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National Association for Proton Therapy updates its model insurance policy

by Gus Iversen, Editor in Chief | April 01, 2015
Rad Oncology Proton Therapy
Built on 25 years of clinical findings, the National Association for Proton Therapy (NAPT) released its first model insurance coverage policy in March of 2014. Now — one busy year for proton therapy later — the association has issued an update to that policy which incorporates new clinical findings to support the treatment's use.

"Working with medical leaders from around the country, we believe that this new evidence continues to support our existing coverage recommendations," wrote Tyler Wilson, the executive director of the NAPT, in an e-mail to DOTmed News.

The updates come from 15 articles published in peer-reviewed journals, whose findings were found to be significant and compelling in determining who is a good candidate for proton therapy.

"Of note, the body of proton beam therapy evidence is expanding in many ways, including the diversity of cancer centers (from around the world) that are releasing their findings. We are also seeing an evolution in the types of cancers that our clinical leaders are targeting with proton beam therapy," wrote Wilson.

Those 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 of the new articles also add to the growing body of evidence supporting proton therapy as a cost effective treatment for many cancer indications and a way to achieve better quality of life outcomes than alternative treatments.

The NAPT's model policy — which is endorsed by the Particle Therapy Cooperative Group-North America, (PTCOG-NA) and the Alliance of Dedicated Cancer Centers (ADCC) — is based on local Medicare and Blue Cross Blue Shield coverage policies, and is intended to assist providers and payors making coverage decisions.

The document centralizes 375 scientific articles related to proton therapy and a list of clinical conditions supported by a body of evidence for positive outcomes.

The announcement of the policy model update took place in conjunction with the National Proton Conference in Washington, D.C. Proton therapy's popularity has been growing alongside the body of evidence recommending it for various treatments.

The American Society for Radiation Oncology released their own policy model for proton beam therapy in May of 2014.

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