Hundreds of Alzheimer’s Advocates Urge CMS to Support Coverage of Innovative Diagnostic Scans
Safe and effective PET beta-amyloid scans will allow doctors to advise patients on the proper course of care and speed clinical trials
WASHINGTON, DC – Nearly 350 Alzheimer’s advocates submitted comments to the Centers for Medicare & Medicaid Services (CMS) this week, urging the agency to provide coverage for a tool able to more precisely diagnose patients being evaluated for dementia.
In addition to helping ensure patients receive an accurate diagnosis, as well as appropriate treatments and therapies, the technology can help researchers optimize design and recruitment of clinical trials for potential Alzheimer’s and dementia therapies.
Last month, CMS issued a proposed coverage policy that would severely restrict beneficiary access to the diagnostic tool. The proposal would require Coverage with Evidence Development, or CED, for a subset of dementia populations, meaning lengthy and costly clinical trials would need to be conducted in order for any patient to have the scan covered by Medicare. A one-month public comment period ends at 5 pm ET Friday, and CMS expects to issue a final decision in September.
George Vradenburg, chairman of USAgainstAlzheimer’s, member of the Advisory Council on Alzheimer’s Research, Care, and Services, convener of the Global CEO Initiative on Alzheimer’s Disease, and member of the Commission on Long-Term Care released the following statement on the pending CMS decision:
“In the past few days, we have seen a groundswell of support from Alzheimer’s advocates and patients for Medicare to provide appropriate coverage of the innovative diagnostic PET beta-amyloid scan. Patients showing signs of mild cognitive impairment have grown weary from the long and costly odyssey they must endure to arrive at an accurate diagnosis in difficult-to-diagnose cases.
“These safe and effective innovative diagnostic tools – similar to earlier-generation tools already approved by Medicare – will allow doctors to provide their patients with the appropriate course of care, and speed advances in scientific research. Still, CMS says more evidence is needed to demonstrate the effectiveness of the scans despite the issuance earlier this year from a panel of medical and scientific experts of very thoughtful and evidence-based Appropriate Use Criteria (AUC) that would limit use of the technology to a subset of difficult-to-diagnose dementia patients. The longer we wait, the farther behind we’ll fall in the race to stop a disease that has robbed millions of families of their loved ones in the most demeaning and horrific way possible.
“Alzheimer’s has grown into our nation’s most pressing public health crisis, and is poised to become a major fiscal crisis if it continues on its current trajectory. Today, we estimate that half of all dementia patients never receive a diagnosis of dementia. We can stop Alzheimer’s within the decade, but only with the right resources and tools appropriately applied and by obtaining accurate and timely diagnoses. If we are serious about addressing this crisis, we need to break down barriers to innovation instead of erecting more.”
USAgainstAlzheimer’s is a 501(c)(4) national advocacy campaign and advocacy network committed to stopping Alzheimer’s by 2020. An independent non-profit organization working in partnership with the Alzheimer’s community, USAgainstAlzheimer’s works to stop the disease by advancing policies that support research for a cure. For more information about USAgainstAlzheimer’s, please visit: http://www.usagainstalzheimers.org.