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).

Weekend Edition
April 20, 2018
Friday - Sunday
Paul Street
Ruling Class Operatives Say the Darndest Things: On Devils Known and Not
Conn Hallinan
The Great Game Comes to Syria
Jeffrey St. Clair
Roaming Charges: Mother of War
Andrew Levine
“How Come?” Questions
Doug Noble
A Tale of Two Atrocities: Douma and Gaza
Kenneth Surin
The Blight of Ukania
Howard Lisnoff
How James Comey Became the Strange New Hero of the Liberals
William Blum
Anti-Empire Report: Unseen Persons
Lawrence Davidson
Missiles Over Damascus
Patrick Cockburn
The Plight of the Yazidi of Afrin
Pete Dolack
Fooled Again? Trump Trade Policy Elevates Corporate Power
Stan Cox
For Climate Mobilization, Look to 1960s Vietnam Before Turning to 1940s America
William Hawes
Global Weirding
Dan Glazebrook
World War is Still in the Cards
Nick Pemberton
In Defense of Cardi B: Beyond Bourgeois PC Culture
Ishmael Reed
Hollywood’s Last Days?
Peter Certo
There Was Nothing Humanitarian About Our Strikes on Syria
Dean Baker
China’s “Currency Devaluation Game”
Ann Garrison
Why Don’t We All Vote to Commit International Crimes?
LEJ Rachell
The Baddest Black Power Artist You Never Heard Of
Lawrence Ware
All Hell Broke Out in Oklahoma
Franklin Lamb
Tehran’s Syria: Lebanon Colonization Project is Collapsing
Donny Swanson
Janus v. AFSCME: What’s It All About?
Will Podmore
Brexit and the Windrush Britons
Brian Saady
Boehner’s Marijuana Lobbying is Symptomatic of Special-Interest Problem
Julian Vigo
Google’s Delisting and Censorship of Information
Patrick Walker
Political Dynamite: Poor People’s Campaign and the Movement for a People’s Party
Fred Gardner
Medical Board to MDs: Emphasize Dangers of Marijuana
Rob Seimetz
We Must Stand In Solidarity With Eric Reid
Missy Comley Beattie
Remembering Barbara Bush
Wim Laven
Teaching Peace in a Time of Hate
Thomas Knapp
Freedom is Winning in the Encryption Arms Race
Mir Alikhan
There Won’t be Peace in Afghanistan Until There’s Peace in Kashmir
Robert Koehler
Playing War in Syria
Tamara Pearson
US Shootings: Gun Industry Killing More People Overseas
John Feffer
Trump’s Trade War is About Trump Not China
Morris Pearl
Why the Census Shouldn’t Ask About Citizenship
Ralph Nader
Bill Curry on the Move against Public Corruption
Josh Hoxie
Five Tax Myths Debunked
Leslie Mullin
Democratic Space in Adverse Times: Milestone at Haiti’s University of the Aristide Foundation
Louis Proyect
Syria and Neo-McCarthyism
Dean Baker
Finance 202 Meets Economics 101
Abel Cohen
Forget Gun Control, Try Bullet Control
Robert Fantina
“Damascus Time:” An Iranian Movie
David Yearsley
Bach and Taxes
FacebookTwitterGoogle+RedditEmail