Click for Overview - Proton International, USA

Addition to Current
Radiation Facility Program
Some features are
under development and
will be subject to review
by competent authorities
(FDA, Notified bodies,
et al...)
• Existing facilities are too large
• Controversy reins within the radiation community on the
best use of the particle
• Once you announce you are interested everyone will come
out of the woodwork to “pitch” protons
• Often the information is wrong and self serving
• Costs, proformas, business plans, and financing
strategies are offered that are unrealistic
• Often there is little to no experience involved with the
group, even though they may say they have it.
• There is no free lunch:
• There is a better way
• Protons are feasible
• You need to lead with the clinical desire and focus
• Match the financial and business terms as a result of
the clinical needs and approach
• Cost – Large expensive facilities require cash flows to repay
the loans that are difficult achieve due to the large number
of daily patients required to reach breakeven
• Ownership and Control – Existing facilities often position
the hospital and MDs as minority participants creating a
program on campus that someone else controls
• Reimbursement – Strong pressure on reimbursement for
proton therapy and the use of the technology has
implications for what you may treat and the resulting
business plans.
• Clinical Applications – Given the controversies how is the
particle best used?
• Build one or two room solutions under a cost structure and
operational structure that can withstand reimbursement
• Match size to clinical demand and desires of the MD
community and patient needs
• Leverage experience and purchasing power
• Be Smart, Understand and Include all costs, not just
equipment and building as many will quote
• Structure a financing solution that is low cost, long term,
and does not demand unrealistic throughput assumptions
• Above all own and control the project
• Assure your clinical demands match your technology
• Understand the various technology solutions to assure you
are choosing wisely for your project
• All In Project Costs Must Support Realistic Breakeven and
Patient Throughput
• Equipment
• Building and Design
• Financing Costs
• Interest During Construction Period
• Length of Time to First Patient (Most Important
Driver of Cost)
• Working Capital
• Legal and Other Fees
• PI, USA Can Provide Cost Effective Solutions That Can
Tolerate Reimbursement Pressure:
• Favorable Equipment Rates
• Development Experience Multiple Centers
• Less Expensive Financing Solutions
• Reducing Time to First Patient
• Full Turnkey Solutions For All Project Phases
• Maintain 100% ownership
• Minimize capital invested (4M for One Room)
• Structure in a financially efficient manner
• Long Term Single Digit Debt
• There is no need for an external partner
• Building One and Two Room Centers That Can Withstand
Reimbursement Pressure
• Minimize Cost
• Establish Financing Strategies That Allow Reasonable
Patient Numbers To Service the Debt
• Stop The Madness – Focus On Reasonable Financial
Returns For The Service. Why Are You Developing
Protons? To Make Money Or To Have The Technology For
Your Patients While Assuring Financial Viability?
• Open A Center That Can Operate At Reduced PT
• One Room Facilities That Can Work At Photon Rates!!
• The Use Of Proton Therapy Should Be Driven Clinically Not
• Our Solutions Are Based On Effective Cost, Financing,
and Equipment Strategies That Allow The Program To
Focus On Clinical Applications Not “Filling” Rooms
• Treat What You Want To Treat
• Don’t Rely On One Diagnosis
• Understand The Interplay Between Diagnosis,
Fields, Throughput, Reimbursement and Project
• There Are Viable Solutions That You Can Employ To
Effectively Treat Your Patients In One and Two
Room Facilities That Deliver Clinical Relevance
With Financial Success
• Project Business Plan and Feasibility
• Equipment Selection and Purchase
• Financing Package
• Long Term Debt
• Single Digit Rates
• Low Equity Requirements 4M For One Room
• Building Design
• Project Management of Key Elements
• Experienced Team Assures On Time On Budget Project
Based On Experience From 4 Projects All Completed
Ahead of Schedule and Under Budget
Management of Construction
Management of Installation
Management of Commissioning and Physics Oversight
• Complete Clinical Envelope
• Clinical Treatment Protocols
• Clinical Research and Registry Set Up
• All Required Training
Others As Needed
• Operations Oversight
• Guaranteed Equipment Uptime
• On Site Trained Engineers and Operators
• All Periodic Maintenance
• Emergency Response
• All Spare Parts
• Emergency Response
• Software and Hardware Upgrades
• Throughput Management
• Insurance and Reimbursement Support
• Initial Contracting
• Ongoing Support
• Initial Meeting To Present Program And Financial Proforma
and Sensitivity Analysis
• Collection Of Data To Review Project Specific Plans
• Financial evaluation and clinical review
• Enhance model with hospital payer mix
• Enhance model with clinical expectations of
treatment mix
• Enhance model with hospital expected staffing
• Enhance model with unique hospital assumptions
• Follow Up Meeting
• Presentation Of Proforma And Plans
• Provide Term Sheet