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Radiopharmaceuticals: Should reimbursement rule treatment options?

by Gus Iversen, Editor in Chief | June 18, 2015
Molecular Imaging
From the June 2015 issue of HealthCare Business News magazine


Three particular radiopharmaceuticals that may not fit nicely into the current reimbursement model are: Indium, which is used for labeling white cell studies to look for infection; Octreoscan, which is done on rare neuroendocrine tumors; and DaTscan for Parkinson’s disease.

The SNMMI proposed to CMS that theyseparate radiopharmaceuticals out from the APC system and make new categories based on what types are used. “We’re concerned that the cost of new drugs coming down the line is probably going to be expensive and probably won’t fit in the current APC system,” says Dr. Gary Dillehay, the outgoing president of the SNMMI and professor of radiology at Northwestern Memorial Hospital in Chicago.

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The cost of tracers is influenced by many factors that are not always understood by the practicing physician. Among those factors, according to Dillehay, might be the expenses associated with getting through the FDA approval process.

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