Last year, HealthCare Business News interviewed Todd Ketch just a few months after he assumed the role as NAPT CEO. With nearly a year and a half under his belt, we circled back with him to get an update on how things are going for him and the association.

HCB News: How are you settling in?
TK: The time has gone by very quickly. It feels like I joined the organization just yesterday. It’s been a busy time with NAPT, learning about proton therapy, getting to know the association leaders and members, planning two national proton conferences and working to develop and move forward a number of association initiatives.

HCB News: Last we spoke, there were 20 operating centers in the U.S. with 15 under construction. Can you give an update on the numbers today?
TK: There are now 25 centers treating patients in the U.S. and at least 12 under construction or in development. I think there will be three new centers coming on line this year.

HCB News: How long, on average, does it take from the commitment to open a new center to actually treating the first patient?
TK: This varies significantly, depending on the location, type of center, regulatory requirements, financing and a host of other issues. The new compact, single treatment room proton therapy machines are creating opportunities for facilities to access the therapy for less money and with smaller space requirements. You would expect this type of installation to take less time than a large, multi-room facility, but I think three to five years is about the minimum I’ve heard about. We’ll see if advancements in the technology and experience installing compact systems can compress the time.

HCB News: One of the initiatives you identified as key was public education to extol the benefits of proton therapy and to help promote the news about the new centers and increased access. How is that going?
TK: We’re always looking to share the news about proton therapy. We still have work to do to get the word out so that patients, caregivers, health care providers and others will think about and ask for proton therapy as an option. With new centers treating patients and evidence building to support the use of proton therapy for more conditions, we’ll be stepping up our efforts to spread the word.

HCB News: Is there any news on the research or procedure front to talk about?
TK: It seems like new evidence is released its significant benefits to cancer patients. We’ll be releasing an updated model policy for insurance coverage of proton therapy in March and it will include more than 100 new references supporting therapy for a variety of disease sites.

HCB News: How have the efforts gone to increase insurance coverage for more disease sites?
TK: 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?
TK: 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?
TK: 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?
TK: 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?
TK: There is significant international interest in proton therapy. New centers are being considered or built in Canada, the U.K., Middle East, China, India and many other countries. The opportunity to save and improve lives around the world is certainly significant and other countries want this option for their citizens.

HCB News: Has any staff been added to assist on your goals, or are there plans to add more staff for NAPT?
TK: NAPT operates as efficiently as possible using a mix of staff and other management resources. There is growth happening in the industry and for NAPT, so we’ll continually assess the needs of the members and make resource decisions to meet those needs.

HCB News: We always end with asking what your predictions are. So what do you predict the field of proton therapy will look like by 2027?
TK: Proton therapy will continue to expand across the U.S. and the world. Institutions involved with cancer treatment recognize its significant benefits and are choosing to obtain the technology for their patients. Access to the therapy will continue to improve as the technology advances, improving the treatment and reducing the cost and other resource requirements. The number of lives saved and patients spared the difficulties of radiation side effects will expand as the clinical evidence builds and calls for coverage increase to the point where they can’t be denied.