Michigan cost-cutting stymies cancer radiation treatment centers

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West Michigan Cancer Center, with seven campuses, might be affected by the panel’s decision. Source: IMPAC  

The Certificate of Need Commission in Michigan, in an attempt to rein in medical costs, has issued a ruling that would prevent hospitals in the state from each spending $100 million or more to provide a new form of radiation treatment for cancer.

The commission, which sets standards for major hospital construction, ruled that it would allow only one center to be built in the state for proton beam therapy, forcing the state’s largest hospitals — four of which had already proposed their own centers — to collaborate on a $160 billion project, according to The New York Times (NY Times).

“The costs of multiple centers, each having the most expensive medical equipment yet developed, would be tremendous,” the state’s Certificate of Need Commission said.

The commission also approved a resolution that set a Sept. 16 deadline for the collaborative to reach several benchmarks to finance, govern and build the high-tech cancer center, Crain’s Detroit Business (CDB) reported.

Proton therapy can deliver radiation more precisely than the x-rays now generally used to treat cancer, reducing the side effects from stray radiation and might improve the cure rate.

The NY Times reported that critics of the therapy say its advantage over x-rays has not been proved, except in certain rare tumors, and that proton therapy might not be worth the substantial extra cost. They say hospitals are engaged in a wasteful “arms race” for the prestige and profits that come from having a proton center.

There are now five proton centers in the United States, most built in the last few years, and at least a dozen more have been announced, according to the NY Times.

Beaumont Hospitals in Royal Oak, Mich., one of the largest healthcare systems in the state, is resistant to the decision and has plans to build its own $159 million proton therapy center on its campus outside Detroit. It had agreed to work with ProCure Treatment Centers, a company that specializes in building proton centers and arranging their financing, according to CDB. The new center should open by 2010, the hospital said.

Beaumont’s announcement in March led other hospitals to submit their own proposals, which in turn led to proposals for the collaborative project.

Executives at Beaumont and ProCure said they suspected the collaborative proposal was “really an attempt by rival hospitals to slow down their project or kill it.” A collaboration of five or more hospitals, as contemplated by the state, would be “unworkable,” reported the NY Times.

The Michigan commission acknowledged that a collaborative project could bog down and could change its decision if progress is not made.

At least five hospitals would have to agree to participate in the collaboration and contribute a collective $13 million by June 5. A business plan must be ready by Sept. 6, according to the NY Times.