CMS proposal limits coverage of drug to help diagnose Alzheimer’s.


On Wednesday, the Centers for Medicare & Medicaid Services proposed that “Medicare will pay the costs of brain imaging that uses a Eli Lilly & Co. drug to help diagnose Alzheimer’s disease only for patients participating in approved clinical studies,” Bloomberg News (7/4, Lopatto) reported. According to regulators, “there isn’t enough evidence to show the scan will benefit all people with dementia, though in some cases it may help diagnose whether a patient has Alzheimer’s.” The test, which costs $3,000 and was approved last year by the Food and Drug Administration, “uses Lilly’s Amyvid [florbetapir F 18] imaging agent to trace a brain protein linked to Alzheimer’s.” 


This position is hearltess and ignores the fact that early diagnosis can have many benefits to both the patient and the family. Understanding treatment options and planning for long term care as well as asset planning can be very important issues in any family struggling with this dreaded disease.