or less) is also driving costs down. Thus the cost is expected to reduce as better proton technology becomes more widely available. An analysis published in 2005 determined that the cost of proton therapy is not unrealistic and should not be the reason for denying patients access to the technology. In some clinical situations, proton beam therapy is clearly superior to the alternatives. A study in 2007 expressed concerns about the effectiveness of proton therapy for prostate cancer, but with the advent of new developments in the technology, such as improved scanning techniques and more precise dose delivery ('pencil beam scanning'), this situation may change considerably. Amitabh Chandra, a health economist at Harvard University, said, "Proton-beam therapy is like the Death Star of American medical technology... It's a metaphor for all the problems we have in American medicine." Proton therapy is cost-effective for some types of cancer, but not all. In particular, some other treatments offer better overall value for treatment of prostate cancer. As of 2018, the cost of a single-room particle therapy system is US$40 million, with multi-room systems costing up to US$200 million. Treatment centers As of August 2020, there are over 89 particle therapy facilities worldwide, with at least 41 others under construction. As of August 2020, there are 34 operational proton therapy centers in the United States. As of the end of 2015 more than 154,203 patients had been treated worldwide. One hindrance to universal use of the proton in cancer treatment is the size and cost of the cyclotron or synchrotron equipment necessary. Several industrial teams are working on development of comparatively small accelerator systems to deliver the proton therapy to patients. Among the technologies being investigated are superconducting synchrocyclotrons (also known as FM Cyclotrons), ultra-compact synchrotrons, dielectric wall accelerators, and linear particle accelerators. United States Proton treatment centers in the United States (in chronological order of first treatment date) include: The Indiana University Health Proton Therapy Center in Bloomington, Indiana opened in 2004 and ceased operations in 2014. Outside the US Australia In July 2020, construction began for "SAHMRI 2", the second building for the South Australian Health and Medical Research Institute. The building will house the Australian Bragg Centre for Proton Therapy & Research, a addition to the largest health and biomedical precinct in the Southern Hemisphere, Adelaide's BioMed City. The proton therapy unit is being supplied by ProTom International, which will