Breast: +7%
GI Tract: +6.4%
Head & Neck: -3.8%
Prostate: -11%
In 2023, a decrease was noted in treatments for head and neck cancer, currently the subject of a phase III randomized trial supporting the value of proton therapy for these conditions.

“NAPT will continue its work to increase public awareness of the value proton therapy for head and neck conditions and ensure that payor guidelines reflect the most recent clinical findings,” said Maggiore. “Meanwhile, despite progress, barriers to proton treatment remain. Prior authorization remains a challenge and continues to require the utilization of valuable operational and staffing resources.”

Prior authorization for proton therapy was required in more than 65 percent of claims, accounting for a majority of patients waiting more than six days to receive treatment – a potential life-threatening delay. Survey data reported on prior authorization includes:

73% percent of patients experienced an average wait time of more than 6 days for PT treatment authorization in 2023, an increase from 63.8% 2022.
75.8% of patients in 2023 “sometimes” or “often” experienced delays in care delivery due to prior authorization, an increase from 75% in 2022.
29.9% of prior authorizations in 2023 were initially denied, down from 33.8% in 2022 – a decline resulting from the effective advocacy efforts of NAPT and its members.

Proton therapy currently represents less than 1% of all radiation oncology treatments by modality, and approximately 65% of the U.S. population lives more than 100 miles from a treatment center. The proton therapy community, however, continues to experience growth as an increasing number of patients experience this life-saving, life-changing treatment.

“While initial prior authorization denials are down, authorizations granted on appeal have also decreased, potentially signaling a growing inflexibility among payors,” said Maggiore. “At NAPT, we will continue to advocate on behalf of patients to ensure their treatment is covered. Our members remain committed to advancing the practice of proton therapy and creating access to one of the medical community’s most innovative and effective cancer treatments.”

Read a summary of the NAPT member survey findings https://proton-therapy.org/resource-item/2024-napt-member-survey-executive-summary/.

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The National Association for Proton Therapy (NAPT) is an independent nonprofit organization founded in 1990 to educate and increase awareness about the clinical benefits of proton therapy. Its members include 48 of the nation’s leading cancer centers, many of which are NCI-designated comprehensive cancer centers and NCCN members. The mission of NAPT is to work collaboratively to raise public awareness of the clinical benefits of proton therapy, ensure patient choice and access to affordable proton therapy, and encourage cooperative research and innovation to advance the appropriate and cost-effective utilization of proton therapy.

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