Proton therapy center closure could be sign of the times
The Indiana University Health Proton Therapy Center will close in December, marking the first time a proton-beam therapy center in the U.S. has shut its doors since the rapid proliferation of the costly treatment centers began a decade ago.
University executives and an independent review committee attributed the center’s financial losses to a range of issues, including the cost of maintaining its aging cyclotron. But the committee also suggested the industry may be on the verge of a “proton bubble” as the centers struggle to serve a sufficiently large patient population.
Many centers have based their volume expectations on treating prostate cancer patients. But insurers have started to push back on providing proton therapy coverage to those patients because of insufficient evidence proving its superior benefits over other treatments.
“I look at this closure as a sign that insurers are finally empowered to say this is a dubious medical technology” in the treatment of patients with prostate cancer, said Amitabh Chandra, director of health policy research at the Har- vard Kennedy School of Government. “The ‘build it and they will come’ philosophy around these centers is being questioned.”
The IU center, located in Bloomington, was the third proton therapy facility in the the U.S. when it opened in 2004. It’s jointly owned by the Indiana University Research & Technology Corp., a not-for-profit that handles IU-related business development, trademarks and intellectual property, and IU Health, an Indianapolis-based health system that owns 15 hospitals in the state.
When faced with the prospect of spending millions to update the center’s equipment, the university called for an independent review of the facility. The review panel unanimously recommended closing the center. The committee’s report highlighted issues affecting the proton industry, including the lack of completed randomized clinical trials, improvements in alternative treatments, changing care patterns for patients with prostate cancer, and the rise in new payment models, such as bundled payments, that may remove incentives to use the therapy.