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RELEASE: For Prostate Cancer, Medicare Pays Double for the Same Result with Proton Beam Therapy

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Contact: Tom Caiazza
Phone: 202.481.7141
Email: tcaiazza@americanprogress.org

Washington, D.C. — An analysis of Medicare physician payment data by the Center for American Progress concludes that Medicare spends millions of dollars annually to treat prostate cancer with proton beam therapy, which is no more effective than—but twice the price of—the standard radiation treatment. This newly developed procedure requires the construction of special facilities, often costing hundreds of millions of dollars. The cost of treating cancers with proton beam therapy is dramatically higher—in many cases, double—than with other advanced therapies such as intensity-modulated radiation therapy, or IMRT. Despite this, studies have consistently shown that proton beam therapy offers no improvement for patients with most cancers, including prostate cancer.

The issue brief is the second in a series that takes a deep look into the recently released Medicare physician payment database to highlight inefficiencies in the system through case studies of specific treatments or procedures.

“At more than double the cost of alternative treatments, proton beam therapy—while effective in some narrow cases—is far from the best choice when treating prostate cancer,” said Topher Spiro, Vice President for Health Policy at CAP and lead author of the brief. “Proton beam therapy’s rapid growth in utilization is, in most cases, absolutely not justified by its effectiveness over other treatments.”

In the brief, titled “Prostate Cancer Treatment: Unproven Proton Radiation Therapy Wastes Millions of Dollars,” CAP’s health experts show that Medicare and seniors could save $12 million per year by choosing equally effective treatments such as IMRT over the more costly proton beam therapy. The brief cites several studies that show that patient outcomes would be the same under IMRT as proton beam therapy. With the number of expensive proton therapy centers on track to double in the next few years, proton beam therapy poses a growing risk for an even greater waste of taxpayer money.

This on-going series, titled “The High Price of Unnecessary Treatment,” will use Medicare physician payment data to identify wasteful Medicare spending. The series will highlight treatments that have proven to be ineffective or cases where equally effective alternatives can be used at a fraction of the cost to patients and taxpayers.

Click here to read the brief.

For more information on this topic, contact Tom Caiazza at 202.481.7141 or tcaiazza@americanprogress.org.

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