Patient denied proton therapy dies, family received $25 million in court

While considered effective and more precise in targeting tumors, proton therapy still faces challenges, namely coverage for such procedures from insurers.

One family learned this, sadly, through the loss of their wife and mother, Orrana Cunningham, to stage 4 nasopharyngeal cancer. Diagnosed in 2014, Cunningham was recommended to undergo PBT by her doctors who saw the treatment as far more effective for her than radiotherapy. Her insurance provider, however, disagreed, viewing the treatment as “experimental” and denying her coverage. She and her husband worked to raise funds for her to receive PBT but were unable to obtain the money in time, as Cunningham passed away in May 2015.

Her family subsequently sued the insurance provider, with an Oklahoma court ruling this past November in the clan’s favor and awarding it $25 million.

“While coverage policy is an important tool that can reduce inappropriate use of medical technologies, it can also create barriers to evidence development,” Bekelman, a senior fellow and an associate professor of radiation oncology and medical ethics and health policy at the Leonard Davis Institute for Health Economics at the University of Pennsylvania’s Perelman School of Medicine, told HCB News in an op-ed.

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