>>Notes from Chicago
Here’s a quick report from Chicago.
Varian, Tomo and Intuitive Surgical executives attended the CyberKnife presentation at AUA. They stood in the back of the room and scowled. You can make of this whatever you want, I still maintain that if they didn’t view Accuray as a threat, they wouldn’t have nearly as much energy on trying to discredit CyberKnife for prostate.
At the Radiosurgery Course, there were excellent technical presentations from CyberKnife users specializing in CyberKnife for malignant tumors of the prostate (both homogeneous and HDR treatment patterns), lung (both primary and metastatic), brain (both primary and metastatic), spine, liver, pancreas and kidney as well as benign tumors of the spine and trigeminal neuralgia.
The main points of interest to investors:
Prostate results are excellent and if we were going to see biological failures we should have already seen at least some at three years out. The technical explanation has to do with the presumed alpha/beta ratio for prostate cancer (you can go look that debate up if you want to) but the bottom line for investors is that the data may not be old enough to be 100 percent conclusive but it’s starting to look particularly grim for the high alpha\beta ratio school and that’s good news for CyberKnife.
We investors tend to view CyberKnife as a treatment when in reality it is a tool that can be used in a numerous variety of ways. All of the treatment models are still works in progress. Centers are still experimenting with dosages, fraction schedules, treatment plans and other techniques. Outcomes are improving as physicians gain more experience with CyberKnife. Whatever the stats look like now, they are going to look even better a few more years out and that applies to just about all, if not in fact all, types of treatments.
Some centers that have been treating prostate for three years are now finding they get almost all their new patients from patient-to-patient referrals. Centers are also reporting that they are seeing very sophisticated patients that have done their research and know what they want when they come through the door.
Accuray has a fulltime team focused on coding and coverage issues. They are making progress and the trend is moving in our direction. While CyberKnife Centers are currently billing and being paid pursuant to non-listed codes, proposals for specialty specific codes (including prostate) have been presented for all of the major CyberKnife treatments.
Georgetown went from a $95 million per year deficit to a $22 million per year profit in large part due to the cash flow and rebranding effects of their CyberKnife program, this according to Linda Winger, MSc, FACHE, Vice President of Professional Services and Research Administration.
Ms. Winger is also the founder of the CyberKnife Coalition and an active and effective advocate for CyberKnife. When Palmetto dropped CyberKnife for prostate from Medicare coverage in California, Nevada and Hawaii, Ms. Winger played a key role in helping Palmetto see the light and restore patient access for these cases. Ms. Winger has also been actively lobbying Capital Hill to create awareness of CyberKnife. She reports that these efforts have already started to bear fruit in that she was able to enlist the support of both of California’s Senators (Boxer and Feinstein) in her successful effort to persuade Palmetto to restore coverage for CyberKnife for prostate. Since, in my view, government takeover of the healthcare system is the only serious threat to widespread CyberKnife adoption in the United States, the news that California’s two Communist Senators are supportive of CyberKnife and have already intervened on the side of patient access is especially encouraging.
Varian, Tomo and Intuitive Surgical executives attended the CyberKnife presentation at AUA. They stood in the back of the room and scowled. You can make of this whatever you want, I still maintain that if they didn’t view Accuray as a threat, they wouldn’t have nearly as much energy on trying to discredit CyberKnife for prostate.
At the Radiosurgery Course, there were excellent technical presentations from CyberKnife users specializing in CyberKnife for malignant tumors of the prostate (both homogeneous and HDR treatment patterns), lung (both primary and metastatic), brain (both primary and metastatic), spine, liver, pancreas and kidney as well as benign tumors of the spine and trigeminal neuralgia.
The main points of interest to investors:
Prostate results are excellent and if we were going to see biological failures we should have already seen at least some at three years out. The technical explanation has to do with the presumed alpha/beta ratio for prostate cancer (you can go look that debate up if you want to) but the bottom line for investors is that the data may not be old enough to be 100 percent conclusive but it’s starting to look particularly grim for the high alpha\beta ratio school and that’s good news for CyberKnife.
We investors tend to view CyberKnife as a treatment when in reality it is a tool that can be used in a numerous variety of ways. All of the treatment models are still works in progress. Centers are still experimenting with dosages, fraction schedules, treatment plans and other techniques. Outcomes are improving as physicians gain more experience with CyberKnife. Whatever the stats look like now, they are going to look even better a few more years out and that applies to just about all, if not in fact all, types of treatments.
Some centers that have been treating prostate for three years are now finding they get almost all their new patients from patient-to-patient referrals. Centers are also reporting that they are seeing very sophisticated patients that have done their research and know what they want when they come through the door.
Accuray has a fulltime team focused on coding and coverage issues. They are making progress and the trend is moving in our direction. While CyberKnife Centers are currently billing and being paid pursuant to non-listed codes, proposals for specialty specific codes (including prostate) have been presented for all of the major CyberKnife treatments.
Georgetown went from a $95 million per year deficit to a $22 million per year profit in large part due to the cash flow and rebranding effects of their CyberKnife program, this according to Linda Winger, MSc, FACHE, Vice President of Professional Services and Research Administration.
Ms. Winger is also the founder of the CyberKnife Coalition and an active and effective advocate for CyberKnife. When Palmetto dropped CyberKnife for prostate from Medicare coverage in California, Nevada and Hawaii, Ms. Winger played a key role in helping Palmetto see the light and restore patient access for these cases. Ms. Winger has also been actively lobbying Capital Hill to create awareness of CyberKnife. She reports that these efforts have already started to bear fruit in that she was able to enlist the support of both of California’s Senators (Boxer and Feinstein) in her successful effort to persuade Palmetto to restore coverage for CyberKnife for prostate. Since, in my view, government takeover of the healthcare system is the only serious threat to widespread CyberKnife adoption in the United States, the news that California’s two Communist Senators are supportive of CyberKnife and have already intervened on the side of patient access is especially encouraging.
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