Trouble at Elekta?

[Palex80]

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Apparently the CEO resigned 10 days ago "for personal reasons with immediate effect".

 

[BobbyHeenan]

We need a strong Elekta to counterbalance Varian. In the heyday of multiple linac manufacturers I remember having some "wiggle room" to negotiate...but now in my experience Varian is just like "meh, we know we're the best, not going to work with you here's the price."

 

[medgator]

We need a strong Elekta to counterbalance Varian. In the heyday of multiple linac manufacturers I remember having some "wiggle room" to negotiate...but now in my experience Varian is just like "meh, we know we're the best, not going to work with you here's the price."

It's a defacto Monopoly now imo....

 

[BobbyHeenan]

It's a defacto Monopoly now imo....

It very nearly is. We have a mix of machines in our cancer center network. We pretty much all agreed we liked the Varian interface/machines better (the previous SDN post someone had made about Truebeam vs. Versa was excellent, right on point), but Elekta cost was VASTLY better in our recent purchase, so we are giving them a chance with some of our new machines. I just hope they stay solvent, etc to keep at least some pressure on Varian.

 

[Palex80]

It appears to me that Elektas focus on the MRI Linac has pretty much absorbed all resources of the company so that development of their other "normal" LINACs and software (user friendliness!!!) was neglected in the past years.
It will surely pay off, if MR-guided radiotherapy will be proven essential to the point that every larger clinic would like to have one of those machines to treat certain indications.

 

[medgator]

It appears to me that Elektas focus on the MRI Linac has pretty much absorbed all resources of the company so that development of their other "normal" LINACs and software (user friendliness!!!) was neglected in the past years.
It will surely pay off, if MR-guided radiotherapy will be proven essential to the point that every larger clinic would like to have one of those machines to treat certain indications.

Unfortunately i don't think it will be worth it, and it will just push Varian into an even more dominant market position for standard linac based radiation therapy

 

[Grubbe-a-dub-dub]

I'm just speculating here - but I'm pretty sure Varian is sitting back on the MR-linac space just to pounce on a company in financial trouble (ViewRay cough cough).

Pure speculation...

 

[medgator]

I'm just speculating here - but I'm pretty sure Varian is sitting back on the MR-linac space just to pounce on a company in financial trouble (ViewRay cough cough).

Pure speculation...

Accuray did that to TomoTherapy inc after the stock had fallen 70-80% from the IPO...

Accuray to Acquire TomoTherapy for Approximately $277 Million in Cash and Stock

/PRNewswire/ -- Accuray (Nasdaq: ARAY), a global leader in the field of radiosurgery, and TomoTherapy Incorporated (Nasdaq: TOMO), creator of advanced...

www.prnewswire.com

Didn't really help accuray that much though 🙄

 

[seper]

I have a feeing that "multiple planning charges" loophole may completely close soon

 

[medgator]

I have a feeing that "multiple planning charges" loophole may completely close soon

It'll get APM'd

 

[OTN]

I have a feeing that "multiple planning charges" loophole may completely close soon

That's exactly what I tell the ViewRay rep every time he tries to show me a pro forma. Those planning charges aren't going to be here for long at all.

 

[scarbrtj]

I have a feeing that "multiple planning charges" loophole may completely close soon

“Loophole? It’s standard of care in this space.” - Academic rad oncs, 2020
“The multiple planning charges loophole is being taken advantage of in private practice and must be closed.” - ASTRO, 2022

 

[MegaVoltagePhoton]

I don’t see the appeal of mri guided radiation for most indications but i suppose if adapting it should be reimbursed right?

also cynically...I hope it does work because we need any kind of possible technological
boon we can get as a field

 

[Neuronix]

also cynically...I hope it does work because we need any kind of possible technological boon we can get as a field

Why is that cynical?

This is something that I find that funny about some SDN posters. On the one hand they think our specialty is stagnant and clamor for increasing indications. On the other hand we have a new technology with promise and they poo-poo it. Ok guys.

 

[deleted941485]

“Loophole? It’s standard of care in this space.” - Academic rad oncs, 2020
“The multiple planning charges loophole is being taken advantage of in private practice and must be closed.” - ASTRO, 2022

Except for large cancer centers Ofcourse.

 

[deleted941485]

I don’t see the appeal of mri guided radiation for most indications but i suppose if adapting it should be reimbursed right?

also cynically...I hope it does work because we need any kind of possible technological
boon we can get as a field

That’s why I decided to stop worrying and love protons.

 

[deleted941485]

It'll get APM'd

Once that happens, I’m sure that specially designed and shielded room you constructed will make a great COVID bunker that or waiting out the apocalypse.

Either way buyers will be far less enthusiastic and in the APM world it’s all about minimizing work anyway. I don’t wanna see or hear about a second plan to review and sign off on.

 

[ramsesthenice]

Those planning charges aren't going to be here for long at all.

In our experience they never did exist. Apparently almost none of them get approved. I look at it like I look at protons. There are reasons to think they are advantageous but should payers have to foot the bill to prove it?

For people that do a lot of GYN brachy the Elekta applicators are pretty nice. Their hybrid IC/IS system is pretty slick. Its a good way of using a needle or two if anatomy is less than ideal without putting the patient (and provider) through a Seyad. That said, the planning system is buggier than Varian's so there is still room for improvement.

 

[salubalu]

Accuray pretty good

 

[ramsesthenice]

I don’t see the appeal of mri guided radiation for most indications

Outside of an academic center or very large PP you won't. The continuous real-time imaging and plan adaption can help you get away with things like dose escalation or SBRT in tricky situations you might not otherwise. It can be nice to have around for some things but it will never be your work horse. I mean, I guess you could fill it up with prostate patients but the throughput is far less than a conventional linac so good luck with that.

 

[Mandelin Rain]

Protons had their (more than a fair) chance to produce data. They failed. Defund them.

Your move MR Linac.

 

[salubalu]

I’m beginning to develop crouton therapy.