USAgainstAlzheimer’s Disappointed with Medicare’s Final Decision To Limit Coverage of Innovative Diagnostic Tool
Despite public protest, decision will bar thousands of Alzheimer’s and dementia patients from access to PET beta-amyloid scans that help optimize diagnoses
WASHINGTON, DC – The Centers for Medicare & Medicaid Services (CMS) this week issued a final decision on a coverage policy in favor of severely restricting beneficiary access to beta-amyloid positron emission tomography (PET) imaging agents as a diagnostic tool for patients with Mild Cognitive Impairment (MCI).
The final policy requires 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. Access to this powerful tool that can differentiate among potential dementia diagnoses – including that of Alzheimer’s disease – is critical for Medicare beneficiaries.
In July, more than 1,200 Alzheimer’s advocates submitted comments to CMS, urging the agency to provide coverage for this tool, which can more precisely diagnose patients being evaluated for dementia. In addition, more than 400 researchers from USAgainstAlzheimer’s ResearchersAgainstAlzheimer’s Network also signed a letter that was submitted to CMS in support of coverage for the diagnostic imaging tool.
Beyond 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.
George Vradenburg, chairman of USAgainstAlzheimer’s, member of the Advisory Council on Alzheimer’s Research, Care, and Services and the Commission on Long-Term Care, released the following statement on the final CMS decision:
"USAgainstAlzheimer’s is very disappointed by the decision from the Centers for Medicare & Medicaid Services (CMS) to deny appropriate patient access to beta-amyloid imaging agents.
“Despite extensive feedback during the public comment period from experts in the field, as well as the patient and caregiver community, CMS has stifled an important tool for establishing an early diagnosis in millions of patients through this coverage decision.
“This anti-patient and anti-innovation move by the agency is in direct conflict with the command of the National Alzheimer's Project Act to encourage early diagnosis of Alzheimer's. USAgainstAlzheimer’s will continue to collaborate with other leaders in the field to educate CMS and other payers about the importance of thorough and meaningful coverage for patients across the entire dementia spectrum, including Alzheimer's disease."
USAgainstAlzheimer’s is a national advocacy campaign and network committed to ending Alzheimer’s by 2020. An independent nonprofit organization, USAgainstAlzheimer’s works to advance policies and resources for Alzheimer’s research and to mobilize individuals and organizations frustrated at a broken status quo, to demand urgency and action from political, business and civic leaders. USAgainstAlzheimer’s Networks connect groups in American society who are particularly touched by Alzheimer’s—women, African Americans, researchers and more—who have a unique voice in the fight for a cure. Visit www.usagainstalzheimers.org.