Demonstrating cost and clinical benefits critical to expansion of European seed brachytherapy markets

The nascent European seed brachytherapy market has been grappling with issues of high procedural and investment costs and a lack of local clinical evidence. However, growing evidence of the overall clinical and cost benefits of seed brachytherapy coupled with rising patient awareness is set to boost market expansion.

At present, only a limited number of European centres offer seed brachytherapy with less than a quarter of eligible prostate cancer patients receiving this treatment alternative. High investment costs – averaging over USD 200,000 – coupled with typically low reimbursement rates for new, relatively unproven technologies have dampened adoption levels.

“While the investment costs may initially be high, the cost benefit must come from reduced treatment time and avoidance of further treatment costs,” comments Frost & Sullivan Research Analyst Sheila Ewing. “Currently, there is little economic evidence of cost savings comparing procedures. Further clinical and economic evidence must be provided for innovation to occur.”

Perceived clinical benefits of seed brachytherapy in comparison to traditional practices such as prostatectomies, external beam, and intensity modulated radiation therapy (IMRT) include less invasive and faster delivered treatments, thus resulting in improved patient outcomes. Moreover, reduced treatment time, avoidance of overnight hospital stays and speedier recovery times are likely to underline the cost efficiencies generated by seed brachytherapy.

The critical challenge for market participants is to demonstrate such clinical and cost benefits to both healthcare providers and end users. “Whereas the emphasis on evidence-based healthcare and the continued focus on price per procedure as opposed to a total cost approach is likely to impede penetration, this is likely to be offset by the increasing realisation of the impact of total costs of seed brachytherapy and the growing appeal of less invasive procedures,” adds Ms. Ewing.

So far, clinical trial results within Europe comparing seed brachytherapy to conventional radiation treatment or surgery have been limited. Now, however, growing awareness of several positive clinical results from long-term studies conducted in the United States is encouraging physicians to review seed brachytherapy as a treatment option for prostate and breast cancer.

At the same time, manufacturer backed efforts to develop clinical trials in each European country are set to more clearly establish seed brachytherapy’s benefits, paving the way for regulatory approval and funding, thereby further promoting seed brachytherapy procedures. This trend, coupled with cost reduction initiatives, is set to advance the growth prospects of the European seed brachytherapy market.

Pushed by European clinical trial results and improved distribution in European countries, revenues of the implantable prostate seeds brachytherapy segment (comprising iodine and palladium isotopes) are projected to expand from an estimated USD 14.0 million in 2004 to USD 22.7 million in 2010. And while there is little clinical evidence documenting the difference between iodine and palladium, the former is expected to dominate contributing nearly 81.8 per cent of revenues to this segment in 2010.

Similar trends are expected to underpin the exceptional growth – a compound annual growth rate of 65.2 per cent is forecast between 2003-2010 – for the post-surgical seed brachytherapy segment, propelling it from USD 1.8 million in 2004 to nearly USD 36.4 million in 2010.

Limited treatment options offered by physicians for prostate and breast cancer coupled with lengthy waiting times for conventional treatments are motivating patients to investigate promising alternatives such as seed brachytherapy. Internet research and direct-to-consumer advertising by manufacturers are aiding in raising awareness. This is being reinforced by European seed manufacturers who are trying to emulate their U.S. counterparts through implementation of early detection tests using prostate-specific antigen (PSA) and mammogram tests. As early cancer detection increases and long waiting lines for traditional radiation treatment persist, seed brachytherapy is likely to become a viable treatment option for many cancer patients.

Potential applications in spinal metastases, head, neck and other cancers are set to boost market growth. Overall demand is also set to increase due to technological advances, wider range of techniques and growing acceptance of brachytherapy procedures.

“Manufacturers and distributors can increase market share by marketing products directly towards potential patients,” advises Ms. Ewing. “Alliances, distribution agreements and other key strategies will become necessary to surmount emerging challenges.”