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Wellpoint Anthem Updates Policy to Include Coverage of SBRT for Prostate Cancer

Wellpoint Anthem Blue Cross Blue Shield, the second largest commercial payer in the United States, recently announced that it has updated its SRS/SBRT policy to cover treatment for early stage prostate cancer.

Stereotactic body radiation therapy, or SBRT, is a powerful, noninvasive treatment approach that targets radiation beams to match the size and shape of a patient’s tumor, minimizing damage to surrounding tissue. At Oklahoma CyberKnife, prostate cancer patients are treated with this outpatient method using CyberKnife® technology.

The organization attributes its policy change to the matured body of evidence released by numerous research studies and experts in the field that demonstrate acceptance and support of SBRT as a viable treatment option for prostate cancer.

The American Society for Radiation Oncology’s (ASTRO) 2013 Model Policy is among the sources that provided supportive context and rationale for Anthem’s policy update. ASTRO’s expert opinion cited in Anthem’s policy states that the organization believes, “Data supporting the use of SBRT for prostate cancer have matured to a point where SBRT could be considered an appropriate alternative for select patients with low to intermediate risk disease.”

Another notable excerpt from the policy update confirms the length of treatment time associated with SBRT is among the benefits to patients, stating that, “The hypofractionation associated with SBRT shortens the treatment time to five visits, compared to the seven to nine weeks required for IMRT. This shortened treatment time is an aspect appreciated by individuals.”

For more information on Anthem’s SRS/SBRT policy change and medically necessary criteria for SBRT treatment of prostate cancer, click here.

This is not intended as medical advice to replace the expertise and judgment of your health care team. It is intended to help you and your family make informed decisions, together with your doctor.