1705 - Disparities in Access to Platelet-Rich Plasma (PRP) for Musculoskeletal Rehabilitation and Sports Medicine Care in Lower-Income Communities

Platelet-rich plasma (PRP) is increasingly integrated into sports medicine and physical medicine & rehabilitation (PM&R) practice for managing tendinopathies, osteoarthritis, and other musculoskeletal injuries. Despite promising evidence for pain reduction and functional improvement, PRP use is rarely reimbursed by insurers, leaving patients to cover substantial out-of-pocket costs. These structural barriers may disproportionately affect individuals from lower-income areas who are already at higher risk of musculoskeletal morbidity and limited access to rehabilitation services. The study aims to review peer-reviewed evidence on disparities in PRP access, focusing on geographic, financial, and health system factors relevant to PM&R clinicians working in sports and musculoskeletal medicine.

Design:

A structured literature review of PubMed-indexed studies (2010–2025) was performed, with inclusion criteria emphasizing PRP utilization, pricing, reimbursement, and practice-area socioeconomic data. Priority was given to U.S.-based studies relevant to rehabilitation care delivery.

Results:

PRP procedures demonstrate extreme cost variation, ranging from $175 to $4,973 per injection across the U.S., with top orthopaedic hospitals reporting $350 to $2,815 per injection. PRP clinics are disproportionately located in higher-income zip codes, where local wealth also correlates with higher procedure pricing, creating affordability barriers in lower-income communities. For knee osteoarthritis, the average quoted cost is ~$700 per injection, with most practices requiring cash payment and lacking price transparency. Medicare data confirm that PRP use increased between 2010–2014, but coverage is “rarely provided,” forcing reliance on out-of-pocket financing. 

Conclusions: For PM&R and sports medicine practitioners, the evidence demonstrates that PRP remains clustered in wealthier areas, with high and inconsistent costs, and limited payer support, creating significant disparities in access for patients in lower-income communities. These inequities restrict the ability of rehabilitation specialists to offer regenerative interventions across diverse populations. Future directions include aligning coverage with evidence-based indications, standardizing reporting of patient demographics, and piloting community-based or sliding-scale programs to improve equitable access.