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Proton therapy goes mainstream

by Gus Iversen, Editor in Chief | October 07, 2015
From the October 2015 issue of HealthCare Business News magazine

Rossi, at the Scripps Proton Therapy Center, estimates there are approximately 3,000 intensity modulated radiation therapy (IMRT) facilities in the U.S. versus 18 proton facilities. “If we get to the point where the cost is similar, there will be a severe lack of resources,” he says. “We already know that protons are better,” adds Rossi. “That’s been proven six ways to Sunday.” For him, the only mystery remaining is how much better.
Chandra characterizes prostate cancer as the main reason proton therapy is a big business, and while physicians using the technology may not entirely disagree with him (Scripps treats more prostate cancer than any other indication, at MD Anderson it's the leading indication alongside lung cancer at about 25 percent), their goal of radiating as little healthy tissue as possible includes all tumor sites.

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“With prostate cancer, protons allow me to treat less of the bladder, less of the rectum, and a lot less of the small intestine,” says Rossi, adding that with an aging population, physicians must be more cognizant than ever about the risk of delayed injury or side effects, which can be very costly in their own right.

“Proof-of-concept studies are showing that toxicity’s dose effects have a cost that is not always measured in the amount of reimbursement that comes from delivery. We need to look at the episodic cost of care through time-driven activity-based costing methods (TDABC) instead of just the reimbursement of treatment,” says Frank.
If advocates of proton therapy for prostate cancer are correct, the benefits simply need time to illustrate themselves. In the meanwhile, research from the University of Florida Proton Therapy Institute, published in the International Journal of Radiation Oncology Biology Physics, found that 99 percent of patients treated for prostate cancer were experiencing “excellent” quality of life five years after treatment.
“These proton therapy results compare very favorably with IMRT results, particularly for intermediate risk-disease, where disease control rates of 70 percent to 85 percent are typical,” said Dr. Nancy P. Mendenhall, lead author and medical director of the UF Proton Therapy Institute, in a statement accompanying the study’s publication.
Demonstrating value to payors
As with computers and cell phones, the proliferation of proton therapy is expected to continue reducing its costs. If prostate treatment is still a point of some controversy, cost benefits for other tumor locations are coming increasingly into focus.

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