PREVIEW-U.S. Medicare panel to weigh prostate treatments

* Medicare advisers meet April 21

* Agency seeks advice on impact of radiation therapies

* May affect coverage of Accuray device, others

By Susan Heavey

WASHINGTON, April 18 (BestGrowthStock) – At a time of growing
debate over prostate cancer treatments, U.S. Medicare officials
will take a closer look at radiation therapy and its ability to
reduce deaths and side effects in men.

The Center for Medicare and Medicaid Services (CMS) has
asked a panel of outside experts meeting on Wednesday to say
how confident they are that various types of radiation
treatment can improve patient outcomes.

Researchers have found that many prostate cancers are so
slow-growing that most men will die from other causes, sparking
debate over whether diagnosis is too frequent and whether
treatments, which also include surgery, are excessive.

While the meeting will not directly address the agency’s
reimbursement rates, CMS is seeking advice that could later be
used to determine its payment policies. It oversees 45 million
elderly and disabled covered by the Medicare health insurance
program, about 40 percent of them men.

Any changes in how the agency — the nation’s largest
healthcare payer — covers radiation treatments could affect
the use of therapies by companies such as Accuray Inc (ARAY.O: ),
Siemens AG (SIEGn.DE: ), TomoTherapy (TOMO.O: ), and Varian Medical
Systems (VAR.N: ).

The experts will discuss the effectiveness of Accuray’s
CyberKnife robotic radiosurgery system and other radiation
treatments such as external beam radiation and implantable
radiation “seeds”.

The immediate impact on stocks is likely to be neutral,
said Josh Jennings, a medical device equities analyst at
Jefferies & Co.

But “if they feel that radiation therapy is being
overutilized, there could be a chance for some negative
recommendation” that could later cause some waves, he said.

Much debate surrounds how to treat prostate cancer in the
medical community, with surgeons, cancer radiologists and
urologists taking different approaches.

“The problem is trying to find … the prostate cancers
that need to be treated and which ones don’t, and that’s not
perfectly clear today,” Dr. Theodore DeWeese, a radiation
oncologist at Johns Hopkins Kimmel Cancer Center in Baltimore.

CMS has said looking at all the various treatments would be
too big a task for one day.

“The scope of this (meeting) is limited to radiotherapy for
the treatment of localized prostate cancer with comparisons to
watchful waiting,” it said in announcing the panel.


Medicare already pays for prostate cancer treatments. But
for officials at Accuray, the potential for payment changes is
a top concern.

With no formal Medicare rule requiring national coverage of
its CyberKnife treatment, coverage varies by region. Two areas
— the Northwest and parts of the West — have opted against

Quentin Helm, Accuray’s vice president for patient access,
said he hoped CMS would keep the status quo but was concerned a
future decision could rule against payment nationwide.

“When there’s doubt about what Medicare’s going to do, that
can be a deterrent to private insurers” that already offer a
“mixed bag” when it comes to reimbursement, Helm said.

Prostate cancer affects mostly older men — and Medicare
covers those aged 65 and older — but private payers often look
to CMS in making their own payment policies.

Unlike the use of CyberKnife with other cancers, “with
prostate it’s kind of spotty,” Helm said, referring to private
payer coverage.

John’s Hopkins’ DeWeese said there is a lack of consensus
about focused radiation products. “As of today, there’s very
little data to support that approach in terms of its likelihood
of a cure,” he said. “It might be equally effective, but it’s
certainly not proven.”

But Dr. Sean Collins, a radiation oncologist at Georgetown
University Hospital in Washington who uses the CyberKnife, said
it seems CMS is “trying to hold (CyberKnife) to a higher level
of standards.”

Collins, who will speak on Accuray’s behalf on Wednesday
but is not a paid consultant, said CyberKnife has the same side
effect risks as other types of radiation but requires just a
few visits rather than two months of daily doses. “I think
CyberKnife is a reasonable treatment option,” he said.

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(Reporting by Susan Heavey; Editing by Tim Dobbyn and Diane

PREVIEW-U.S. Medicare panel to weigh prostate treatments