Intervention of interest: Proton beam therapy

ICER completed a Technology Assessment of proton beam therapy (PBT) for the public meeting of the Washington State Health Care Authority Clinical Committee.

ICER’s review found that PBT was superior to surgical treatment of tumors of the eye, and appears to be a safer alternative to conventional radiation in brain and spinal tumors as well as pediatric cancers, although most of the evidence in the latter two conditions has been based on simulation modeling rather than actual clinical study.

There was insufficient evidence to determine whether PBT offers any improvement over alternative treatments for many other conditions, including bone, breast, gastrointestinal, head and neck cancers, lymphomas, and benign arteriovenous malformations.

For many other conditions, including prostate, liver and lung cancer, PBT provides comparable outcomes but at greatly increased cost. Payments for PBT are typically 2-3 times higher than for other forms of radiation treatment and may approach $50,000 per course of treatment in some situations. The higher costs and limited evidence of effectiveness have prompted many policymakers to carefully examine the circumstances under which PBT should be offered.

Date of Review: March 2014

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Final Documents

Below you will find the final documents from the assessment review process:

“Our independent and comprehensive review shows that while data exist to support the use of PBT for a few select cancers, there is inadequate evidence to support its use across a broad range of conditions. ICER is proud to support public, transparent processes in which the evidence on clinical effectiveness and value are considered together to make the best use of limited health care resources. This report demonstrates the critical role that evidence-based medicine has in supporting high quality, high value outcomes for patients, payers and physicians in Washington and across the nation.”