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Expensive cancer treatment centers spreading to small cities

Kate Archer Kent Sep 30, 2013
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Proton beam therapy is among the most expensive cancer treatments, but there’s little evidence that it’s any better than conventional radiation dosages and some private insurers are starting to tell physicians they’ll no longer pay for it.

Still, proton beam facilities are popping up across the country. The latest on the books in Dallas is estimated to cost $270 million. Even small cities want a piece of the proton therapy business.

Construction is underway on one in Shreveport, Louisiana. It’s one of at least 15 proton therapy centers rising up around the country.

Dr. Lane Rosen, director of radiation oncology at Willis-Knighton Health System, says patients are demanding proton beam therapy. Currently, they have to make a five-hour drive to Houston for the nearest facility.

“This is not something that the average radiation oncology department can afford to do,” Rosen says.

Rosen thinks the proton therapy that will be offered at Shreveport’s $40 million facility will be the future of cancer treatment.

“Even if you’re not willing to accept an improvement in cure, the reduction in side effects is absolute and undebated,” Rosen says.

The research is far from complete, according to Dr. Joel Tepper, a radiation oncology professor at the University of North Carolina. But that hasn’t curbed enthusiasm.

“It’s very good for marketing. You can say we have the latest and the greatest,” Tepper says.

Tepper contends the financial model here is built on volume: building a center that costs a lot of money but packing in a lot of patients.

“There’s a large burden on the health care system in the country to pay more money for a procedure that is no better,” Tepper says.

But private health insurers may not foot the bill for long. At least three major providers recently stopped covering the procedure in early stages of prostate cancer. That hasn’t deterred proton center construction. Amitabh Chandra, a professor of public policy at Harvard University and a critic of proton beam therapy, says that’s because these facilities take years for investors to secure tens of millions of dollars.

“Now the world has changed, and so, the people who bet on proton beam are likely to be very upset with the fact that it’s not going to be reimbursed by private insurers,” Chandra says.

But Dr. Lane Rosen is focused on the day he can zap cancer cells with proton beams. His unit will be ready for patients a year from now.

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