Protons for Prostate Cancer: the Dream Versus the Reality

Extract

Proton therapy has generated much excitement among physicians and patients. During the period from 2006 to 2009, the number of prostate cancer patients treated with protons nearly doubled ( 1 ) and use continues to rise. There are 11 operational proton facilities in the United States, opening at a rate of more than 1 per year over the past 6 years. Why is everyone so excited? There are at least three reasons. Two are clear, and one is complex.

First, protons are a new technology. Although, proton therapy has been around for more than 20 years, it is viewed as a new or advanced technology. Everyone in the United States wants new; it sells both breakfast cereal and therapies.

The second reason is reimbursement: The current method of reimbursement by Centers for Medicare & Medicaid Services (CMS) is based on cost and not effectiveness. Prostate cancer proton treatment is delivered quickly because it uses just a few beams (high throughput) and there are many men with prostate cancer (high volume). High reimbursement per case × High throughput × High volume = High profit.