Trial-Only Medicare Coverage Proposed For PET Alzheimer’s Scans
This article was originally published in The Gray Sheet
Beta amyloid positron emission tomography scans to help diagnose dementia would only be covered by Medicare as part of a clinical trial under a proposed national coverage decision. Eli Lilly requested broader coverage for its Amyvid PET imaging agent.
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Agency’s final national coverage determination for beta amyloid positron emission tomography to diagnose dementia confirms that Medicare will cover the procedure only in clinical trials. On the positive side, it may offer a bit more flexibility in trial design.
Alzheimer’s researchers are planning to join with industry in a unified response to a Medicare coverage proposal that would, in their view, disastrously constrain use of positron emission tomography, and imaging agents like Eli Lilly’s Amyvid, in the diagnosis and management of Alzheimer’s patients.
MedCAC panel has limited confidence that there is enough evidence to show beta amyloid positron emission tomography imaging of the brain changes health outcomes. The vote does not bode well for the technology’s coverage proposal due in July.