The Proton Beam Arms Race

Varian Proton Therapy System

We have great respect for former BI-Deaconess CEO Paul Levy. We’re particularly enamored by his insistence on administrative transparency and reimbursements for evidence-based therapies. Commonsense managerial goals like this that can do a lot to improve quality and reign in healthcare costs.

But, in an open letter on his blog, he asked CMS to stop the proton beam arms race. And, as gadget lovers and fans of science fiction, that was a little tough for us to stomach.

We’ve been following the application of proton beams ever since its appearance on Star Trek and were delighted to learn that doctors could use them for cancer therapy, as well. The idea is tumors can be destroyed or shrunk with more localized tissue irradiation than other external beam therapies.

The therapy is enormously expensive, and despite the operation of 29 proton beam centers worldwide and several decades of research, it’s not clear whether this therapy provides better outcomes (though it seems fewer side effects are noted).

Levy’s not arguing that proton beam therapy should stop, only that Medicare should stop reimbursing providers for using it until there is compelling evidence of its efficacy. And while that’s a reasonable argument, we can’t help but worry that limiting payments for this practice will limit its adoption, development and study. And that may leave us vulnerable when the Klingons attack.

Paul Levy: Dear CMS: Stop the proton beam arms race…