From the June 2014 issue of HealthCare Business News magazine


Beyond amyloid
Also in the pipeline at GE Healthcare are PET tracers that target other mechanisms in the brain associated with Alzheimer’s, dementia and neurodegeneration.

“Dementia is an emerging field in terms of our understanding of the mechanisms,” Newton says. “We see enormous value in diagnostics.”
One of these other agents could detect inflammation associated with neurodegeneration. Another, a tracer similar to Vizamyl, binds to tau proteins, and accumulation of abnormal tau can be an indication of Alzheimer’s disease.

“We think that these kinds of diagnostics are important in understanding how brain disease develops, and could help in the development of therapeutics,” Newton says. “What we have to do is to step up and do the studies to help CMS see the value that we see in the product.”

NHS coverage not so simple
In December, Britain’s National Health Service announced that it would cover betaamyloid PET imaging to rule out Alzheimer’s, marking the first time beta amyloid PET imaging would be covered under a public health system.

It’s not quite so simple, says Dr. John Buscombe, a Cambridge-based nuclear medicine consultant.

“We assume that PET amyloid imaging will be funded, but those funds are very limited,” Buscombe says. “We are allowed to spend 1/10 of the English PET budget outside of oncology, but that money must cover all PET imaging in infection, endocrinology and cardiology as well as dementia. If only a few patients are imaged there will be no problem, but Alzheimer’s is common and many patients present with early memory loss, some of which have Alzheimer’s. So, the budget could be used up in a few months. All we know is the government will try and spend less money on PET next year, so the situation may get worse.”

There is also a complex system of licensing to be legally allowed to do beta-amyloid imaging. Buscombe says the first non-research patient was only imaged fairly recently, at a time when the number of patients imaged in England was less than 50.

It’s much too early to work out the impact, Buscombe says. “It will be at least a year before we can assess the clinical impact of this new technique.”

Since Medicare isn’t reimbursing patients in the U.S., private insurance companies aren’t either. Dillehay says Eli Lilly and Co. has provided free doses of Amyvid and Northwestern Memorial Hospital, where he works, has offered a reduced technical fee for patients who pay out of pocket.

Impact on investment
Richard Zimmermann, a nuclear medicine consultant based in France, notes that investor interest is impacted by whether or not a drug is reimbursed.

June 2014 Magazine

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