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The Cost of PRP: Disparities in orthobiologic utilization
Ellen Lutnick1, Eoin Devoy1, Nicholas Frappa1
1University at Buffalo Dept. of Orthopaedics, Buffalo, NY, 14215, USA.
Journal of Orthopaedics
|January 16, 2026
Summary
Platelet-rich plasma (PRP) injections for musculoskeletal issues are more common in wealthier, insured individuals. High costs and lack of insurance access limit PRP utilization for lower-income and uninsured populations.
Area of Science:
- Orthopedics and Regenerative Medicine
- Health Services Research
- Social Determinants of Health
Background:
- Orthobiologic injections, such as platelet-rich plasma (PRP), offer potential therapeutic benefits for musculoskeletal conditions.
- Understanding the accessibility and cost of PRP injections is crucial for equitable healthcare delivery.
- Social determinants of health (SDoH) may significantly influence the utilization patterns of advanced medical treatments.
Purpose of the Study:
- To evaluate the cost and accessibility of platelet-rich plasma (PRP) injections for musculoskeletal conditions.
- To analyze the correlation between PRP injection utilization and social determinants of health (SDoH).
- To identify disparities in PRP injection access based on socioeconomic factors.
Main Methods:
- Retrospective review of 727 PRP injections administered between 2010 and 2025 at an academic orthopedic practice.
- Analysis of injection costs stratified by patient demographics (race, sex) and anatomical location.
- Correlation of aggregated ZIP code-level injection data with US census-derived SDoH variables using statistical comparisons (Wilcoxon rank-sum, Kruskal-Wallis tests).
Main Results:
- PRP injections averaged $574, with males incurring higher charges than females.
- Injection utilization showed a significant socioeconomic gradient: the highest income quartile accounted for 40.7% of injections, versus 13.6% for the lowest.
- The uninsured rate was a key predictor, with each 1% increase in uninsured residents associated with a 10% decrease in PRP utilization.
Conclusions:
- PRP injections are disproportionately accessed by older, white, insured patients from higher socioeconomic backgrounds.
- High out-of-pocket costs and lack of universal insurance coverage create significant barriers to PRP access for lower-income and uninsured individuals.
- Addressing socioeconomic disparities is essential to improve equitable access to potentially beneficial orthobiologic treatments like PRP.
