Payers Restrict Coverage for Proton Radiation Therapy

Weighing the cost-benefit ratio of proton radiation therapy, private and public payers are placing coverage limitations on the use of this treatment.

As proton cancer treatment centers expand, payers and providers may have to collaborate to expand the evidence base, to avoid the highly-expensive technology crowding out other investments.

The Midwest’s first proton beam cancer therapy center is closing its doors amid ongoing efficacy questions and financial struggles. At the advice of an outside review committee, Indiana University Health is closing its proton therapy center early next year, once the current roster of patients have completed treatment.

IU Health’s center was the nation’s third proton treatment facility and the Midwest’s first when it opened in 2004. It offered cancer patients the potential of more selective radiation treatment with fewer side effects, but ten years later, its clinical benefits remain unclear, its technology is slightly outdated and its finances seem unsustainable.

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Source: Healthcare Payer News