Panel requires additional data about brain amyloid imaging for Alzheimer's disease
The Alzheimer's Association is disappointed that the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) panel does not believe that there is adequate evidence whether or not PET imaging of brain beta amyloid changes health outcomes, and urges the Centers for Medicare & Medicaid Service (CMS) to review the evidence and make a positive determination about coverage. The Association sincerely appreciates the opportunity to participate in this important review process.
The Alzheimer's Association strongly supports early and accurate diagnosis of Alzheimer's disease, and believes that it leads to better outcomes and higher quality of life for people with Alzheimer's and their families. It does this by: enabling earlier access to appropriate treatments, allowing the family to build a care team and seek out education and support services, enabling enrollment in Alzheimer's/dementia clinical trials, and providing an opportunity for the development of advance directives and financial planning.
The Alzheimer's Association supports the consensus criteria developed by the taskforce convened by the Association and Society of Nuclear Medicine and Molecular Imaging (SNMMI) that describes appropriate use of brain amyloid imaging. (Published online as an article in press on Jan. 28, 2013, by Alzheimer's & Dementia: The Journal of the Alzheimer's Association and Journal of Nuclear Medicine.) The Association recommends that CMS cover brain amyloid imaging according to those criteria.
According to those criteria, appropriate candidates for amyloid PET imaging include:
- Those who complain of persistent or progressive unexplained memory problems or confusion and who demonstrate impairments using standard tests of cognition and memory.
- Individuals meeting tests for possible Alzheimer's, but who are unusual in their clinical presentation.
- Individuals with progressive dementia and atypically early age of onset (before age 65).
The Alzheimer's Association recommends use of brain amyloid imaging and associated insurance coverage primarily to clarify an unclear diagnosis in people who are already experiencing memory and thinking symptoms. We do not recommend its use in non-symptomatic people and a positive result is not a definitive diagnosis of Alzheimer's. Brain amyloid imaging is one more tool to give doctors additional information to help clarify an otherwise unclear diagnosis.
The Alzheimer's Association is the world's leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. For more information, visit www.alz.org.