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Is Platelet Rich Plasma a Viable Therapy Option?
Search online in your city for keyword “platelet rich plasma therapy” and you will quickly understand that there are several practices offering these options in most areas. You will also find several articles and studies…with mixed messages on the clinical results.
Most insurance companies publish statements that platelet rich plasma (PRP) is “experimental and investigational for all indications”. Aetna is one such insurer. Their policy effective date for Blood and Adipose Product Injections for Selected Indications relative to this assertion was in May of 2009. 1 Their last review of this policy was in April for 2018, and next review of this policy is scheduled for August of 2019. Medicare only covers autologous (from your own blood) platelet-rich plasma (PRP) for patients who have chronic non-healing diabetic, pressure, and/or venous wounds but only if they are enrolled in an approved clinical research study 2.
A high percentage of medical practitioners sing the same song as the insurance companies, telling their patients who ask that platelet rich plasma is unproven by science, voodoo therapy or simply does not work. Perhaps the fact PRP can’t bill and get paid by insurance companies is a contributing factor to some of the negative responses by the medical community.
If the largest insurance companies approved platelet rich plasma therapy for coverage today, would the nay-saying practitioners’ response still be negative?
A simple Google search proves that there are plenty of medical practitioners offering PRP as a cash-pay option, often blending PRP in with other protocols to improve results.
Why Are Over 9500 Platelet Rich Plasma Articles Not Enough?
There have been articles on platelet rich plasma published on Pub Med’s website dating back as early as 1954. It seems the scientific community has had ample time to get definitive answers on the viability of this protocol. Yet many conclude that more further study is necessary.
Given that PRP is derived from your own blood there are just two other variables involved in the preparation of the plasma. First, there is the mixture blending with the extracted blood that helps the blood to separate. Next, there is the device (centrifuge) that separates the blood so that the platelets can be removed. Variables here are impact the ease of extraction based on a good separation and comfort of the actual injection. What remains then are the actual results. Of these PRP articles, 732 Clinical Trials are published, but only 45 are specifically on Osteoarthritis. Again, results vary, usually based on the sample size or variables in the study itself.
Interesting how many drugs have been adequately studied and approved for insurance in much less time than PRP has been, supposedly, trying. The interesting question is why?
Clinical Studies on PRP for Review
Here are a few studies that provide positive results for several orthopedic applications of PRP:
Effect of intra-articular injection of platelet-rich plasma on interleukin-17 expression in synovial fluid and venous plasma of knee osteoarthritis patients [LINK]
Clinical Results of Platelet-Rich Plasma for Partial Thickness Rotator Cuff Tears: A Case Series [LINK]
A Prospective, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating Meniscal Healing, Clinical Outcomes, and Safety in Patients Undergoing Meniscal Repair of Unstable, Complete Vertical Meniscal Tears (Bucket Handle) Augmented with Platelet-Rich Plasma [LINK]
The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. [LINK]
Professional Sports Drives Public Relations for PRP
Here is an industry that is clearly driven by profits. There are several examples in the news of professional sports figures being injected with Platelet Rich Plasma to get them back in action faster. Many injuries sustained by professional athletes fall under the PRP sweet spot for accelerated body healing. Perhaps the popularity among sports professionals creates enough demand so it is less pressing for those with vested interests to seek a definitive clinical conclusion.
In fact, there is a study on the focus of PRP News Stories between 2009-2015 that validates the proliferation of Sports News reporting representing PRP as a routine protocol.3
Certainly not a scientific approach, yet why would athletes and sports teams continue to utilize PRP if it didn’t provide specific healing benefits? These athletes have their careers on the line so are highly motivated to recover from their injuries. Common sense would dictate their designated team medical practitioner would only select the best treatments.
FDA’s Involvement in PRP is Minimal
Most PRP preparation systems (Centrifuges) have utilized the FDA’s 510(k) clearance process because it is less costly and fast. This specific FDA clearance does not equate to approval for treatment of any indication. FDA has a clearance protocol that does include approval for treatment, but so far few have been completed.
Conclusion
One of the more common reported results throughout the published PRP articles reviewed on Pub Med’s website indicates few, if any, contraindications from PRP use. Because PRP is derived from the patient’s own blood, it is a highly natural modality.
In addition, the hard cost for practitioners delivering PRP is relatively low, based on our distribution of Juventix Regenerative Medicine’s PRP products. So, offering PRP as an option is often less than insurance copays and affordable for most as an out-of-pocket expense.
Based on results observed by IPS in practices who utilized the Juventix PRP products, PRP, when used for specific injuries and injected with the needed frequency, has provided excellent patient outcomes.
Keep in mind that big pharma does not profit when PRP works.
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- Aetna Statement on Blood and Adipose Product Injections for Selected Indications-http://www.aetna.com/cpb/medical/data/700_799/0784.html
- Medicare / CMS Decision Memo for Autologous Blood-Derived Products for Chronic Non-Healing Wounds (CAG-00190R3) - https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=260
- PRP News Stories Data: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5549909/