Is cord blood banking cost-effective?

The "green journal" Obstetrics & Gynecology has published another article designed to discourage OB/Gyn's from supporting private cord blood banking.  This one is authored by maternal-fetal doctors at the University of California, San Francisco, Dept. of Obstetrics.

The study uses formulas that compute the public health cost-effectiveness of a medical intervention.  The authors apply these formulas to private storage of cord blood.  The computation requires a number of assumptions about medical parameters, including the likelihood of needing stem cell therapy, the likelihood of finding a bone marrow match, the chances that stored cord blood would be viable, etc.

The authors claim that, even under what they consider "optimal" assumptions for private cord blood banking, the collective expense to "society" (the families) is $352,931 per life year saved.  They consider that too expensive for a collection of families to spend saving a few children's lives, so in their opinion private cord blood banking is not cost-effective.

This study is flawed because:

1. The adopted assumptions, even in their "optimal case", underestimate the likelihood of using stored cord blood, according to Verter & Nietfeld 2010.
   
2. A public health formula is not applicable to a private family economic decision.  The actual cost to any one family is only about four thousand dollars spent on cord blood processing plus 18 years of storage.
3. It is unethical for doctors to dictate to parents how much they should spend trying to save one child's life.
   

References:
Kaimal, AJ, et al. 2009; Obstetrics & Gynecology 114(4):848-855
Verter, F. & Nietfeld JJ 2010; Cytotherapy 12: suppl. 1, abstract #157.