The Cost Variability of Orthobiologics

Objectives: Despite limited clinical data, many orthopedic practices offer orthobiologic injections. Such injections are not covered by insurance, and thus patients pay out of pocket for these treatments. The purpose of this study was to assess the variability in costs for platelet rich plasma (PRP) and stem cell (SC) injections across practices and evaluate for variables that influence pricing. Methods: A list of 1,345 orthopedic sports medicine practices across the United States was compiled. Calls were made inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, practice type (academic or private), 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, 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only stem cell injections, and 487 (36.2%) did not offer either treatment. The mean (± SD) cost of a PRP injection was $707 ± $388 (range, $175 to $4,973), and the mean cost of a SC injection was $2,728 ± $1,584 (range, $300 to $12,000). Practices offering PRP and SC injections tended to be larger (for PRP - 11.6 physicians per practice vs. 8.1, P<0.001; for SC - 12.3 vs. 9.7, P=0.006). In addition, practices that offered PRP injections were located in areas with higher mean income ($67,500 vs. $64,300, P=0.047). Variables associated with higher cost of PRP injection included city population (P<0.001) and mean 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. The cost for PRP injections is higher in practices located in highly populated areas and in areas with greater mean incomes.

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The Cost Variability of Orthobiologics

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119880256 ◽

2019 ◽

Vol 12 (1) ◽

pp. 94-98

Author(s):

Amit Mukesh Momaya ◽

Andrew Sullivan McGee ◽

Alexander R. Dombrowsky ◽

Alan Joshua Wild ◽

Naqeeb M. Faroqui ◽

...

Keyword(s):

United States ◽

Sports Medicine ◽

Platelet Rich Plasma ◽

Treatment Options ◽

The United States ◽

Median Income ◽

Level Of Evidence ◽

Significant Variability ◽

The Mean ◽

The Cost

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.

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What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?

The Journal of Knee Surgery ◽

10.1055/s-0038-1669953 ◽

2018 ◽

Vol 32 (09) ◽

pp. 879-885 ◽

Cited By ~ 8

Author(s):

Nicolas S. Piuzzi ◽

Mitchell Ng ◽

Ariel Kantor ◽

Kenneth Ng ◽

Stephanie Kha ◽

...

Keyword(s):

United States ◽

Standard Deviation ◽

Knee Osteoarthritis ◽

Clinical Efficacy ◽

Health Care Providers ◽

Platelet Rich Plasma ◽

The United States ◽

Care Providers ◽

Knee Oa ◽

The Mean

AbstractPlatelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA. A prospective cross-sectional study was performed based on 286 centers identified in the United States offering PRP injections for knee OA. A total of 179 (73.4%) centers were successfully contacted via e-mail or phone, using a simulated 52-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the current marketed prices and clinical efficacy, either reported as “good results” or “symptomatic improvement,” claimed by each treating center. The mean price for a single unilateral knee same-day PRP injection was $714 with a standard deviation of $144 (95% confidence interval [CI]: $691–737, n = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5–78.3%, n = 84). Out of the 84 clinics, 10 claimed “90 to 100% efficacy,” 27 claimed “80 to 90%,” 29 claimed “70 to 80%,” 9 claimed “60 to 70%,” 8 claimed “50 to 60%,” and 1 claimed “40 to 60%.” These findings provide a unique perspective on the PRP market for the treatment of knee OA that is valuable to physicians and health care providers in providing better education to patients on the associated costs and purported clinical benefits of PRP injections.

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Comprehensive survey of United States internet users’ sentiments towards cryopreservation

PLoS ONE ◽

10.1371/journal.pone.0244980 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244980

Author(s):

Christopher Robert Gillett ◽

Taylor Brame ◽

Emil F. Kendiorra

Keyword(s):

