Reference what RSAoaky said above. He nailed it perfectly in describing the issue in a pp environment, and no it's not just about $$$$
This isn't breast cancer where the data has much longer follow-up and the hypofx data
actually looks better than standard.
The data isn't as mature and there are concerns regarding toxicity esp in patients with larger glands and/or higher baseline aua scores.
In a competitive pp environment, the only reason to jump into this is if the payors are pushing you into it, otherwise, why take the risk of being more toxic than the other guy in town?