Anthony J. Montagnolo, executive vice president and chief operating officer at ECRI Institute, writes in Trustee magazine, “A Question of Value: Proton therapy’s benefits have a big price tag. Is it right for your hospital?“
Although this is an article and a publication targeted at directors of hospitals and health care systems, what it says should be of interest to journalists, patients and consumers. Excerpt:
“First question: How well does this really work? An even better question: What objective clinical evidence exists to support using this clinical technology over existing alternatives? Though the first question seems obvious, the corollary question emphasizes that we should compare a new technology to what we currently have; that is, look for its comparative effectiveness. Thus, for proton beam therapy, the question is whether it works better than more conventional therapies, not just that it does what it is purported to do. This isn’t as simple as it seems. Many clinical trials are not true head-to-head comparisons, and much of the clinical literature does not provide conclusive data regarding whether one therapy or treatment is superior to another.
In the specific case of proton beam therapy, the clinical literature has little in the way of direct comparisons that might help us assess its effectiveness if we are trying to answer the corollary question. ECRI Institute’s staff reviewed the literature in 2010 and concluded that no true analysis of the efficacy of proton therapy was possible given that the data available was insufficient.
This conclusion mirrors that of reports issued by the Agency for Healthcare Research and Quality, which similarly indicated that a systematic review of the clinical literature on this technology likely would not yield conclusions on the effectiveness of proton beam therapy.
While this lack of data should not be taken to mean that proton beam therapy does not work, it does mean that there is the possibility that it does not provide much benefit over conventional therapy. Basically, we just don’t know. So, investing in this therapy carries the risk that the technology may not prove worth it–and with a $100 million to $200 million price tag on the line, that is a major risk.”