News Release

Society of Nuclear Medicine supports inclusion of PET as a CMS reimbursed indication for Alzheimer’s disease

Business Announcement

Society of Nuclear Medicine and Molecular Imaging

Reston, Virginia…On January 10, 2002, Dr. Peter S. Conti, MD, PhD, Associate Professional of Radiology at the University of Southern California plans to present the following statement before the Diagnostic Imaging Panel Medicare Coverage Advisory Committee of CMS at a hearing being held in Baltimore, Maryland at the Convention Center.

“On behalf of the Society of Nuclear Medicine, I would like to offer our strong support for the addition of Alzheimer's disease as a CMS reimbursable indication for FDG-PET (positron emission tomography) scanning.

“Right now more than 19 million Americans are estimated to be caring for someone with Alzheimer's disease, and home care for a person whose disease has progressed is estimated to cost about $47,000 per year. By the middle of this century, as many as 14 million of today's baby boomers could have Alzheimer's disease. As you know, the standard wisdom is that there is no definitive way to diagnosis Alzheimer's disease other than by brain biopsy or autopsy.

“The information compiled by the UCLA group and presented to CMS, from studies all over the United States, strongly supports the value of PET as a alternate diagnostic approach for this devastating condition. Recently, the Journal of the American Medical Association also published an important study reinforcing the diagnostic value of PET and Alzheimer’s disease (JAMA 2001: 286:2120-2127). This study followed 284 patients to either long-term follow up or autopsy for a confirmatory diagnosis of Alzheimer’s disease. PET scans early in the dementia process demonstrated a prognostic sensitivity of 93%, and a prognostic specificity of 76%. Overall accuracy was thus 88% (250/284).

“We believe that there are compelling reasons why PET is a valuable tool for physicians attempting to determine whether the memory lapses and behavior patterns seen in these patients are due to Alzheimer's disease or to some other process.

1. Since FDG-PET is more effective than clinical examination for the differential diagnosis and identification of various dementia causes, the greater diagnostic accuracy provided by PET, early in the course of a dementia illness, will lead to more effective disease management.

2. PET enables physicians to clearly identify and differentiate between various types of dementia. This can be critical not only for treatment of these other diseases, but for the initiation of Alzheimer's-specific medications.

3. Notwithstanding the potential for therapeutic intervention, the usefulness of FDG PET is important for patient quality of life. Specifically, additional certainty with respect to the diagnosis will help the patient and family make more appropriate life-decisions. In addition, the increased certainty may help family members cope with the condition (e.g., depression affects more than half of primary family caregivers and uncertainties about the diagnosis may contribute to family and care-givers’ feelings of depression and helplessness). A negative study would be of value to patients as well, as it can predict the absence of further cognitive impairment with fairly high certainty, which could well affect decisions the patient and family make about the future (e.g., retirement, moving or staying near home, not taking a cholinesterase inhibitor, etc.).

“In short, the radiopharmaceutical 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) with PET can be used to assist with the characterization of early dementia in geriatric patients for whom the differential diagnosis includes one or more kinds of neurodegenerative disease associated with a dementia process. We believe it is particularly helpful in this population when there has been a change in cognitive status, when the etiology is not apparent, or when symptoms are not reversed in a reasonable amount of time.

“Providing families and physicians with the means to better manage those with this disease would seem to be a more cost-effective approach to care; we believe this approach should include access to and reimbursement for PET scans.

“We urge you to agree with the many researchers whose work is presented today and add Alzheimer's disease to the list of reimbursable indications for PET.”

The Society of Nuclear Medicine is an international scientific and professional organization of more than 13,000 members dedicated to promoting the science, technology, and practical application of nuclear medicine. SNM is based in Reston, Virginia. For more information, visit www.snm.org.

###

William Uffelman 703-809-9000 /wuffelman@snm.org


Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.