processing requirements will probably lead to increased costs, so we have assumed processing costs toward the higher end of the range reported. We have not adjusted for the impact of economies of scale on the collection costs incurred by a national bank.

Cost of Transplantation (cT)

We assume that transplanted patients incur costs of $220,000 over a one year period, based on figures reported in Lee et al. (1998). We lack the data to compute net lifetime costs for these patients.

Administrative Costs (A)

The collection and storage cost estimates from the blood bank survey are average costs and thus include overhead costs. However, we assume that a national cord bank will incur additional administrative costs for oversight, research, and analyses such as this one. We assume that A = $1,000,000.

Discount Rate (r)

We assume that r = 0.03, based on the recommendation of the Panel on Cost-Effectiveness in Medicine and Health (Gold et al., 1996).

Initial Inventory (N0)

Based on data listed on www.bmdw.org, there are approximately 80,000 cord blood units currently in storage in the United States. However, the quality of these units is uncertain because many were processed and stored using protocols that would not meet the standards likely to be adopted by the committee. Thus, the existing inventory is below 80,000 units, although it is difficult to say by how much. For this analysis, we assume that the initial, usable inventory is 50,000 units.

Initial Endowment (E)

Congress has appropriated $9,000,000 for establishing a national cord bank.

Cost Estimates

Table E-6 displays the results of the cost analysis. We estimate that the break-even fee for an inventory level of 50,000 units is $15,336. This figure



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