Insurance Approval for Proton Beam Therapy and its Impact on Delays in Treatment

This study is the first to comprehensively assess the state of prior authorization (PA) for proton beam therapy (PBT). The majority of adults who require PA are initially denied and subsequently experience significant care delays. We found no clinical characteristics that predicted insurance approval for PBT. Insurers have not provided coverage for patients on randomized clinical trials to generate high-quality evidence for PBT and have not adopted clinical practice guidelines to guide their coverage decisions.

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