NAPT Updates Proton Therapy Model Policy

WASHINGTON, March 31, 2015 /PRNewswire-USNewswire/ -- The National Association for Proton Therapy (NAPT) today issued an updated model insurance coverage policy for treating patients with proton beam therapy. This updated policy incorporates 15 significant and compelling articles published in peer reviewed journals in just the last 12 months.

The recently published articles discuss the use of proton beam therapy for numerous cancer sites, including head and neck tumors, non-small lung cancer, esophageal cancer and locally advanced breast cancer, as well as cancers in pediatric patients. Several articles contribute to the growing body of evidence related to the cost effectiveness and improved quality of life outcomes associated with proton beam therapy.

Proton therapy is a form of conformal external beam radiation treatment that delivers a precise beam to the patient's tumor site while sparing surrounding healthy tissue and cells, thus reducing side effects and increasing better post treatment outcomes.

The policy, endorsed by the Particle Therapy Cooperative Group-North America (PTCOG-NA) and the Alliance of Dedicated Cancer Centers (ADCC), identifies types of cancers and other diseases for which proton therapy is appropriately supported by existing scientific literature and 25 years of clinical experience. Based on a local Medicare coverage policy for patients in numerous states and for certain Blue Cross Blue Shield members, the model policy was developed to assist providers and payors with coverage decisions related to proton beam therapy. The document centralizes 375 scientific articles related to proton beam therapy and a list of clinical conditions supported by scientific evidence into a single document. NAPT encourages payors to accept and adopt this model coverage policy as their own.

Commenting on the newly announced model policy, Tyler Wilson, executive director of NAPT, said, "This model policy was originally released in March 2014. Updating this policy after just one year, and incorporating 15 high quality studies that have been published since its release, highlights the active and prolific research community in this area. Proton beam therapy is  a safe and effective technology.  The dedicated community of proton therapy researchers and providers are committed to enhancing care for patients and are constantly developing evidence to support its use. The evidence cited in the model policy is compelling."

Steven J. Frank, MD, medical director at MD Anderson Proton Therapy Center, Houston, TX said, "The evidence that is emerging from treating head and neck cancer patients with proton therapy  is that while the incremental cost of the delivery of protons is more initially, by the end of treatment the episodic cost of care is similar to standard radiation as patients experience less toxicity with protons and, as a result, require fewer emergency department visits, hospitalizations, and feeding tubes.  This makes proton therapy a cost effective form of radiation therapy, and we believe that once payors understand these benefits, access to this effective treatment against cancer for many patients will increase."

The complete model policy is posted at: www.proton-therapy.org

About the National Association for Proton Therapy (NAPT):
NAPT is a non-profit organization promoting education and public awareness of the clinical benefits of proton beam radiation therapy for cancer treatment. The organization is supported by world-renowned cancer centers that offer life-saving proton therapy treatment to patients. Founded in 1990, NAPT is an advocate for the advancement of proton beam technology and patient access to the unique therapy. Encouraging cooperative research and educating regulators, payment providers, and policymakers about the benefits of the therapy is critical to NAPT's mission. The website (www.proton-therapy.org) is intended to inform patients, health care providers, public and private payers, and the news media about cancer treatment utilizing proton beam radiation.

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SOURCE National Association for Proton Therapy

Related Links

http://www.proton-therapy.org