KLAS: Providers hesitant to jump on proton therapy bandwagon
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While proton therapy is gaining attention and largely viewed as effective, most providers are holding back from investing in the treatment due to the sizable initial investment of $150 to $200 million and concerns regarding market saturation, lack of patient referral base, staffing requirements and a lack of supporting clinical data, according to healthcare market research firm KLAS.

KLAS also determined that there is much confusion and uncertainty around proton therapy, based on a survey of almost 100 providers conducted by the Orem, Utah-based firm. For example, while participants in the study cited prohibitive initial costs as a deterrent to investment, they actually underestimated the true costs with a median estimate of $100 million.

“For most providers, the initial investment in proton therapy is too much for them to even consider adopting the technology. Most of the currently live proton therapy centers are partnered with outside investors and rely on donors to help make it happen,” wrote report author Monique Rasband in the executive summary. She added that providers reported costs upwards of $1 million per year for electricity alone.

“If a smaller, more affordable unit were to become available, like ones Mevion, IBA, and ProTom are marketing, more providers would consider proton therapy,” the report continued. Single-vault systems come with a considerably reduced price tag of about $25 million.

Mevion has three sites under construction and IBA has one single-vault unit under construction. No single-vault systems have final FDA approval, though Mevion and IBA seem closest, according to KLAS.

With regard to effectiveness, most providers interviewed thought proton therapy was effective and some believed it was more effective than traditional beam therapy in select situations, such as pediatric cancers. A total of 69 percent mentioned pediatric cancers as effective, with prostate and ocular cancers coming in a distant second and third place with 33 percent and 22 percent of providers noting effectiveness, respectively.

Underscoring the debate and confusion around proton therapy effectiveness, while some described it has having fewer negative side effects, about 25 percent of those interviewed believed it had the same or worse side effects when compared with traditional radiation therapy. Still others pointed out that effectiveness has to be proven as there is a dearth of studies comparing proton therapy to other treatment methods, according to KLAS.

Other findings in the report include:
  • Mevion and IBA tied for the lead when providers were asked which vendor they’d look to for proton therapy, with 22 votes each.
  • IBA, with eight of the 10 currently operating sites, was described by providers as the most proven vendor.
  • Elektra is the software leader, with the most sites using its oncology information system and treatment planning software.
  • Thirteen providers indicated they had purchased or plan to purchase a proton therapy system in the next five years.