Despite the good results PRP therapy has demonstrated for both orthopedic and aesthetic conditions, the treatment is not being widely utilized by a large number of Americans. The problem is not one of efficacy or safety. It is not even one of a lack of awareness. Rather, people are not availing themselves of this exciting new treatment because their health insurance plans do not cover it. So what’s the solution?
Apex Biologix, a Utah company that provides the equipment and supplies necessary to conduct PRP treatments, believes the solution lies in technology. If equipment manufacturers can develop new equipment capable of producing better PRP materials faster and with no loss of quality, the cost will go down.
The Medical Insurance Problem
Before we can understand technology as a solution, we must first understand the problem with health insurance and PRP therapy. Most health insurance companies consider PRP therapy and its related regenerative medicine cousins as ‘experimental’ medicine. PRP is far from experimental. It has been around for more than 40 years; it is a therapy that surgeons routinely use to promote wound healing after surgery.
Classifying PRP therapy as experimental gives insurance companies an out. They do not have to cover it even if their customers want it. Indeed, that is the case. At the time of this writing, there do not appear to be any health insurance companies willing to cover PRP therapy. Thus, patients must pay for the treatment out-of-pocket.
Insurance Solutions are No Solution
The first reaction to an insurance company not covering PRP therapy is to try and convince that company otherwise. But is this the right way to go? Insurance solutions are no solutions at all because of the systemic deficiencies of our health insurance system.
Assuming health insurance companies could be convinced to cover PRP therapy, is there anyone who actually believes doctors would be fully compensated for the treatments they offer? Insurance companies would treat PRP therapy the same way they treat any other procedure. They would only reimburse doctors partially, and they would put significant restrictions on how and when the therapy could be utilized. This would artificially drive up prices which, in turn, would affect out-of-pocket costs for patients.
Technology Is the Solution
We absolutely should be working with insurance companies to try to get them to change their minds about PRP therapy. But we must do so understanding that we need another remedy for the high cost of PRP therapy. That remedy is technology.
Consider that some forms of PRP material processing used by doctors and clinics can take up to 45 minutes. All that time is billable time, as the patient waits for material processing to be complete so that injection can begin. What if processing time could be reduced to 10 minutes? That would mean less time in the office, more time for doctors to see other patients, and an overall reduction in cost as a result.
Another consideration is the actual concentration of blood platelets the processing produces. A higher concentration of platelets would be more efficacious than a lower concentration, so equipment manufacturers are looking for ways to increase the quality of PRP material following processing. Improving quality improves efficacy, thereby reducing the total number of treatments a person may need. Fewer treatments translates into lower costs as well.
There are other ways technology can bring down the cost of PRP therapy. At any rate, technology is the future of regenerative medicine as a whole. The better it gets the better doctors will be at using regenerative medicine therapies to treat a variety of conditions.