Using PET scans to check for evidence of Alzheimer’s disease will be covered under U.S. government insurance, the Centers for Medicare and Medicaid Services said Tuesday.
The move, anticipated but controversial, will set a precedent that private insurers may be likely to follow.
“This new Medicare coverage will improve care for Americans living with suspected Alzheimer’s disease,” said Health and Human Services Secretary Tommy Thompson.
Positron emission tomography, or PET, can image living brain cells in “real time” to give an idea of which areas are most active at any given time. Combined with the right computer software, they can be used to show areas damaged by the tangles and toxic protein buildups that mark Alzheimer’s.
“CMS determined that use of PET for the diagnosis of suspected (Alzheimer’s disease) would be covered for patients when a specific diagnosis remains uncertain despite a thorough clinical evaluation,” the agency, which administers the state and federal health insurance system for the elderly and poor, said in a statement.
“In addition, in view of indications of the potential benefit of PET, Medicare will also cover PET in other patients with early dementia or unexpected memory loss who are enrolled in clinical trials.”
Alzheimer’s is the most common cause of dementia. It affects 4.5 million Americans, including former President Ronald Reagan who died earlier this month with the disease.
It can be diagnosed with some certainty using pen-and-paper tests, but the only definitive diagnosis is made after death by looking at the brain.
But Dr. Gary Small of the University of California at Los Angeles said PET scans can help diagnose the disease earlier. ”Earlier is better,” Small said in a telephone interview.
Alzheimer’s is not curable but drugs and vitamin B-12 may slow its progression, and the sooner they are given, the more brain function the patient can maintain.
“The families want to know,” Small added. “Even if the answer is positive, I can see the relief on their faces, and they can start the patient on something like Aricept,” an Alzheimer’s drug.