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The researchers are proposing an approach that leverages lessons learned from these successful experiences — bringing together public and private insurers, proton therapy centers, hospitals, radiation therapy equipment vendors and patient advocates to establish a program of coverage that includes trial participation in one of the seven trials. Commercial insurance medical policies that do not cover treatment with proton therapy can make it difficult for patients to participate in randomized clinical trials funded by the NCI, part of the National Institutes of Health, that are evaluating the therapy. Other barriers will be addressed, including physician and patient engagement in the clinical trials.
The NCI is hosting a meeting with insurers later this month to consider opportunities and challenges to establish such a program. In contrast, Medicare typically does cover proton therapy through local coverage determinations, thus allowing patients to participate in trials. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine, and Princeton House Behavioral Health, a leading provider of highly skilled and compassionate behavioral healthcare.
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