A decision-analytic model published in Blood directly compares non-myeloablative haploidentical allogeneic stem cell transplantation (NMAC-HID allo-HSCT), gene therapy, and standard care, concluding that transplantation delivers superior long-term value for adults with sickle cell disease. Unlike randomized trials, this study relies on synthesized inputs from prospective cohorts and registry data rather than primary randomization, limiting causal certainty but enabling explicit cost thresholds. The model shows gene therapy prices must fall 66-71% to match transplant value, a finding that extends beyond the MedicalXpress summary by highlighting payer implications: immediate formulary pressure on Blue Cross plans and state Medicaid programs already capping gene therapy at $2-3 million per patient. Related peer-reviewed work in JAMA (2024 observational cohort, n=312) documented reduced graft-versus-host disease rates under reduced-intensity conditioning, supporting the model's efficacy assumptions, while an independent Health Affairs analysis (sample drawn from 2023 claims data) flagged hydroxyurea adherence gaps that transplantation sidesteps. No industry conflicts were disclosed in the Blood paper. These data connect to broader patterns of curative therapy pricing, where high upfront costs collide with lifetime disease burden concentrated in under-resourced populations, an angle original coverage overlooked in favor of patient-choice framing.