The Society of Nuclear Medicine (SNM) this week said it supports the Centers for Medicare & Medicaid Services' (CMS) decision to approve coverage of PET for Medicare beneficiaries with suspected Alzheimer's disease (AD) or fronto-temporal-dementia under specified circumstances.
On Sept. 15th, CMS announced the final national coverage decision on the use of PET for the early diagnosis of Alzheimer's. FDG-PET will be covered for "patients with documented cognitive decline of at least six months and a recently established diagnosis of dementia who meet diagnostic criteria for both Alzheimer's and fronto-temporal dementia (FTD), who has been evaluated for specific alternate neurodegenerative diseases or causative factors, and for whom the cause of the clinical symptoms remains uncertain."
Significant additional conditions also must be met. For patients with mild cognitive impairment (MCI) or early dementia, FDG-PET is covered only when part of a clinical trial that meets specific criteria
"The decision by CMS to cover PET scans for Medicare beneficiaries who are at risk for AD and who are enrolled in clinical trials is also a very important step in developing effective diagnostic tools and therapies that will be the key to overcoming this growing threat to the health and well-being of America's senior population," said Peter S. Conti, MD, PhD, chair of the SNM's PET Center of Excellence and president-elect of the Society.
AD does not affect brain anatomy until it is at an advanced stage, but characteristic changes in function begin to show up in the early stages, often when clinical tests based on memory or tasks fail to distinguish between Alzheimer's and other forms of senile dementia. Since drugs are only expected to halt progression of the disease, not reverse its effects, successful drug therapy will depend on an accurate and early diagnosis, according to SNM.
Current drug therapy slows progression of the disease for some individuals and is most effective in the early stages. "The available evidence supports the conclusion that PET scans help to evaluate patients with progressive symptoms of dementia but for whom a diagnosis remains unclear despite a thorough standard medical evaluation," said Sean Tunis, MD, CMS' chief medical officer.