por Sean Ruck
, Contributing Editor | March 06, 2017
From the March 2017 issue of HealthCare Business News magazine
HCB News: How have the efforts gone to increase insurance coverage for more disease sites?
We continue our work on this front to see insurers recognize the significant benefits of proton therapy and make coverage more available to patients. Unfortunately, too many patients are forced to work through the process of appealing insurance denials in hopes of getting the treatment covered for themselves or a loved one. Proton therapy should not be considered an experimental or investigational treatment option. The therapy has been in clinical use for decades and has proven effective at treating patients with minimal side effects. Proton therapy should be held to the same standard of clinical evidence as other radiation treatment when insurance companies make coverage decisions. That would remove the major barrier to patient access.
HCB News: Does the change in government concern you in regard to those coverage efforts?
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We’ll be working through the changes just like everyone else. The benefits of proton therapy to cancer patients won’t change and we’ll continue our work to make sure that the treatment is available.
HCB News: Has proton therapy moved into any turf wars with existing modalities? Do you anticipate that happening?
Proton therapy is an important option for many patients, but that’s not true for all. Other modalities may be more appropriate, depending on the needs of the patient. That’s where we need to focus — the needs of the patient. It’s not about turf. It’s about giving patients, working with their doctors, access to all the options and allowing them to determine what’s best for their situation.
HCB News: With proton therapy being a younger technology, there has been a challenge with getting the evidence-based research nailed down. How is that coming along at this point?
The evidence continues to gather in support of proton therapy for a growing list of indications. Some want to see randomized controlled trials comparing protons and conventional radiation. Those trials are occurring, but they take years to complete. We need to pursue that evidence, but in the meantime we need to recognize that there is no safe level of radiation exposure to healthy tissues and organs, and that proton therapy does the best job of delivering radiation to tumors without the significant side effects that come from exposure to surrounding tissues.
HCB News: What is the international climate on proton therapy? Are there any countries new to it, either breaking ground, or opening their first center(s) since we spoke in January 2016?