Why Proton Therapy?

There was a post today on twitter from @HCDMagazine in regards to the $200M Proton Cancer Center that Emory Healthcare and Winship Cancer Institute broke ground on today. It will be 100,ooo+ sq ft facility with at least 5 treatment rooms and can accommodate about 2200 cancer patients/year.
The question I have is in regards to healthcare in general. If we are moving from a world of fee for service (pay per click) towards a world in which we pay for value (pay for the best outcome) then why are organizations still placing bets with protons?
Now, do not get me wrong. I love technology. I believe that protons have a place in the world of radiation oncology in the treatment of pediatric cancers. I know I would want this type of treatment for anyone I know that has a child that needs radiation therapy.
However, I question the real efficacy and improved outcomes in other types of cancer. I know there have been small conclusions that have been drawn for prostate, but let’s be honest with ourselves, the number of men that truly need to be treated versus the number that are treated is drastically different. So again, why the need for so many $200M facilities?
Prior to 2006 there were only 6 proton facilities in the United States. Since that time the number has more than doubled. Why?
It is my personal opinion that a lot of it was due to reimbursement and that it was more attractive and financially advantageous for organizations to invest in protons.
However, with the ACA and continued cuts in reimbursement, along with the lack of new NIH and NCI dollars for research, perhaps the trend to invest in larger proton facilities will begin to diminish.
No outcomes to support leveraging protons, should then mean no increase in higher payments?????
If genomics, precision, and personalized care are the wave of the future then why spend dollars in old technology that hasn’t shown a clinical advantage for all cancer patients?
I just had to ask….
As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM

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