"The For-Profit Side of Cancer
Treatment", (c) Andrew Pollack, The New York Times, December 26,
2007LOS ANGELES — To doctors visiting his company’s booth at
a recent medical meeting, Scott Phillips extolled the medical virtues of
the company’s equipment for treating cancer with protons. But he also
appealed to their financial interests.
With enough patients “it becomes a very lucrative system,” Mr.
Phillips, a sales manager with Optivus Proton Therapy, said at the meeting
of the American Society for Therapeutic Radiology and Oncology held here
in late October. Referring to one proton center that treats up to 175
patients a day, he added, “You can imagine what the return on investment
is on that.”
It is also a good return for the companies that make and sell the
equipment. The market leader appears to be Ion Beam Applications of
Belgium. Others are Hitachi of Japan and Siemens of Germany. Varian
Medical Systems acquired a proton equipment company, Accel, earlier this
year.
Other companies help finance, build and operate the facilities. The
most well known, ProCure Treatment Centers, is signing up community
hospitals and even private medical practices. The hospitals or doctors get
a small ownership stake, and therefore a small part of the profits, while
directing the medical treatments.
ProCure’s first project is being built in Oklahoma City by two medical
practices with a total of six radiation oncologists. Some wealthy local
residents, led by Aubrey McClendon, who runs a big natural gas company in
the area, invested $35 million in the $100 million project.
The company then arranged the rest of the financing through two Belgian
banks that do business with Ion Beam Applications, the equipment supplier.
Financing the proton centers has been a challenge even for big academic
medical centers, which have taken different approaches.
While M. D. Anderson Cancer Center is part of the University of Texas,
its proton center is not. To avoid endangering the university’s credit
rating, the proton center is a separate, for-profit entity.
M. D. Anderson supplies staff members for the center, but owns only 15
percent. The rest is owned by various investors recruited by an investment
bank in Houston.
The University of Pennsylvania’s $140 million proton operation will be
part of a nonprofit medical center. It is being built with the medical
center’s own money and donations.
Timothy R. Williams, former co-chairman of the radiation oncology
society’s health policy committee, said in a talk at the October
conference that the profession was threatening to debase itself if doctors
were building centers for the money or competitive advantage.
“Plenty of programs,” Dr. Williams said, “are doing it for the wrong
reasons.”