Increasing access to automated red blood cell exchange (aRBCX) in all clinically eligible sickle cell disease populations in the United Kingdom has substantial potential to improve health outcomes and save costs.

For both clinically eligible populations, the key drivers of cost savings for aRBCX compared with manual red blood cell exchange (mRBCX) were fewer months on chelation therapy, a reduced number of disease-modifying transfusions, and a decrease in acute events.