by
Astrid Fiano, DOTmed News Writer | September 23, 2008
A U.S. Medicare Advisory panel on Evidence Development and Coverage has determined that the current clinical data for nine conditionally approved cancer indications of Fluoro-D-Glucose (FDG) positron emission tomography (PET), are too ambivalent to lift current restrictions and support further Medicare coverage.
The panel convened on August 20, 2008 to focus on the oncologic indications of FDG PET for nine cancers (brain, cervical, small cell lung, ovarian, pancreatic, testicular, prostate, bladder and kidney). The panel reviewed the scientific evidence of the impact of PET as part of a management strategy to improve patient-centered outcomes. The panel also considered data generated in accordance with a prior national coverage determination to cover PET for specified cancers.
Medicare covers PET scans for breast cancer and heart disease, but only covers the other cancers if doctors adhere to a registry requirement, where patient data is used to determine PET's effectiveness. Advocacy organizations representing doctors as well as PET manufacturers are arguing that data supports a wider use of PET scans, and the registry requirement should be removed.
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Reuters News reported that the panel expressed reservations that the industry-supplied clinical data could be applied to other cancers. The panel also doubted the probability that PET scans could help doctors make better decisions or improve patients' condition. Lifting the registry requirement would have allowed greater use of PET among Medicare patients by making it easier for doctors to order the scans.
The primary issue is the effectiveness of PET scans compared to other imaging techniques such as computed tomography or magnetic resonance imaging scans in detecting cancer.
The Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) provides the Center for Medicare and Medicaid Services (CMS) with independent guidance and expert advice to CMS on specific clinical topics, including unbiased and current deliberation of "state of the art" technology and science. The panel reviews and evaluates medical literature and data on the effectiveness of treatments and services covered under Medicare.
Medicare is expected to make a draft decision on the issue in January 2009, and a final ruling in April 2009.
