FacebookTwitterGoogle+RedditEmail

Selling Proton Therapy

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).

 

More articles by:

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).

July 18, 2018
Bruce E. Levine
Politics and Psychiatry: the Cost of the Trauma Cover-Up
Frank Stricker
The Crummy Good Economy and the New Serfdom
Linda Ford
Red Fawn Fallis and the Felony of Being Attacked by Cops
David Mattson
Entrusting Grizzlies to a Basket of Deplorables?
Stephen F. Eisenman
Want Gun Control? Arm the Left (It Worked Before)
CJ Hopkins
Trump’s Treasonous Traitor Summit or: How Liberals Learned to Stop Worrying and Love the New McCarthyism
Patrick Bond
State of the BRICS Class Struggle: Repression, Austerity and Worker Militancy
Dan Corjescu
The USA and Russia: Two Sides of the Same Criminal Corporate Coin
The Hudson Report
How Argentina Got the Biggest Loan in the History of the IMF
Kenn Orphan
You Call This Treason?
Max Parry
Ukraine’s Anti-Roma Pogroms Ignored as Russia is Blamed for Global Far Right Resurgence
Ed Meek
Acts of Resistance
July 17, 2018
Conn Hallinan
Trump & The Big Bad Bugs
Robert Hunziker
Trump Kills Science, Nature Strikes Back
John Grant
The Politics of Cruelty
Kenneth Surin
Calculated Buffoonery: Trump in the UK
Binoy Kampmark
Helsinki Theatrics: Trump Meets Putin
Patrick Bond
BRICS From Above, Seen Critically From Below
Jim Kavanagh
Fighting Fake Stories: The New Yorker, Israel and Obama
Daniel Falcone
Chomsky on the Trump NATO Ruse
W. T. Whitney
Oil Underground in Neuquén, Argentina – and a New US Military Base There
Doug Rawlings
Ken Burns’ “The Vietnam War” was Nominated for an Emmy, Does It Deserve It?
Rajan Menon
The United States of Inequality
Thomas Knapp
Have Mueller and Rosenstein Finally Gone Too Far?
Cesar Chelala
An Insatiable Salesman
Dean Baker
Truth, Trump and the Washington Post
Mel Gurtov
Human Rights Trumped
Binoy Kampmark
Putin’s Football Gambit: How the World Cup Paid Off
July 16, 2018
Sheldon Richman
Trump Turns to Gaza as Middle East Deal of the Century Collapses
Charles Pierson
Kirstjen Nielsen Just Wants to Protect You
Brett Wilkins
The Lydda Death March and the Israeli State of Denial
Patrick Cockburn
Trump Knows That the US Can Exercise More Power in a UK Weakened by Brexit
Robert Fisk
The Fisherman of Sarajevo Told Tales Past Wars and Wars to Come
Gary Leupp
When Did Russia Become an Adversary?
Uri Avnery
“Not Enough!”
Dave Lindorff
Undermining Trump-Putin Summit Means Promoting War
Manuel E. Yepe
World Trade War Has Begun
Binoy Kampmark
Trump Stomps Britain
Wim Laven
The Best Deals are the Deals that Develop Peace
Kary Love
Can We Learn from Heinrich Himmler’s Daughter? Should We?
Jeffrey St. Clair
Franklin Lamb, Requiescat in Pace
Weekend Edition
July 13, 2018
Friday - Sunday
Brian Cloughley
Lessons That Should Have Been Learned From NATO’s Destruction of Libya
Paul Street
Time to Stop Playing “Simon Says” with James Madison and Alexander Hamilton
Jeffrey St. Clair
Roaming Charges: In the Land of Formula and Honey
Aidan O'Brien
Ireland’s Intellectuals Bow to the Queen of Chaos 
FacebookTwitterGoogle+RedditEmail