United States ◽

Low Temperatures ◽

The United States ◽

Fear Of Death ◽

Cryoprotective Agents ◽

Internet Users ◽

Comprehensive Survey ◽

Attitudes Towards Death ◽

The Mean ◽

The Cost

Medical cryopreservation is the speculative practice of using low temperatures and medical-grade cryoprotective agents to halt the decay of a recently-deceased person’s brain and body for the prospect of future resuscitation and restoration of function. We conducted a survey of 1,487 internet users in the United States to measure familiarity with, interest in, beliefs about, and attitudes towards cryopreservation. The majority of respondents (75%) had previously heard of the topic. Respondents tended to underestimate the cost of cryopreservation and number of previous cases but overestimate the number of providers. While many respondents expressed interest in signing up (20%) or had actively researched the topic (21%), a much smaller fraction have decided to be cryopreserved (6%). This level of interest is much greater than the number of previous preservation cases would indicate. We found that respondents’ attitudes towards death significantly correlated with their general sentiments towards the topic, with those expressing a desire for longer life or to see the future being more interested and positively inclined. Fear of death was not associated with interest in cryopreservation. Negative sentiments towards cryopreservation were less common than respondents perceived. For example, 14% of respondents believed that “most people” think cryopreservation should be illegal, but only 4% of respondents actually did. Many respondents (42%) were pessimistic regarding the likelihood of cryopreservation being successful, but the mean estimate of time until revival of cryopreserved bodies would be possible was 82 years.

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Costs of medical care for mesothelioma

Rare Tumors ◽

10.1177/2036361319863498 ◽

2019 ◽

Vol 11 ◽

pp. 203636131986349 ◽

Cited By ~ 1

Author(s):

Eric Borrelli ◽

Zachary Babcock ◽

Stephen Kogut

Keyword(s):

United States ◽

Medical Care ◽

Medical Cost ◽

The United States ◽

Healthcare Research ◽

Cost Of Care ◽

Discharge Data ◽

System A ◽

The Cost ◽

Mean Cost

Malignant mesothelioma is a rare and devastating form of cancer with an increasing economic burden. We sought to describe the direct cost burden of mesothelioma to the US health system. A systematic literature review was performed to locate published estimates of the medical cost of mesothelioma. In addition, we performed an analysis of hospital discharge data from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. We also reviewed publicly available legal settlements. We found that published estimates of the cost of medical care for mesothelioma are sparse, and differ with respect to nation, timeframe, and types of cost included. For the year 2014 in the United States, we estimated a mean cost per mesothelioma hospitalization of US$24,124 (95% confidence interval: US$20,819–US$28,983) and a total cost for hospital care of US$44,214,835. In conclusion, we found that reports describing the direct medical cost of care for mesothelioma in the United States are lacking, yet the per-patient cost of care is substantial, as evidenced by analyses of inpatient care and legal settlements.

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Research Trends on the Rotator Cuff Tendon: A Bibliometric Analysis of the Past 2 Decades

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120973688 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097368

Author(s):

Lei Lei ◽

Chi Zhang ◽

Fu-Hua Sun ◽

Yujie Xie ◽

Bin Liang ◽

...

Keyword(s):

United States ◽

Stem Cell ◽

Rotator Cuff ◽

Web Of Science ◽

Platelet Rich Plasma ◽

The United States ◽

Research Trends ◽

Rotator Cuff Tendon ◽

The Past ◽

Number Of Citations

Background: Clinical research on the rotator cuff tendon is increasing, and new approaches are being applied to rotator cuff disease. Considering the integration of research resources and research trends, it is necessary to conduct an analysis of recent research on the topic. Purpose: To identity the research trends, influential journals, key researchers, and core countries of rotator cuff tendon research between 2000 and 2019. Study Design: Cross-sectional study. Methods: All the literature related to rotator cuff tendon research was retrieved from the Web of Science Core Collection on January 7, 2020. Qualitative and quantitative analyses were processed based on Web of Science and CiteSpace. Results: A total of 4131 studies, which included 3830 articles and 301 reviews, were obtained. There was an upward trend of studies on the topic, with small fluctuations in the past 2 decades. The United States had the most studies, and the number of studies from other countries increased over the study period. Most of the funding sources came from the United States. Articles in the Journal of Shoulder and Elbow Surgery had the most citations for rotator cuff research. Frontier topics, such as arthroscopic repair, mesenchymal stem cell, and “platelet-rich plasma, were identified. The number of citations in 2018 ( r = 0.280; P = .005) and 2019 ( r = 0.307; P = .002) had a weak positive correlation with publication date, indicating that the more recently published articles had a higher number of citations. Conclusion: Valuable information on rotator cuff research based on bibliometric analysis was identified. Arthroscopic repair, mesenchymal stem cell, and platelet-rich plasma might be the research frontiers in this field, and researchers should focus on these topics in future studies.

