The Cost Variability of Orthobiologics

Abstract

Background: Mixed results exist regarding the benefit of orthobiologic injections. The purpose of this study was to assess the variability in costs for platelet-rich plasma (PRP) and stem cell (SC) injections and evaluate for variables that influence pricing. Hypothesis: There will be significant variability in the cost of PRP and SC injections throughout the United States. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Calls were made to 1345 orthopaedic sports medicine practices across the United States inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, the practice type, number of providers, and population and income demographics were recorded. Univariate statistical analyses were used to identify differences in availability and cost between variables. Results: Of the contacted offices that provided information on both PRP and SC availability (n = 1325), 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only SC injections, and 487 (36.8%) did not offer either treatment. The mean ± SD cost of a PRP injection was $707 ± $388 (range, $175-$4973), and the mean cost of an SC injection was $2728 ± $1584 (range, $300-$12,000). Practices offering PRP and SC injections tended to be larger (PRP, 12.0 physicians per practice vs. 8.1 [ P < 0.001]; SC, 13.6 vs 9.7 [ P < 0.001]). Practices that offered PRP injections were located in areas with higher median household income ( P = 0.047). Variables associated with higher cost of PRP injections included city population ( P < 0.001) and median income of residents ( P < 0.001). Conclusion: While the majority of sports medicine practices across the United States offer some type of orthobiologic injection, there exists significant variability in the cost of these injections. Clinical Relevance: This study demonstrates the significant variability in costs of orthobiologic injections throughout the country, which will allow sports medicine physicians to appreciate the value of these injections when counseling patients on available treatment options.

Assessment of Characteristics and Methodological Quality of the Top 50 Most Cited Articles on Platelet-Rich Plasma in Musculoskeletal Medicine

“…28,58,69,98 However, there is either insufficient evidence or a lack of efficacy for the use of PRP in rotator cuff tendinopathy, osteoarthritis of the hip, high ankle sprain, Achilles tendinopathy, muscle injuries, acute fracture or nonunion, surgical augmentation in rotator cuff repair, Achilles tendon repair, and anterior cruciate ligament (ACL) reconstruction. 53 With expanding usage of PRP, the global PRP market is expected to grow between $380 million and $4.5 billion within the next 10 years, 44 with the vast majority of spending coming out-of-pocket from patients at a cost of $707 on average per injection (range, $175-$4973) 68 since PRP therapy is not typically covered by most medical insurance companies. 44 As PRP has gained popularity in the field of musculoskeletal medicine, there has been a concurrent sharp increase in the number of publications relating to PRP.…”

Anterior Cruciate Ligament Reconstruction: Is Biological Augmentation Beneficial?

“…In 2020, Momaya et al evaluated the cost of PRP and stem cell injections and determined that the mean cost of a PRP injection in the United States was USD 707 (range, USD 175-USD 4973), and the mean cost of a stem cell injection was USD 2728 (range, USD 300-USD 12,000) [16].…”

Bone Marrow Aspirate Concentrate Is More Effective Than Hyaluronic Acid and Autologous Conditioned Serum in the Treatment of Knee Osteoarthritis: A Retrospective Study of 505 Consecutive Patients

“…There were baseline differences between the groups in the grade of OA, VAS and WOMAC. This is largely due to the retrospective nature of the study as in these patients presenting with milder degenerative changes in the clinical setting, it is more likely to start with the least invasive and also the least expensive treatment [15,47]. Lastly, the efficacy of the treatment could be affected by other factors such as at the frequency/number of treatment visits.…”