Future Patient Access to Proton Therapy is the Focus of NAPT Physician Advisory Committee
By Samuel Jean-Baptiste, MD, MS
I recently had the privilege of representing our institution at the National Association for Proton Therapy's (NAPT) annual conference as a member of the Physician Advisory Committee (PAC). The sessions and discussions will directly affect every patient we treat, every center in operation and every policy decision that shapes access to this technology.
The reimbursement environment for proton therapy is undoubtedly under real pressure. Policymakers tend to weigh the upfront cost of proton therapy centers without accounting for what it actually saves downstream—including but not limited to—reduced toxicity, fewer hospitalizations and better quality of life for many patients.
Consequently, reimbursement equity was a pressing topic. Current payment models do not always reflect the true cost of delivering proton therapy, and free-standing centers, in particular, are often reimbursed at lower rates than hospital-based programs despite comparable healthcare costs and quality. Proposed federal legislation like the Radiation Oncology Case Rate Act, as currently written, would delay proton therapy's inclusion for a decade while anchoring payments to rates that are already inadequate. The Centers for Medicare and Medicaid Services (CMS) is actively seeking input on how to establish a consistent national pricing methodology for proton therapy. Advocating for payment stability and parity across practice settings is an ongoing priority for the PAC.
On the research side, the path forward requires us to be smarter in the questions we ask and how we design trials and recruit patients. Funding for radiation oncology research is limited. Industry support lags far behind medical oncology, and proton-specific trials have become less common than in early years when proton therapy was new on the scene. What emerged from our sessions was a clear strategy advocating for trial designs built around patient-centered composite endpoints, including toxicity, quality of life and functional outcomes. Patient selection will matter enormously. The strongest evidence will likely come from identifying who benefits most, not from trying to prove proton therapy is better for everyone in every setting. Multicenter collaboration through groups like NRG Oncology and the Proton Collaborative Group will be critical due to the limited number of proton therapy centers nationally. We only get answers in a reasonable timeframe if we work together and share data across institutions.
None of this happens without physician engagement. The technical complexity of proton therapy is genuinely difficult to communicate to legislators, payers and even colleagues in other specialties. The PAC exists precisely to keep organized, informed physician voices in the national conversation on reimbursement policy, trial design and the long-term viability of proton therapy as a treatment option for patients who need it. We are proud of the work that has been done thus far, and we look forward to sharing more updates as these conversations continue to evolve.