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Medicare Needs More Data Before Covering Amyloid Scans

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For 22% of patients who had a positive scan, physicians reported that they would change their recommendations about activities of daily living, such as driving, working, and handling finances. Physicians said that they would recommend 16% of patients with positive scans to enroll in a clinical trial.

Although the results may be intriguing, “these are records of intended management.... This is not the same as having hard data on physicians’ actual actions,” said Dr. Pearson.

Benefits of a Diagnosis
Not all patient benefits can be quantified in a research study, said William Thies, PhD, Chief Medical and Scientific Officer of the Alzheimer’s Association. Although some benefits may be intangible, knowing the results of a scan can save patients and families time, money, and grief, he added.

“It’s quite clear that many Alzheimer’s patients had a very prolonged period in which their diagnosis was in question,” said Dr. Thies. “But when they look for answers, they’re given all sorts of vague diagnoses and tortured for many years until they finally learn [that] they have Alzheimer’s. A test that helps us identify those people early can ease their anxiety, eliminate a long, expensive period of diagnostic procedures, and result in profound benefits with regard to long-term disability insurance and planning for their future. They have an ability to come to some kind of closure and move on with the important issues they need to address.”

But panel members said that they needed more hard facts. “I have no doubt that it detects amyloid, just as it’s intended to do,” said Jeffrey W. Cozzens, MD, Chair of Neurosurgery at Southern Illinois University of Medicine in Carbondale. “And I’d like to see Medicare cover it for patients in clinical trials. But I need more real—not theoretical—data in order to fully support it.”

—Michele G. Sullivan
IMNG Medical News

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