Proton Beam Therapy Hits Its First Economic Iceberg

In August, I wrote about the ongoing battle between Proton Beam Therapy (PBT) and conventional Electron Beam Therapy (EBT) to treat prostate cancer. Recent studies have found that there is no discernible advantage to the far more expensive PBT over EBT in treatment effectiveness of reduction of side effects.

icebergI quoted Anthony Zeitman of the Department of Radiation Oncology at the Massachusetts General Hospital, who stated back in 1997 in an editorial titled, “The Titanic and the Iceberg: Prostate Proton Therapy and Health Care Economics” that PBT was a good example of “the expansive vigor of medical innovation heading inexorably toward the harsh reality of economic fact.”

About a year ago, several major insurers made the decision to stop paying for Proton Beam Therapy. Among them were Aetna, Blue Shield of California and Cigna.

At that time, the Wall Street Journal* reported, “Amitabh Chandra, professor of public policy at Harvard University and a critic of proton beam, said he’s “encouraged” by the steps some insurers are taking, but as long as Medicare pays for the therapy, it will be difficult for most insurers to deny coverage. “It’s an important move in the right direction,” he said. But “one would have to be incredibly optimistic to think that this is enough to really put the squeeze on this technology.”

Well, it appears that Chandra’s optimism may not be totally misplaced, even though Medicare continues to pay for PBT.

On September 18, 2014, the Indiana University Proton Beam Therapy Center in Bloomington announced that it will be closing its doors on December 5, 2014. According to its Facebook page, “We are closing due to the age of the equipment and the lack of financing to upgrade.” Clearly, someone in the IU Heath System made an economic decision based on the reality that the proton party may be winding down sooner than anticipated.

This, as ten new PBT centers are under construction in the US, which will bring the total to 24 centers.*

It will be interesting to watch this technology vs. economics drama play out over the next few years.

*“Prostate-Cancer Therapy Comes Under Attack” WSJ 8/28/13  (Article may be behind paywall.)

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