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Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States

American Journal of Perinatology ◽

10.1055/s-0038-1649481 ◽

2018 ◽

Vol 35 (13) ◽

pp. 1287-1296 ◽

Cited By ~ 4

Author(s):

Suneet Chauhan ◽

Sean Blackwell ◽

Han-Yang Chen

Keyword(s):

United States ◽

Hospital Cost ◽

Maternal Morbidity ◽

Nationwide Inpatient Sample ◽

Hospital Costs ◽

The United States ◽

Severe Maternal Morbidity ◽

The Mean ◽

Procedure Codes ◽

Mean Cost

Objective The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization. Study Design We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs. Results Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1–2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM. Conclusion The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden.

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AB0870-HPR GLOBAL TRENDS IN PRP AND OSTEOARTHRITIS: A BIBLIOMETRIC AND VISUALIZED STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2849 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1458.3-1459

Author(s):

Y. Qiu ◽

Y. Zhang ◽

L. Wen

Keyword(s):

United States ◽

Sports Medicine ◽

Platelet Rich Plasma ◽

Development Trend ◽

The United States ◽

Global Trends ◽

Social Burden ◽

Sports Science ◽

The Uk ◽

Visualized Study

Background:Osteoarthritis (OA) is a serious disease, which is one of the main causes of joint pain and body dysfunction, raising serious economic and social burden. In recent years, there are tremendous articles on the treatment of osteoarthritis, platelet rich plasma (PRP) is one of the new trends in the treatment of osteoarthritis.Objectives:The purpose of this study is to explore the development trend of PRP related osteoarthritis study and grasp the hot spots and directions in this field.Methods:Publications focusing on PRP related osteoarthritis research from 2001 to 2020 were retrieved from Web of Science (WoS) and Science Citation Index-Expanded (SCIE) database. The retrieving methods were as follow: (theme = platelet rich plasma arthritis OR theme = platelet rich plasma osteoarthritis OR theme = platelet rich plasma cartilage OR theme = platelet rich plasma knee OR theme = platelet rich plasma orthopedic OR theme = platelet rich plasma orthopaedic OR theme = platelet rich plasma articular OR theme = platelet rich plasma joint OR theme = platelet rich plasma tendon). Publications were analyzed only when type is articles or reviews. The VOS viewer was used for the generation of bibliographic coupling and visualized study.Results:A total of 2847 publications were retrieved, including 2636 articles and reviews. Before 2000, there were only 15 relevant papers, which were not included in the specific analysis. It is clear that the number of publications on PRP related OA study is increasing every year, a total of 398 articles or reviews were published in 2020. The United States is the leading country in this field, with a number of 932 publications (35.4%), followed by Italy (304 publications, 11.5%) and China (294 publications, 11.2%). The most prevalent areas of PRP related OA research were orthopedics (1013 papers, 38.4%), sports science (651 papers, 24.7%) and surgery (475 papers,18.0%). The top 3 journal that published the most PRP related OA study is American Journal of Sports Medicine (153 papers, 5.8%), Arthroscopy: The Journal of Arthroscopic & Related Surgery (95 papers, 3.6%), Journal of Orthopaedic Research (83 papers, 3.1%). The Harvard University (96 papers, 3.6%), Hospital for Special Surgery (83 papers, 3.1%) and University of London (75 papers, 2.8%) is the top 3 institution that published the most articles or reviews. Filardo G from Italy published the most articles or reviews (52, 2.0%) in this area, followed by Maffulli N from the UK (49 publications, 1.9%) and Kon E from Italy (46, 1.7%). PRP related OA study can be divided into five categories: intra-articular treatment study, clinical trials related study, soft tissue repairment study, gene and molecular biology study, regeneration and implantation study.Conclusion:Publications on PRP related OA study is increasing according to the analysis on current global trends. The United States is now the leading country in this field, with the largest number and the highest quality of publications. Among the five cluster of PRP related OA studies, “intra-articular treatment study” and “regeneration and implantation study” are considered to be the current research hotspots in the PRP related OA field.References:[1]Foster T E, Puskas B L, Mandelbaum B R, et al. Platelet-rich plasma: from basic science to clinical applications.[J]. American Journal of Sports Medicine, 2009, 37(11):2259-2272.Disclosure of Interests:None declared

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Trends of Hospitalization in Acute Pancreatitis in Patients in the United States from 2001-2014

10.31219/osf.io/zd8ab ◽

2019 ◽

Author(s):

Kevin Casey ◽

Roberto Argo ◽

Albert Bianco

Keyword(s):

