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Dr. Colleen Lawton

ASTRO calls for proton beam therapy coverage

by Lauren Dubinsky , Senior Reporter
The American Society for Radiation Oncology (ASTRO) announced that it is now calling for private insurers and Medicare to provide coverage for proton beam therapy (PBT) in certain circumstances.

ASTRO outlines it in the new Model Policy it issued last week. The radiation oncologists and medical physicists who created it explain that they support PBT coverage for appropriate patients, and also identify the areas of that coverage where there is evidence that development and more research is needed.

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"It is ASTRO's role to provide our expertise to payers [toward a result] that ensures access to PBT for the appropriate cancer patients," Dr. Colleen A.F. Lawton, chair of ASTRO's board of directors, told DOTmed News.

PBT is a controversial technology due to its cost and that there is not clear evidence that it is more efficacious or offers reduced side-effect when compared to other type of radiotherapy.

The reason why PBT costs significantly more than radiotherapy is because building a proton beam therapy facility comes with a price tag in the neighborhood of $100 million and up. But despite the cost, PBT has been shown to be effective for several pediatric cancers, particularly in the brain, and for some adult cancers, including ocular melanoma.

But research for breast, prostate and lung cancer is still ongoing, and clinical trials supported by the National Cancer Institute are currently gathering patients in all three disease sites at the 14-plus proton therapy treatment centers in the country.

ASTRO is recommending that PBT be covered for the areas in which it has been proven effective, as well as the areas that are still being studied. "We are calling for coverage for patients participating in clinical trials so that we will have the data needed to confirm PBT's effectiveness for other cancers," said Lawton.

But this is not the first time ASTRO has pushed for coverage for PBT. Last September, the society issued its Choosing Wisely list that outlines five things that physicians and patients should question, including not using PBT for prostate cancer unless it is part of a clinical trial.

The society is also calling for the coverage of PBT for patients who have cancers that are difficult to treat, or highly complex or rare cases where the therapy can provide advantages over other treatment options.

Lawton is "extremely hopeful" that insurers and Medicare will accept the Model Policy because ASTRO has developed it to meet existing evidenced-based care. She added that it's very critical that patients are able to participate in clinical trials so that there will be data to validate appropriate treatment.

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