Proton Beam Therapy: Build it And They Will Come

Today’s Managing Health Care Costs Indicator is 550%
Click image to enlarge.  Source 

Austin Frakt at The Incidental Economist picked up a gem from last month’s Archives of Internal Medicine.

Proton Beam therapy has not been shown to be any more effective for prostate cancer than intensity modulated radiation therapy.  IMRT in turn has not been shown to be any more effective than conventional radiation therapy.   Both newer technologies should be better – they focus the cell-searing radiation more tightly on the tumor, and should preserve more normal surrounding tissue. However, while the costs are dramatically higher, the clinical evidence of benefit has not yet been demonstrated.

In California, where there was only a single proton beam accelerator  from 2003 to 2006, men were 5.5 times more likely to get this therapy. In 2007, researchers reported that the allowed amount for IMRT for prostate cancer was $58, 610 per person,  over twice as much as IMRT (which is substantially more expensive than conventional radiation therapy). Harvard Link.  Proton beam therapy centers cost at least $30 million to build, and as much as over $200 million if they have multiple rooms.

Modern Healthcare reported in 2010 that there were 13 more proton beam therapy centers on the drawing boards for the next few years.  (Gated.   Harvard Link )   If we invest this capital, it insures that our future costs will climb even higher.    Here’s where we really need comparative effectiveness research!