Platelet-Rich Plasma: Time for Insurance Approval?

Authors

Patrick W. Stroh, University of LynchburgFollow

Specialty

Orthopedic Surgery

Advisor

Dr. Reid

Abstract

ABSTRACT

• Using Platelet-Rich Plasma (PRP) injections to treat orthopedic conditions has become more prevalent in the past 10 years.
• PRP injections are used to treat a wide variety of orthopedic injuries including but not limited to tendinopathies, osteoarthritis, tendon, and ligament tears
• PRP uses the donor (patient) blood to obtain platelets, rich in healing factors, or laboratory derived platelets, which can then be injected back into the patient in effort to obtain their healing properties.
• Recent literature has highlighted the benefits of treating these injuries with PRP injections as it has been shown to be as effective, if not more, than the alternatives, i.e., therapy, Non-Steroidal Anti-Inflammatories(NSAID’s), surgery, corticosteroid injections, hyaluronic acid injections.
• In 2018, the average cost of a PRP injection was $718, with none of it covered by insurance. Most patients, who are seen in an orthopedic clinic, do not have the ability to afford this cost, so they miss out on the potential for the treatment. It could be more cost effective for insurance companies than alternative options, i.e., surgery.
• Currently insurance providers do not cover PRP injections.
• With the growing popularity of PRP, there needs to be a re-evaluation by insurance companies to cover this procedure.
• Current evidence supports the use of PRP for chronic tendinopathies/tendonitis, anterior cruciate ligament (ACL) reconstructions, osteoarthritis, and meniscal tears.
• One of the main issues with current literature is the lack of a standardized process for both obtaining and administering PRP. The lack of this standardized process and the volatility of results are what have led to insurance companies refusing to cover the treatment.

Recommended Citation

Stroh PW. Platelet-Rich Plasma: Time for Insurance Approval?. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 3(4).