Khen he arrives at his new job at the particle therapy center in Marburg, Sebastian Adeberg is confronted with a ticklish situation. On the one hand, there is a spirit of optimism in the staff of this special facility for the treatment of tumors. Because the new contract for the future concluded at the end of February for the University Hospital Gießen and Marburg also serves their work. On the other hand, Adeberg and she, together with the executive floor of the third largest German hospital, face two hurdles. A new service contract is required with the medical technology manufacturer Siemens Healthineers, which built the heart of the system, the particle accelerator measuring 90 by 50 meters. Even more important at the moment is an agreement with the health insurance companies on further financing. From next week both sides will be talking about it.
These talks are about the economic pressure that health insurance companies are under. They expect a minus of around 17 billion euros for the current year, with an upward trend. The contracts for the particle therapy center that are still in force run until June 30, according to the chairman of the management board of the university hospital, Gunther Weiß. The management team is aware of the worries of the payers. Nevertheless, Weiß also says: “We assume that we will be able to convince the health insurance companies to continue the financing.”
Greater effectiveness thanks to heavy ions
From the point of view of the university hospital, there are a number of reasons for this. The particle therapy center is one of only two facilities of this type in Germany – the other is in Heidelberg. From there, the cancer and radiation medicine specialist Adeberg moved to the Lahn. Both locations exchange information. After a very bumpy start to the system in 2015, the Heidelberg team was in charge of the system for some time. It is now a subsidiary of Rhön-Klinikum AG, which in turn has owned 95 percent of the university clinic, UKGM for short, since 2006. Particle therapy was launched by the government under Roland Koch (CDU) as a “flagship project”.
The system owes its special radiance in two senses to its technology. It can fight tumors with both hydrogen ions and heavy ions. For the second variant, the particle accelerator fires carbon ions. This type of radiation therapy is characterized by the significantly higher biological effectiveness compared to the other variant. This, in turn, is due to the much denser release of energy to the tissue penetrated, according to Marburg.
Beams hit the tumor point by point all around
Sylvia Heinis, commercial director at the UKGM in Marburg and doctor, raves about the precision of the heavy ion administration. Accordingly, the rays on the way to the target hardly damage the surrounding tissue and then fan out in the tumor. The ulcer is previously scanned in 3D. As a comparison, Weiß chooses the image of a tangerine that is hit point by point by rays from all around – and not just from one side.
With this type of therapy, the facility can also treat patients who otherwise have little or no help, including children. The diseases include malignant tumors on the spine, at the base of the skull and in the neck as well as pancreatic cancer. Among others, the former Prime Minister of Hesse, Volker Bouffier (CDU), benefited from particle therapy in Marburg. According to a clinic spokesman, 350 cancer patients have been treated there in four of the therapy rooms within a year.
A deficit is accepted
Particle therapy does not represent a profit center. In fact, the opposite has been the case since the beginning: “We don’t make any money with the system,” emphasizes Weiß. He estimates the minus incurred over the course of the year to be in the small millions. The clinic shoulders this deficit in the knowledge of the benefits of particle therapy. Their value is also known in the state government: The future contract for the university hospital, which runs until 2033, allows 750,000 euros to be spent annually on the system.
New software and devices required
The money is also needed on the Lahn. While Adeberg said: “The particle therapy center is in a state where it works well.” But he does not hide the need for investments in imaging equipment and the software essential for operation. So far, the computer needs two to three days for a treatment plan. With new software, this should be much faster in the future. After the desired investments, the facility will be at a level to provide top medicine for the next few years, as Adeberg goes on to say. By the way, it is completely normal to renew technology regularly.
However, the cash registers would like better data. With two centers in Germany, however, this is difficult to guarantee: “We all need staying power,” says the 38-year-old Adeberg. There is no question for him that particle therapy has a future. It will be expanded in Asia. Australia is planning four such plants. He is a member of a committee there that deals with this and plans to work with his Australian colleagues. In view of this, Weiß is “energetically optimistic” before the talks with the cash registers.