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Broader Access to PET Scans Needed for New Alzheimer’s Treatments

With potential new Alzheimer’s medicines on the horizon, access to brain scanning technology that underpins treatment has come into sharp focus.

The Centers for Medicare and Medicaid Services (CMS) has begun a review of its coverage policy for PET scans, a specific type of brain scanning technology that can detect amyloid plaques associated with Alzheimer’s disease. The technology helps physicians diagnose and treat the condition—and it will be essential to the effective use of a new class of treatments that target amyloid plaques.

In her essay for STAT News First Opinion, Linda Goler Blount, President and CEO of the Black Women’s Health Imperative, explains why expanding access to PET scans is crucial to the fight against Alzheimer’s:

Medicare currently covers just one amyloid-detecting PET scan per person with Alzheimer’s over their lifetimes. In addition, individuals must be enrolled in a clinical trial to have a PET scan for Alzheimer’s covered by Medicare. There are many reasons Medicare should cover more than one scan per person. A new class of Alzheimer’s treatments that target amyloid plaques in the brain, and which are either approved by the FDA, under review, or in clinical trials, will likely require at least two scans: one to tell doctors if or when to start treatment, and at least one other to monitor whether the treatment is working to shrink or destroy these plaques and when to stop treatment.

Failing to cover multiple scans can leave seniors to pay out-of-pocket for a follow-up scan midway through treatment, which is unrealistic for the overwhelming majority of Medicare beneficiaries.

Ms. Blount further argues that the Biden administration’s policy has a disproportionately negative impact on Blacks, as they are twice as likely to be diagnosed with Alzheimer’s compared to Whites—and bear the greatest costs as caretakers.

The clinical trial restriction also makes it harder for people from underrepresented racial and ethnic groups to access the technology. Most health centers offering PET scans are in major cities and other urban areas, which puts many of the nearly 7 million Blacks living in rural areas out of range. Even in urban areas, participating in a trial is challenging for people living with Alzheimer’s disease, not to mention their families who must take time off work, secure transportation, and navigate complex health care systems.

PET scans have been available and intensely studied for nearly a decade, and there’s little dispute about their effectiveness. In one of the largest studies to date, the use of PET scans led physicians to change the treatment regimen for nearly three in every five patients. Yet despite the preponderance of data, outdated government policies restrict access to them.

Ms. Blount closes her piece with a powerful call to action:

Recent advancements in treating Alzheimer’s have brought renewed hope to millions of Americans. But these breakthroughs are effective only if people can access them. The Biden administration has the power to unlock access to new technologies that reduce health inequities facing Black seniors and make a tremendous difference in their lives.

Let’s hope CMS makes the right call. You can read Ms. Blount’s full essay here.