual cord blood transplants as well as the patient age distribution in 2010, and the survival estimates between 2008 and 2012 for the several diseases treated by cord blood transplantation. Data on aggregate annual costs to the cord blood industry for recruitment, processing, and storage were obtained from published work. We used estimated increases in life expectancy due to treatment using umbilical cord blood and value for life-years gained to estimate the social benefits of the public cord blood inventory annually.

RESULTS

We found that the annual social benefits of between $500 million and $1.5 billion outweigh the current operational annual costs of running cord blood banks of $60 to $70 million by a significant margin.

CONCLUSIONS

We estimated that the annual social benefit of having a cord blood system far outweighs its costs, by more than an order of magnitude. Thus, the social benefits of maintaining the US public cord blood banking system at the present time far outweigh the costs of collecting, storing, and distributing cord blood. This suggests that there is a potential justification for government intervention to align social benefits and costs. Nevertheless, simple fixes may produce unintended consequences, and so a careful design for subsidies is needed.

摘要

背景

一些公共脐带血库在财务上举步维艰,因此仍需探讨是否应向这些脐带血库额外拨款。

目的

估算扣除脐带血库运营成本后公共脐带血库库存的社会效益。

方法

我们使用了卫生资源和服务管理局公布的 2010 年每年脐带血移植数量和患者年龄分布的数据,以及 2008 年至 2012 年几种通过脐带血移植治疗的疾病的存活率估计数据。从已发表的研究中获得了脐带血行业每年在招募、处理和存储方面的总年度成本数据。我们使用脐带血治疗预期寿命的估计增加和生命年收益来估算公共脐带血库存的年度社会效益。

结果

我们发现,每年 5 亿美元至 15 亿美元的社会效益远远超过了目前运营脐带血银行每年 6000 万至 7000 万美元的运营成本。

结论

我们估计,拥有脐带血系统的年度社会效益远远超过其成本,相差一个数量级以上。因此,目前维护美国公共脐带血库系统的社会效益远远超过收集、储存和分发脐带血的成本。这表明政府干预以平衡社会效益和成本是有潜在理由的。然而,简单的修复可能会产生意想不到的后果,因此需要谨慎设计补贴。

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