August 9, 2013 – The Society of Nuclear Medicine and Molecular Imaging (SNMMI) publicly opposed the decision by Centers for Medicare & Medicaid Services (CMS) to not reimburse for amyloid-beta (Aβ) PET imaging, in a letter written August 1, 2013, by SNMMI President Gary Dillehay, MD.
In commenting on the Proposed Decision Memo for Beta Amyloid Positron Emission Tomography (PET) in Dementia and Neurodegenerative Disease, Dr. Dillehay said SNMMI urges the Final Decision Memo cover amyloid-beta (Aβ) PET imaging following appropriate use criteria for patients who currently would benefit from this technology to improve the accuracy of determining the cause of their condition and their management.
Alzheimer's disease on the horizon? PET scans revealed beta-amyloid plaque in the brains of three Alzheimer's disease patients (left) and three normal controls (right). The yellow indicates high uptake of a label that targets beta-amyloid plaque, and the red indicates medium uptake. (Source: http://newscenter.lbl.gov/feature-stories/2008/12/16/predict-alzheimers-disease/)
The letter was in response to CMS position that a beta amyloid scan does not lead to better health outcomes for patients, particularly in the case of a differential diagnosis which can prevent patients from being subjected to inappropriate medications and costs.
CMS stated in the Proposed Decision Memo that “the evidence is not adequate to conclude that PET amyloid-beta imaging improves meaningful health outcomes in beneficiaries who display signs and symptoms of AD.” To which SNMMI replied that it “respectfully disagrees with that statement under the criteria and scenarios laid out in the appropriate use criteria (AUC) developed jointly by the Alzheimer’s Association (AA) and SNMMI.
Dr. Dillehay points out that although CMS did conclude “there is sufficient evidence that the use of PET Aβ imaging could be promising to exclude Alzheimer’s disease in narrowly defined and clinically difficult differential diagnoses, such as AD versus frontotemporal dementia (FTD),” it still declined to cover the procedure under these circumstances.
SNMMI disagrees with CMS that a beta amyloid scan does not lead to better health outcomes for patients, particularly in the case of a differential diagnosis which can prevent patients from being subjected to inappropriate medications and costs. In closing, Dr. Dillehay proposed another meeting with CMS to discuss the provisions of the proposed decision.
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SNMMI rejects CMS decision not to reimburse for amyloid-beta (Aβ) PET imaging. Appl Radiol.