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Different attitudes toward proton therapy drive international growth

par Nancy Ryerson, Staff Writer | September 12, 2013

"There are some developers and private entities interested, but it's going to go at a slower pace until the government really embraces it," said John Jessen, managing principal at VOA Associates.

Courtney also has a China project his team is working on, in Guangdong, China. The facility there plans to design its own equipment to save on costs and optimize treatment for a larger population.

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"What they're really trying to do is get proton therapy promulgated through the country, and not just for the wealthy," said Courtney.

Taiwan has one center, and Korea has one center with another on the way. A center is also planned in Singapore.

Europe expands its proton therapy reach

In December 2012, the first proton therapy center in Central and Eastern Europe opened in Prague, Czech Republic. The center has treated local patients as well as patients from Russia, Germany, Norway, Switzerland, England and Serbia.

"Prague is less than two hours by plane from London, so it's highly accessible to cancer patients throughout Europe," said Mike Cullen, of Proton Therapy UK Ltd.

Like most centers in Europe, it's a multi-room facility, with five treatment rooms. Cullen estimates the anticipated treatment capacity will be 2,000 to 2,500 patients per year.

In the United States, small, one-room centers have become more popular, but Cohen predicts that trend will not be as prevalent in Europe because centers are less dependent on profit.

"Certainly in terms of the business model, there's less private development overseas, and less pressure to meet minimum thresholds for patient volumes," said Cohen. "Generating revenue quickly to address the financing challenge seems to be less intense than it is in the U.S."

Though government-funded centers have benefits in terms of financing, Cohen has noticed drawbacks in the process as well. Many public facilities have an open bid for proton therapy vendors and begin building the facility before making a vendor selection.

"In our experience, it significantly extends the time frame needed to build these projects," said Cohen. "The open bid process can require us to design with a universal approach, so it becomes a facility that can accommodate a number of vendor systems."

Cohen said the open bid process can also ultimately be more costly than leading with a vendor in mind.

Next up for proton

Besides established markets, proton therapy professionals expect the treatment to continue to expand in more underserved parts of the world. Jessen, for one, is working with his team on a project in the Middle East, where religious requirements have impacted the center's design.

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