Selling Proton Therapy

by MARTHA ROSENBERG

eventeen years after direct-to-consumer (DTC) drug advertising was instituted in the US, 70 percent of adults and 25 percent of children are on at least one prescription drug. Topping the adult pill category is–surprise!–antidepressants which are used by an astounding one in four women between 50 and 64. Topping the child pill category is–another surprise!–ADHD meds, though kids increasingly take blood pressure, diabetes and insomnia meds too. (Babies are actually given GERD medicine for spitting up.) Twenty percent of the population is now on five or more prescription medications. Ka-ching.

DTC advertising has done two pernicious things. It has created a nation of hypochondriacs with depression, bipolar disorder, GERD, Restless Legs, insomnia, seasonal allergies and assorted pain, mood and “risk” conditions and it has reduced doctors to order takers and gate keepers. Thanks to TV drug ads, patients tell doctors what is wrong with them and what pill they need, coupon in hand. Drug company-funded web sites even give patients talking points to use when they see the doctor, lest they don’t ring up a sale.

Selling prescription drugs like soap makes a mockery of a medical school education. It has created the need to train doctors in “refusal” skills said Richard Pinckney, MD, Professor at the University of Vermont College of Medicine at a 2010 Chicago conference attended by medical boards, accrediting agencies and representatives from the AMA, FDA, VA and 23 medical centers. Now the same technique is at play with
radiation therapy.

For at least two years, direct-to-consumer radiation ads have aggressively promoted “proton therapy” to patients, an expensive new kind of radiation treatment for people with prostate and other cancer that is said to limit radiation exposure to surrounding organs. While proton therapy sounds like a “scientific marvel,” writes biotech reporter Luke Timmerman, the evidence of its value is limited so far to brain
tumors called medulloblastomas and not other cancers for which it is marketed. There is also a “real problem” with the business model, writes Timmerman. Because a proton center costs $152 million to build and operate, it “creates an incentive for doctors within a network to steer their patients to proton therapy,” including cancer patients who may not be appropriate and who may “benefit just as much from an existing, lower-cost alternative.”

How much more expensive is proton therapy? The average Medicare reimbursement for proton treatment for prostate cancer is about $32,428 versus $18,575 for standard radiation. Other estimates place proton therapy at $50,000 for prostate cancer, twice as much as intensity-modulated radiation therapy (IMRT) which is also employed to limit radiation exposure to surrounding organs.

Is it proton therapy better? Not according to comparative effectiveness studies in the Journal of the American Medical Association (JAMA). Patients on the cheaper IMRT therapy had a 34 percent lower risk of gastrointestinal side effects compared to proton therapy. (IMRT was also associated with  22 percent fewer hip fractures and a 19 percent reduced need for further cancer treatment than traditional radiation though there was a greater risk of erectile dysfunction.)

Will “Ask Your Doctor” radiation ads sell proton therapy the way they have Lipitor, Nexium, Claritin and Prozac? If patients can be experts on diseases and medication, why can’t they be experts on oncology? Or will the medical establishment realize if proton therapy were really superior, ads and patients would not be required to sell it–and pay for the machine.

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

 

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

Like What You’ve Read? Support CounterPunch
September 02, 2015
Paul Street
Strange Words From St. Bernard and the Sandernistas
Jose Martinez
Houston, We Have a Problem: False Equivalences on Police Violence
Henry Giroux
Global Capitalism and the Culture of Mad Violence
Ajamu Baraka
Making Black Lives Matter in Riohacha, Colombia
William Edstrom
Wall Street and the Military are Draining Americans High and Dry
David Altheide
The Media Syndrome Between a Glock and a GoPro
Yves Engler
Canada vs. Africa
Ron Jacobs
The League of Empire
Kim Nicolini
Remembering Wes Craven’s The Hills Have Eyes
Andrew Smolski
Democracy and Privatization in Neoliberal Mexico
Norman Pollack
Obama, Flim-Flam Artist: Alaska Off-Shore Drilling
Lawrence Wittner
Russians and Americans Get Their Kids Ready for War
September 01, 2015
Mike Whitney
Return to Crisis: Things Keep Getting Worse
Michael Schwalbe
The Moral Hazards of Capitalism
Eric Mann
Inside the Civil Rights Movement: a Conversation With Julian Bond
Pam Martens
How Wall Street Parasites Have Devoured Their Hosts, Your Retirement Plan and the U.S. Economy
Jonathan Latham
Growing Doubt: a Scientist’s Experience of GMOs
Fran Shor
Occupy Wall Street and the Sanders Campaign: a Case of Historical Amnesia?
Joe Paff
The Big Trees: Cockburn, Marx and Shostakovich
Randy Blazak
University Administrators Allow Fraternities to Turn Colleges Into Rape Factories
Robert Hunziker
The IPCC Caught in a Pressure Cooker
George Wuerthner
Myths of the Anthropocene Boosters: Truthout’s Misguided Attack on Wilderness and National Park Ideals
Robert Koehler
Sending Your Children Off to Safe Spaces in College
Jesse Jackson
Season of the Insurgents: From Trump to Sanders
August 31, 2015
Michael Hudson
Whitewashing the IMF’s Destructive Role in Greece
Conn Hallinan
Europe’s New Barbarians
Lawrence Ware
George Bush (Still) Doesn’t Care About Black People
Joseph Natoli
Plutocracy, Gentrification and Racial Violence
Franklin Spinney
One Presidential Debate You Won’t Hear: Why It is Time to Adopt a Sensible Grand Strategy
Dave Lindorff
What’s Wrong with Police in America
Louis Proyect
Jacobin and “The War on Syria”
Lawrence Wittner
Militarism Run Amok: How Russians and Americans are Preparing Their Children for War
Binoy Kampmark
Tales of Darkness: Europe’s Refugee Woes
Ralph Nader
Lo, the Poor Enlightened Billionaire!
Peter Koenig
Greece: a New Beginning? A New Hope?
Dean Baker
America Needs an “Idiot-Proof” Retirement System
Vijay Prashad
Why the Iran Deal is Essential
Tom Clifford
The Marco Polo Bridge Incident: a History That Continues to Resonate
Peter Belmont
The Salaita Affair: a Scandal That Never Should Have Happened
Weekend Edition
August 28-30, 2015
Randy Blazak
Donald Trump is the New Face of White Supremacy
Jeffrey St. Clair
Long Time Coming, Long Time Gone
Mike Whitney
Looting Made Easy: the $2 Trillion Buyback Binge
Alan Nasser
The Myth of the Middle Class: Have Most Americans Always Been Poor?
Rob Urie
Wall Street and the Cycle of Crises
Andrew Levine
Viva Trump?