Proton therapy cheaper than some conventional radiotherapy techniques

Costs associated with proton therapy are similar to--and in some cases less than--a number of conventional radiotherapy techniques used to treat early stage breast cancer, according to research from the University of Texas MD Anderson Proton Therapy Center.

For the study, researchers performed a cost analysis using Medicare reimbursement costs to analyze allowable charges for eight different types of partial and whole breast irradiation therapies and treatment schedules available to treat patients with early stage breast cancer. They found that the cost of accelerated partial breast irradiation (APBI) with proton therapy was estimated at $13,833, while whole breast irradiation (WBI) resulted in the highest Medicare charges ($19,599). Average charges involving other treatment options were $12,784.

The researchers point out that the role of APBI is still being evaluated; MD Anderson is currently conducting a clinical trial to assess whether receiving a one-week course of partial breast irradiation with proton therapy will cause fewer and/or less severe side effects than a longer course of radiation treatment.

The idea behind delivering APBI with proton therapy is that it can be delivered at a very precise target, which means a shorter treatment time--10 treatments twice a day over one week, according to the researchers. This compares to standard treatment approaches that might include breast-conserving surgery, followed by whole breast radiation, treatments that are given daily for up to six weeks.

One of the problems associated with proton therapy, the researchers said, has been the assumption that it is more costly than other traditional treatments.

"This cost analysis must be interpreted in light of clinical evidence for proton APBI, which while still in nascent stages, is promising," Valentina Ovalle, a postdoctoral research fellow and the study's principal investigator, said in an announcement. "The findings counter the presumption that proton APBI is so expensive that even excellent clinical results would be immaterial. If the payment barrier for proton therapy is removed so that current and future research can proceed, the outcomes may ultimately benefit patients, physicians and insurers: better treatments at lower costs."

The costs associated with proton therapy have acted to stall the development of the technology. This past summer at the annual conference of the National Association of Proton Therapy, stakeholders bemoaned the reimbursement challenges they face--challenges that include the fact that insurers won't cover these treatments because of the costs involved and the paucity of evidence concerning the benefits of proton therapy. 

To learn more:
- see the announcement from MD Anderson
- see clincial trial summary