PRP and the Health Insurance Conundrum

We make no bones about promoting platelet-rich plasma (PRP) therapy as a way of increasing revenues and expanding a medical practice.

Both PRP and total nucleated cell therapies are gaining wider acceptance along with a growing body of evidence proving their effectiveness. But there is an elephant in the room that, unfortunately, is hindering the growth of PRP therapy in this country. That elephant is disguised as America’s insurance companies.

It is no secret that health insurance providers are not convinced of the efficacy or usefulness of PRP therapy. That, despite growing demand for PRP therapy training among doctors looking to meet increasing demand among patients. It is also no secret that the vast majority of patients who inquire about PRP therapy never go through with it after they find out they have to pay out of pocket. So what’s the solution? Education.

The PRP/health insurance conundrum we now face is very similar to what chiropractic medicine faced 30 years ago. Chiropractors overcame an unwillingness among insurance companies to cover services by educating them about the financial benefits of doing so. Insurance companies eventually figured out that the cost of 10 chiropractic treatments is a fraction of what it costs to cover back surgery.

We Have the Studies Available

It may not have been possible to undertake an effective education strategy 5 to 10 years ago, but that is no longer the case. We now have the studies available to show insurers how effective PRP therapy can be for treating chronic pain and wounds without more expensive, more invasive procedures. Here are just two examples:

    1. Shanghai Jiaotong University – Chinese researchers in Shanghai conducted extensive research involving more than 1,400 patients to test the effectiveness of PRP for knee osteoarthritis. The research proved that PRP injections offer both pain relief and functional improvement.
    2. Chongqing Medical University – A second Chinese study involved ten randomized, controlled trials with more than 1,000 patients comparing saline injections with PRP for treating chronic pain caused by knee osteoarthritis. This study demonstrated the same kind of pain relief and functional improvement as the first study.

Other research has shown that PRP injections can be as effective as corticosteroids. Even now, additional research studies are being undertaken across the globe.

Only a Matter of Time

Provided the medical community makes a concerted effort to educate insurance companies, it is only a question of time before insurance covers platelet-rich plasma therapy. When that day comes, doctors are not going to be able to keep up with demand.

We encourage doctors who treat patients with chronic knee and back pain, sports injuries, and other applicable conditions to consider undergoing PRP therapy training now. Completing training and beginning to offer the procedures will get the ball rolling so that when insurance companies finally do agree the coverage, doctors are prepared to welcome the new influx of patients who will undoubtedly want the treatments.

Training with Apex Biologix

Apex Biologix offers comprehensive PRP therapy training at various locations around the country. You can find the full schedule, along with locations, here on our website. Also note that all our training is provided by experienced regenerative medicine specialists who successfully use the therapies in their own practices.

We are pleased to be able to offer comprehensive regenerative medicine training to America’s doctors. We are big believers in PRP and total nucleated cell therapies for chronic pain, injuries, and wound recovery. We believe it is only a matter of time before insurance companies fully embrace the therapies as well. You need to be ready for it.