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在美国,富含血小板血浆注射治疗膝骨关节炎的价格及宣称的疗效如何?

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

作者信息

Piuzzi Nicolas S, Ng Mitchell, Kantor Ariel, Ng Kenneth, Kha Stephanie, Mont Michael A, Muschler George F

机构信息

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.

Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

出版信息

J Knee Surg. 2019 Sep;32(9):879-885. doi: 10.1055/s-0038-1669953. Epub 2018 Sep 6.

Abstract

Platelet-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,  = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5-78.3%,  = 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.

摘要

尽管富血小板血浆(PRP)注射治疗膝关节骨关节炎(OA)的临床价值和成本效益尚未明确确立,但该疗法仍经常被用于治疗膝关节OA。PRP注射被视为减轻膝关节OA患者疼痛和改善功能的一种潜在手段,有望延迟或避免手术干预的需求。提供PRP注射的机构通常向患者直接收取现金并直接进行服务营销。因此,本研究的目的是量化当前(1)自体PRP注射治疗膝关节OA的价格以及(2)其宣称的临床疗效。基于在美国确定的286家提供膝关节OA的PRP注射服务的机构,进行了一项前瞻性横断面研究。通过电子邮件或电话成功联系到了总共179家(73.4%)机构,模拟一名52岁患膝关节OA的男性患者进行询问。模拟患者按照预设问题来确定每个治疗机构当前宣称的价格和临床疗效,临床疗效以“良好结果”或“症状改善”来报告。单次单侧膝关节当日PRP注射的平均价格为714美元,标准差为144美元(95%置信区间[CI]:691 - 737美元, = 153)。宣称的临床疗效平均值为76%,标准差为11%(95% CI:73.5 - 78.3%, = 84)。在这84家诊所中,10家宣称“疗效为90%至100%”,27家宣称“疗效为80%至90%”,29家宣称“疗效为70%至80%”,9家宣称“疗效为60%至70%”,8家宣称“疗效为50%至60%”,1家宣称“疗效为40%至60%”。这些发现为PRP治疗膝关节OA的市场提供了独特视角,对医生和医疗服务提供者在向患者更好地说明PRP注射的相关成本和所谓临床益处方面具有重要价值。

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