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Demand for proton therapy systems half of what it was five years ago: report

by John R. Fischer, Senior Reporter | March 15, 2021
Rad Oncology Proton Therapy
Demand for proton therapy systems has dipped 3% each year since 2018
Demand for new proton therapy systems is half of what it was in 2015, with the market slowing by 3% each year since 2018, according to MEDraysintell’s Proton Therapy World Market Report & Directory, Edition 2021.

The slowdown has been attributed in the past to several factors, including negative publicity and cost barriers to treatment. One of the biggest challenges has been resistance from health authorities and private insurers to reimburse providers for the treatment.

“Proton therapy, like any business in the medical field, is directly affected by reimbursement policies, which differ in each country or region worldwide. Generally, countries that have a proton therapy center have a reimbursement policy for proton therapy implemented by their national health insurance system and/or covered by private insurances,” Paul-Emmanuel Goethals, co-founder of MEDraysintell, told HCB News.

Fewer than 280 particle therapy treatment rooms — most of which are PT-based — were available for patients as of February 2021. There are 0.4 particle therapy treatment rooms per ten million people, compared to a rough equivalent of 20 radiotherapy systems worldwide, with proton therapy making up 2% of all external radiotherapy installations worldwide.

Less than 0.2% of all cancer patients worldwide underwent particle therapy for treatment in 2020, with proton therapy being the primary modality of this type. Even demand for single-room versus multi-room PT systems has stayed the same, with the 2020 order book for new particle therapy facilities showing 45% for single-room proton therapy, 45% for multi-rooms, and 10% for heavy-ion therapy centers. These proportions have remained the same as the 2013 – 2020 period, according to Goethals.

Compared to 2021, 2015 saw high market activity for PT that continued until mid-2016, when it began to slowly dip. Global investment in particle therapy, including carbon and proton, was almost 20% lower in 2018 than in 2017 and 62% lower than in 2015. Today, the top three vendors share 70% of the particle therapy market, with several companies expected to enter for the first time in the next few years with their own PT systems. Some 20 vendors are expected to compete against one another, with some potentially furthering consolidation by engaging in mergers and acquisitions.

In addition, at least 10% of external radiotherapy patients could benefit from proton therapy, which indicates the need for some 2,800 particle therapy treatment rooms to be installed worldwide and could help propel demand. This can be facilitated according to Goethals by lowering equipment costs and implementing innovative marketing strategies. He adds that such endeavors could help with access in the future to investigational treatments like FLASH therapy.

“A few years will be needed until the advantages of this new technology are demonstrated but it could represent an exciting and potentially promising new direction in the treatment of cancer," he said. "Since 2018, proton Flash therapy has been invested in by several companies in addition to Varian, such as IBA, Mevion and Hitachi.”

The 380-page report analyzes past changes and future trends in the market up to the year 2030, and has a directory of all PT facilities expected to become operational by 2025. It is available for purchase from MEDraysintell.

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