Cost comparisons and noninferiority evidence for various osteobiologics in 3 US states.
| Osteobiologics | Costs Across 3 States | Cost Range | Noninferiority | Verdict | ||
| Maryland | New York | California | ||||
| Bone morphogenetic proteins | Infuse, large kit, 8 cc: $6,000 | Medtronic extra small BMP: $2010 | inFUSE large pack: $5100–5408 | $$–$$$$ | Superior effect in combination with autograft | High costs justified |
| Platelet-rich plasma | $450–475 | $ | No evidence to establish noninferiority | Low costs justified for trial exploration, not for routine use | ||
| Demineralized bone matrix | Optium, 10 g: $900 | Stryker, 1 cc: $191 | DBX: $576–$880, Grafton: $575–600 | $ | Noninferiority to autograft bone | Low costs justified for independent use, avoiding autograft morbidity |
| Biomaterial scaffolds | ||||||
| Tricalcium phosphate | Chronos, 10 g: $635 | Stryker, 1.2 cc: $211 | $ | No evidence to establish noninferiority | Not enough evidence to comment | |
| Bioactive glass | Fibergraft, 10 g: $2,900 | Stryker vitoss bioactive foam, 1.2 cc: $215 | $-$$ | No evidence to establish noninferiority | Not enough evidence to comment | |
| Stem cells (mesenchymal and adipose-derived) | Vivigen, 10 g: $3,300 | Stryker bio4, 1 cc: $255 | $–$$$ | No evidence to establish noninferiority in spinal fusion | Not enough evidence to comment | |
Note: Costs are represented in US dollars ($). The cost range indicates the relative costliness of each biologic and is based on the following scale: <$1000: $, >$1000: $$, <$5000: $$$, >$5000: $$$$.