Tensions between private and public cord blood stem cell banking

27 March 2009

The Times newspaper has reported that some UK National Health Service (NHS) hospitals are refusing to permit private collections of umbilical cord blood at birth. Cord blood is a source of stem cells with the potential to be used for the treatment of serious diseases; both public and commercial stem cell banks store samples of cord blood for these purposes. However, public cord blood banks provide samples for the treatment of unrelated individuals; commercial companies may reserve each samples for the sole use of the original donor, although the Virgin Health Bank is a commercial bank that also requires an altruistic donation of a sample from each collection to a public resource. Of note, although cord blood retained for potential future use by the new baby would be a perfect tissue match, the probability of it being needed is extremely small. An individual receiving cord blood from a public resource would not receive a perfect tissue match – but, given a significantly large pool of available samples, it should be possible to identify a sample that will provide a satisfactory tissue match for transplantation purposes.

In 2008, the UK Human Tissue Authority (HTA) announced new regulations governing the collection of umbilical cord blood requiring that in hospital maternity units must be licensed to perform collections; licensing requires that hospitals meet certain minimum standards of procedure both for harvesting the cells and for maintaining care of the mother, as well as paying several thousand pounds (see previous news). Commercial banks now provide a licensed healthcare professional to perform the harvesting procedure.

The Times newspaper has reported that King’s College hospital in London and Watford General hospital in Hertfordshire have banned the collection of stem cells at birth for private (individual) storage, whilst permitting collections for donation to the public NHS Cord Blood Bank or Anthony Nolan Trust cord blood bank. Other hospitals such as the University College London hospital are reported to ban any personal collections of stem cells, including for donation to public banks (see Times report). Individuals who wish to store cord blood for private use – including those with strong personal reasons for doing so, such as the woman featured in the article, whose sister died from a rare blood disorder – may need to pay not only for private collection of the cord blood, but also to give birth in a private hospital that would permit this, which would be substantially more expensive. This could be seen as widening still further the inequity of healthcare services available to the majority of citizens and the few with significant personal wealth.

This is a particular issue in the UK, with a national public healthcare system. In countries where insurance-based medical care is prevalent, commercial cord blood banking is already booming, notably in Asia and the US. This month the merger of two cord blood banks Biocell and Cellsense to create Australia’s largest private cord blood bank, Australian Stem Cell Healthcare Pty Ltd, was announced, making it possible for parents have cord blood collected after giving birth in any hospital in Australia. Biocell chief executive Professor Mark Kirkland also commented that “…the size of Australian Stem Cell HealthCare Pty Ltd gives us the power to lobby government and private health funds in order to make storage of cord blood stem cells an affordable and essential service for all Australians, which is in line with international endeavours" (see NineMSN news report). Whilst donors retain ownership of the samples, the companies are reportedly involved in collaborative research into stem cell therapeutics (see LifeScientist news article).

Meanwhile in the US, new legislation has been introduced that would provide tax advantages for families paying for cord-blood banking (see press release). The Family Cord Blood Banking Act would amend the Internal Revenue Code to add cord blood banking services as a qualified medical expense, allowing individuals to pay for it via flexible health savings or reimbursement systems, or to include it with other tax-deductible medical expenses (see press release).

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