United States ◽

Acute Pancreatitis ◽

Length Of Hospital Stay ◽

The United States ◽

Primary Objective ◽

Hospital Charges ◽

Cost Burden ◽

Patient Demographics ◽

The Mean ◽

The Cost

Background & Purpose: The prevalence of acute pancreatitis(AP) has increased over time and is one of the most important gastrointestinal causes of frequent admissions to hospital in the United States. The cost burden of AP has been steadily increasing. The primary objective of our study was to analyze patient demographics, cost burden, mortality and length of stay associated with AP hospital admissions.Methods: Nationwide inpatient sample (NIS) database was used to identify AP admissions in all patients from ≥18 years of age from 2001 to 2014 using ICD-9-CM code 577.0 as the principal discharge diagnosisResults: The number of hospitalizations increased from 215,238 in 2001 to 279,145 in 2014. In-hospital mortality decreased from 1.74% in 2001 to 0.66% in 2014. Mean length of hospital stay has decreased from 6.1 days to 4.6 days during the same period, but the mean hospital charges increased from $19,303 in 2001 to $35,728 in 2014. The proportion of males to females with acute pancreatitis is slowly trending up from 2001 to 2014. Conclusion: The number of hospitalizations due to acute pancreatitis has been steadily increasing, and further research needs to be done on finding out the reasons for increased causes of hospitalization and ways to decrease the cost burden on patients and hospitals.

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A Bibliometric Analysis of the Top Cited Articles in Sports and Exercise Medicine

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120969902 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712096990

Author(s):

Omeet Khatra ◽

Armita Shadgan ◽

Jack Taunton ◽

Amir Pakravan ◽

Babak Shadgan

Keyword(s):

United States ◽

Sports Medicine ◽

Controlled Trial ◽

Country Of Origin ◽

Well Being ◽

The United States ◽

Journal Title ◽

Exercise Medicine ◽

Sports And Exercise ◽

Study Type

Background: Although citation analysis is common in many areas of medicine, there is a lack of similar research in sports and exercise medicine. Purpose: To identify and examine the characteristics of the 100 top cited articles in the field of sports and exercise medicine in an effort to determine what components make an article highly influential. Study Design: Cross-sectional study. Methods: The Web of Science, Scopus, and PubMed databases were used to determine the 100 top cited articles from 46 journals in the field of sports and exercise medicine. Each of the 100 articles was then analyzed by 2 independent reviewers, and results were compared. Basic information was collected, including journal title, country of origin, and study type. Different categories were compared using descriptive statistics of counts or percentages. Results: The 100 top cited articles were published in 15 of the 46 identified sports and exercise medicine journals, with the most prolific being Medicine and Science in Sports and Exercise (n = 49), American Journal of Sports Medicine (n = 18), and Sports Medicine (n = 7). In terms of country of origin, the top 3 contributors were the United States (n = 65), Canada (n = 9), and Sweden (n = 8). The most commonly researched anatomic areas were the knee (n = 15) and the brain (n = 3). Narrative reviews were the most common study type (n = 38), and only a single study on the 100 top cited articles list used a randomized controlled trial design. The most prevalent fields of study were exercise science (55% of articles) and well-being (16% of articles). Conclusion: Narrative reviews from the United States and published in English-language journals were the most likely to be highly cited. In addition, the knee was a common anatomic area of study on the top cited list of research in sports and exercise medicine

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The cost of a general stochastic epidemic

Journal of Applied Probability ◽

10.1017/s0021900200094961 ◽

1972 ◽

Vol 9 (02) ◽

pp. 257-269 ◽

Cited By ~ 9

Author(s):

J. Gani ◽

D. Jerwood

Keyword(s):

Recursive Equation ◽

Stieltjes Transform ◽

Stochastic Epidemic ◽

The Mean ◽

The Cost ◽

Mean Cost ◽

General Stochastic

This paper is concerned with the cost Cis = aWis + bTis (a, b > 0) of a general stochastic epidemic starting with i infectives and s susceptibles; Tis denotes the duration of the epidemic, and Wis the area under the infective curve. The joint Laplace-Stieltjes transform of (Wis, Tis ) is studied, and a recursive equation derived for it. The duration Tis and its mean Nis are considered in some detail, as are also Wis and its mean Mis . Using the results obtained, bounds are found for the mean cost of the epidemic.

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