2 decades later, why cord blood banking fails to gain traction in India

Cord blood banking, touted as a revolutionary healthcare innovation, is yet to gain popularity in India despite its availability in the country for nearly two decades.

The cord blood banking market in India is worth only ₹300 crore a year and growth over the years has been low, in single digits over the years. Compared to this, the global stem cell banking market is projected to reach $9.41 billion by 2023 from $6.29 billion in 2018, at a CAGR of 8.4% from 2018 to 2023, according to various research estimates.

While globally, 60,000 plus transplants happen annually using cord blood stem cells, that in India is only around 3,000 transplants a year. In nearly two decades, companies like LifeCell, CordLife, CryoViva, etc. have banked nearly 700,000 units of cord blood in the country. Of this, the Indian pioneer LifeCell, started in Chennai in 2004 a decade after cord blood banking was started in the U.S. in 1994, still holds more than half the Indian market. It banks over 40,000 units.

Tissues from the stored cord blood can be used for curing diseases like complex auto-immune disorders such as arthritis, respiratory diseases, regeneration of bones, soft tissues repair (cartilage in spinal cord), etc.

"Although I feel more transplants are needed in India and more can happen, there is not much awareness regarding the procedure, nor is obtaining a match an easy process. Stem cell registries are existent, although it is extremely difficult to find a match. And even if they do, people sometimes refuse to carry the donation forward," Mayur Abhaya, managing director and CEO — LifeCell International, told Fortune India.

He says some public banks like Jeevan Stem Cell Bank are now being shut down and this industry needs more investments and increased awareness to tap its potential. Community cord blood banking is an option to popularise and optimise potential of cord blood banking, he says.

LifeCell’s cord blood banking service ensures 98% match to those registered and the stored samples have undergone various tests. Hence it would only take a few days to obtain a match in comparison to other banks where it might take months to avail a match, he says noting that the industry in India is still in a nascent stage. "We should remember these units are not stored for immediate use and the probability of requirement of the unit increases only by age," he says.

Companies like LifeCell charges ₹20,000 for the first year, which covers extraction and transportation charges, post which ₹4,000 per year will be charged as storage fees. The storage also comes with medical insurance of ₹20 lakhs and free worldwide shipping of the units in case the procedure takes place outside India.

Apart from cord blood storage services, LifeCell now offers genetic testing for more than 4,000 conditions. "The testing constitutes pre and post pregnancy tests that can help determine the nature of the fetus and can be crucial in determining whether one should carry on with the pregnancy or not. We are now the largest provider of genetic testing in India for mother and child", says Mayur Abhaya.

LifeCell has also entered into therapeutics by marketing stored placenta as a product for wound management. Tissues obtained from the placenta help heal wounds, especially like diabetic foot ulcers, that are difficult to heal. It is already a billion dollar industry in the U.S.

LifeCell has been conducting clinical trials with the umbilical cord tissue (different from the stem cells obtained from the cord blood that is stored in banks) to manage Covid-19 related ailments, to help help patients with acute respiratory disorders. About 40 patients are under trial and the results are expected by end of the year. It is also researching post-transplant recovery. Usually after a transplant, it takes time for the body to form a full immune system until they are in an immunocompromised state. "Our research now consists of multiplying the cells in the lab itself before to avoid prolonged immunocompromisation, and bolster quick recovery," he says.

LifeCell is also conducting trials to reduce toxicity levels that come with transplants, by using stem cells to wipe out chemotherapy drugs. If successful, the treatment can reduce a lot of transplant-associated deaths. The treatment involves using a mixture/cocktail of stem cells from bone marrow stem cells.