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Indiana University Health says it will close its Proton Therapy Center by the end of the year. The school says the facility has operated at a financial deficit for most of its existence. The move is expected to affect approximately 120 employees. You can view Indiana University's notice to the Indiana Department of Workforce Development by clicking here.

August 22, 2014

News Release

Bloomington, Ind. – Indiana University Research and Technology Corp. and Indiana University Health announced today they have accepted the recommendation of an outside review committee to close the financially struggling IU Health Proton Therapy Center once the current roster of patients has completed treatment, which is expected to occur no later than Jan. 1, 2015.

As a result of the decision to close the cancer treatment facility, the IU Cyclotron also will close by the end of the year. The combined facility, on the northern edge of the IU Bloomington campus, employs approximately 120 people. The IU Center for Exploration of Energy and Matter, which is at the Cyclotron but not reliant on the use of the proton beam for its work, will remain open.

IU Health Proton Therapy Center, a joint venture of IU Health and the IU Research and Technology Corp., became the nation's third proton therapy facility, and the only one in the Midwest, when it opened in 2004. The facility uses a proton beam generated by the IU Cyclotron, which was established at its current location in 1976 as a physics research facility, to provide focused radiation treatments that have proven especially effective in treating certain types of tumors, most notably those associated with cancer of the eye and brain in children.

Over the past decade, however, a significant increase in the number of newly designed proton therapy facilities in the country — along with advances in cancer treatment, falling insurance reimbursement rates for proton therapy treatment and aging equipment at the IU Health Proton Therapy Center/IU Cyclotron — have led to a declining patient base and revenues, as well as increased operating costs. As a result, the facility, which has operated at a deficit for most of its existence, is no longer financially sustainable.

“The IU Health Proton Therapy Center has provided treatment to 2,000 patients since its inception, due to the considerable skill, dedication and passion of the IUHPTC and IU Cyclotron staff,” said Dr. Jay Hess, vice president for university clinical affairs and dean of the IU School of Medicine.

“Unfortunately, rapidly advancing technology and changes in the dynamics of cancer treatment have left us with a dwindling patient base and a facility that is many times more expensive to operate than most of our competitors in this field.

“Both IU and IU Health are committed to doing everything possible to ensure that our current patients receive the same high standard of care that has become IUHPTC’s hallmark over the past decade.”

IU also will fully support its employees throughout the closing process and beyond. The closing affects about 65 employees at the IU Cyclotron and more than 50 IU Health Proton Therapy Center employees, who were informed of the decision this morning. Affected employees will receive job placement assistance, and comprehensive severance packages will be given to those employees who do not find other comparable positions at IU, IU Health or an outside employer.

The Proton Therapy Center is currently treating approximately 30 patients, who will continue to receive proton radiation therapy until their current course of treatments is complete.

“Cancer care is one of the most active areas in medical research and innovation,” said Dennis Murphy, executive vice president and chief operating officer at IU Health. “Our highly skilled physicians are focused on providing the most effective ways to battle cancer and always work to ensure that our patients have access to the most appropriate treatment for their disease.”

The review committee was formed this spring at Hess' request to analyze the future viability of the Proton Therapy Center and the Cyclotron, which operated at a $3.5 million deficit in fiscal year 2013 and have generated significant cumulative operating losses since the Proton Therapy Center opened in 2004. IU has already experienced a $20 million loss on its constructed assets and has approximately $15 million in receivables due from the Proton Therapy Center.

The five-member committee examined detailed documents pertaining to the combined facility and conducted a site visit where it toured the facility and heard presentations from staff comprising all aspects of the Proton Therapy Center and Cyclotron operations.

While the committee praised the caliber of the workforce at the IU Health Proton Therapy Center and the IU Cyclotron, and lauded the standard of patient care, it noted several factors that keep the operation from being competitive with similar facilities today and into the future, even with increased investment. Those include:

• The number of proton therapy treatment facilities in the United States has grown to 15, with another 20 in development or planning. Most, if not all, of these facilities offer advanced technology, making them significantly less expensive to operate than IU Health Proton Therapy Center.

• Despite the growth in proton therapy centers, there is considerable debate over the extent to which this style of treatment — which can cost 10 to 100 times more than the next most-expensive tumor treatments — will ever become widely used. Indeed, the review committee cited a possible “proton bubble” that will force many older, more indebted facilities to close in the near future.

• A “substantial improvement” in alternatives to the proton beam as treatment options.

• Significant changes in approach to prostate cancer care that greatly minimize the use of proton therapy in treatment. Prostate cancer had once been seen to have the potential of greatly expanding the demand for proton therapy.

• The IU Health Proton Therapy Center conducts only modest clinical research, due in large part to the facility’s location in Bloomington rather than a more centrally located city with greater health care resources readily available.

• The underlying technology used by the Proton Therapy Center has not kept pace with changes in the field. Even replacing the Cyclotron, as had been proposed, would not allow for the development of state-of-the-art technology.

• The facility is considerably larger than needed for the current patient volumes, resulting in much higher staffing levels than necessary.

• Non-clinical research revenues associated with the Cyclotron are minimal, with little prospect for new research contracts given the aging equipment and technology.

The complete report of the review committee is available online.

“This decision wasn’t made lightly,” Hess said. “The review committee was extremely thorough in its analysis of operation and finances at the facility, as well as in examining the competitive and medical landscape surrounding proton therapy.

“The committee came to the conclusion that with the many alternative cancer treatment options available to patients, along with the cost to upgrade and maintain the facility, continuing the operation in today's health care environment simply is not viable.”

Sources: Indiana University, The Indiana Department of Workforce Development

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