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When do the superior outcomes from proton therapy justify the costs?

by Lauren Dubinsky, Senior Reporter | July 03, 2024
Rad Oncology Proton Therapy

He has also been able to illustrate work productivity outcomes in patients who receive proton therapy versus radiotherapy. “That translates into societal benefits, because these employees pay taxes, they get back to work, and they're productive, and that is also a value that we aim to demonstrate and show in these cost-effectiveness analyses,” he added.

Leading the way to better coverage
Frank stresses that although the indications for proton therapy are growing, not every cancer patient is a candidate for the treatment. He estimates that about 20% of his patients would see real benefits from it.

MD Anderson recently opened up a new center with four additional rooms that allows for real-time tumor tracking, three-dimensional imaging on a day-to-day basis, and surface imaging.

“We have advanced the technology to be able to deliver protons in a similar manner to that by which we deliver conventional X-rays,” said Frank. “It really has expanded the indication and the enthusiasm of the physicians and the multidisciplinary teams to use this lifesaving technology.”

However, the cost to build and sustain one of these facilities is a major hindrance to adoption, and helps explain why there are only about 40 centers in the U.S.

But as the technology advances and the size of the centers gets smaller, it will become more accessible.

“We're seeing this as not just a U.S. phenomenon,” Frank said. “This is a global phenomenon and it's going to continue to grow rapidly over the next two decades.”

Medicare patients and pediatric patients who have cancers with a demonstrated benefit from proton therapy typically receive coverage, but what about patients between 21 and 40 years of age that may have testicular or cervical cancer? That’s where Frank’s focus is now.

“We want to make sure that these groups in between get equal access,” he said. “This level-one evidence and this phase-three data is so critical, because this is the practice-changing type of data that helps move the policy and [provides] access for more patients going forward.”

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Joern Meissner

solution to the cost-challenge

July 05, 2024 10:21

Dear Editor,
thank you for the nice article pointing out the challenges with proton therapy accessibility and its cost. I wish the article would’ve also focused on solutions, on reducing cost.

Upright patient treatment may be part of the answer. There is currently one FDA cleared proton therapy system that can do upright and supine treatment, is much smaller and hence less costly. There is a second upright treatment system that is about to be FDA cleared. both manufacturers claim that their system fits into linac vault. while this claim needs to be validated through a feasibility study for each installation, it is also easy to see how this is a cost advantage.

attendees of ASTRO, ESTRO and PTCOG know who I’m talking about so I don’t have to mention their names here, and risk that my comment does not get published.

Best regards,
Joern Meissner

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