Medicare to cover controversial prostate treatment

Highmark Medicare Services Inc., which administers payments for 4.2 million Medicare subscribers from Washington, D.C., to Pennsylvania and New Jersey, was considering dropping coverage for stereotactic body radiotherapy (SBRT). Several machines can deliver this treatment, but it is most commonly associated with CyberKnife, made by Accuray Inc. Accuray mounted a public relations campaign against the proposed rule change.

The American Society for Radiation Oncology said last year that SBRT is promising but not yet well proven. Supporters of SBRT say it is cheaper and faster than the more common IMRT (intensity modulated radiation therapy) and that early results are comparable. Men typically get about 40 treatments over eight weeks with IMRT and five higher doses over a week or two with SBRT.

In its decision, effective Oct. 28, Highmark acknowledged that data about treatment with SBRT "is of short term duration relative to the natural history of prostate cancer." It requires doctors to document why they've chosen SBRT and that patients were told about other options.