QUARTERLY REPORT SEPTEMBER 2011
POSITIVE DEVELOPMENTS IN THE REIMBURSEMENT OF PROTONTHERAPY BY MANDATORY AND PRIVATE HEALTH INSURERS
Progress with General Medical Insurance Plan Germany (AOK)
Since the onset of operations in March 2009, the RPTC is working closely together on a contractual basis with the Bavarian branch of Germany’s second largest public healthcare insurer, AOK. The cost coverage clearance for proton therapy by this public insurer is quick, uncomplicated and reliable for Bavarian patients and ensures that these cancer patients can benefit from a radiation therapy on the highest level.
In addition to managing the Bavarian patients, the AOK Bavaria functions as a clearing house for the cost coverage of proton therapy for all other public insured patients from the EU. A procedure, which likewise works without any complications.
For AOK-insured patients from other federal states in Germany the story is a different one, however. When requiring a trans-regional treatment, whether it is proton therapy or any other, patients still need approval from their regional AOK branch. The complex decision making process associated with this procedure has, in many cases, significantly delayed the reimbursement. To improve this situation, the AOK Bavaria has in mid-October started a campaign for proton therapy targeted at the other AOK branches, where they share and promote their own positive experiences at the RPTC.
Progress with Other Public Health Insurers in Germany
As we have reported earlier, the RPTC already has contracts over cost coverage of proton therapy with several other public health insurers and their respective collectives.
More and more insured patients have realized by now that proton therapy is one of the most seminal treatment methods for cancer. Likewise, an increasing number of public insurers in Germany is becoming aware of the benefits of this effective yet gentle treatment method. Following the initiative of Germany’s largest collective of public health insurers, the RPTC is now in negotiations with them in order to develop a collaborative co-operation agreement. The current draft has the promise to result in a cooperation that is optimal for the patients of that collective. We hope to provide you with further positive information soon.
Progress with Private Health Insurers
Following the initiative of a large German private health insurer, we are pleased to announce that we have recently signed a contract, which transforms the formerly complicated case-by-case decisions into the standardized cost coverage of proton therapy at the RPTC by the respective insurer. We will make a conjoint announcement shortly.